MedicationPrenatal careSupport
You
& your baby
& your baby
Opioid use disorder & pregnancy
Treatment can support you and your baby
A guide to medication, recovery, and caring for your newborn.
Sources [1], [2] • Slide 1 / 20
Your care journey
You can make a plan for every stage
Three things to understand before you leave today.
- 1
Pregnancy
Choose treatment that works for you.
- 2
Birth
Plan pain relief and newborn care.
- 3
Recovery
Keep support in place after delivery.
Sources [1], [2] • Slide 2 / 20
Understanding the words
Dependence and opioid use disorder are different
Knowing the difference can make treatment less confusing.
01
Physical dependence
Your body has adapted to an opioid. Stopping may cause withdrawal, even when you take medicine as prescribed.
02
Opioid use disorder (OUD)
A pattern of opioid use that causes harm or is hard to control. A clinician can help assess it.
Taking a prescribed opioid does not, by itself, mean you have OUD.
Sources [2], [3] • Slide 3 / 20
A safer next step
Talk with your team before stopping opioids
Wanting to protect your baby makes sense. Ask for a safe plan.
- 1
Pause
Avoid sudden changes on your own.
- 2
Call your team
Discuss withdrawal, cravings, and worries.
- 3
Make a plan
Medication treatment is usually preferred to withdrawal.
Return to use after stopping can lead to overdose, especially after your tolerance falls.
Sources [1], [3] • Slide 4 / 20
How treatment helps
Medicine helps control cravings and withdrawal
Methadone and buprenorphine are recommended treatments during pregnancy.
01
Medication
Helps you feel steady.
02
Prenatal care
Follows your health and pregnancy.
03
Support
Helps with stress and daily needs.
Taking treatment is a step toward recovery.
Sources [1], [2] • Slide 5 / 20
Choosing together
The right medicine fits your needs and your life
Your experience, preferences, and access to care matter.
01
Methadone
Treatment through a licensed opioid treatment program.
02
Buprenorphine
Treatment may be available through an office or clinic.
Staying well on your treatment matters. Do not switch medicines on your own.
Studies link buprenorphine with better average newborn outcomes. Much of that evidence is observational: it shows an association, not a guarantee for your baby.
Sources [3], [4] • Slide 6 / 20
Methadone
Methadone offers a structured treatment program
Your program works with you on medication and follow-up.
- 1
Connect
Find a licensed program.
- 2
Plan visits
Ask about visits and take-home options.
- 3
Stay in touch
Report symptoms and missed doses.
Store take-home medicine securely, away from children. Do not take an extra dose for a missed dose.
Sources [9], [10] • Slide 7 / 20
Buprenorphine
Buprenorphine can fit office-based care
A clinician plans how to start it safely and checks how you feel.
- 1
Visit
Discuss current opioids and past treatment.
- 2
Start with guidance
Timing matters to avoid sudden withdrawal.
- 3
Follow up
Review cravings and access to refills.
Ask which form is right for you. Do not start or switch on your own.
Sources [2], [3] • Slide 8 / 20
Staying steady
Report cravings so treatment can be adjusted
Pregnancy can change the amount or timing of medicine you need.
“I feel withdrawal or cravings before my next dose.”
Tell your team. A dose change can be part of good care.
Do not lower your dose to try to prevent newborn withdrawal.
Sources [3] • Slide 9 / 20
Another medicine
Naltrexone needs a separate discussion
Pregnancy safety information is more limited for naltrexone.
01
Already taking it?
Talk with your team before changing it. Staying stable and the risk of return to use both matter.
02
Considering starting it?
It is usually not the first choice in pregnancy. Ask a specialist about your options.
Sources [1], [3] • Slide 10 / 20
After your baby is born
Newborn withdrawal can be treated
Some babies exposed to opioids need observation and treatment after birth.
- 1
Observe
The team watches feeding, sleep, and other signs.
- 2
Comfort
Care starts with support for your baby.
- 3
Treat as needed
Some babies also need medicine.
This is called neonatal opioid withdrawal syndrome (NOWS), sometimes NAS. Withdrawal is not addiction, and it does not mean your treatment was a mistake.
Sources [2], [3] • Slide 11 / 20
Caring together
Your comfort and presence can help your baby
Ask how your hospital includes families in newborn care.
01
Eat
Feeding support helps your baby get enough nutrition.
02
Sleep
A calm, quiet space supports rest.
03
Console
Holding and skin-to-skin contact may help when safe.
Some teams use “Eat, Sleep, Console” to guide care. Medicine may still be needed.
Sources [5] • Slide 12 / 20
Your feeding plan
Breastfeeding is often possible during treatment
Methadone and buprenorphine taken under the tongue are generally compatible with breastfeeding.
01
Review together
Discuss all medicines, substances, and health conditions with your team.
02
Make a safety plan
Avoid breastfeeding during nonprescribed opioid use. Contact your team promptly for a safe feeding plan.
If your dose changes, ask what to watch for in your baby. Your team can support you with breastfeeding or another feeding choice.
Sources [6] • Slide 13 / 20
Your birth plan
You deserve effective pain relief during birth
Treatment medicine does not cover all labor or surgical pain.
Obstetric team
Anesthesia team
Treatment team
Plan additional pain relief before delivery. Continue your treatment medicine as directed.
Tell the hospital team what you take so they can coordinate safe pain care.
Sources [3] • Slide 14 / 20
Life after delivery
Recovery care continues after your baby is born
There is no fixed end date for treatment. Delivery is not a reason to stop.
01
Medicine
Arrange refills and your next visit.
02
Emotional support
Ask for help with mood, sleep, and stress.
03
Daily support
Plan help with rides, meals, and baby care.
Before discharge, know who to call if you need help.
Sources [1], [7] • Slide 15 / 20
Overdose emergency
Naloxone and a response plan can save a life
If someone will not wake up or is breathing slowly, act now.
- Call 911.Say the person may be overdosing.
- Give naloxone.Follow the product directions; more doses may be needed.
- Stay and help.Follow the dispatcher’s CPR or rescue-breathing instructions.
Do not withhold naloxone because of pregnancy. Show someone you trust where you keep it.
Sources [3], [8] • Slide 16 / 20
Getting help early
A return to use is a reason to seek help promptly
You deserve support at every stage of recovery.
“I missed doses or used again. I need help getting back to care.”
01
Call your team
Ask for help with cravings, missed doses, or return to use.
02
Name the barrier
Transport, housing, cost, or mood can affect care. Ask what support is available.
For an overdose emergency, call 911.
Sources [2], [9] • Slide 17 / 20
Take-home messages
Remember these five steps
Small plans can keep care connected.
- Stay connected to treatment.
- Discuss medication changes with your team.
- Prepare for your baby’s care.
- Plan follow-up after birth.
- Keep naloxone accessible.
Sources [1], [2], [8] • Slide 18 / 20
Bring these to your visit
Questions to Ask Your MFM Specialist
Your maternal-fetal medicine (MFM) specialist helps care for higher-risk pregnancies.
- Which medicine fits my needs?
- Who do I call for cravings or missed doses?
- What is our birth and pain plan?
- How will my baby be monitored?
- Is breastfeeding appropriate for me?
- Who coordinates care after discharge?
Use Print / PDF to keep this question list with the guide.
Sources [2], [3], [6] • Slide 19 / 20
Keep this guide
Reliable information can help you take the next step
Start with your care team, then use trusted resources.
This guide is for education and does not replace care from your own clinicians. For an overdose emergency, call 911.
Sources checked September 14, 2026. Full citations are in References and the printed appendix. This guide has no forms, trackers, or storage for personal health information.
Sources [1], [2] • Slide 20 / 20