Yes, opioid treatment during pregnancy is available and recommended. If you are pregnant or planning to become pregnant, ask for care right away. A qualified prenatal and addiction-care professional can discuss safe options with you. Never stop or change a prescribed opioid or medication for opioid use disorder on your own.
Treating opioid use disorder is a different question than taking an opioid prescription for pain. This guide focuses on care for opioid use disorder.
We publish a U.S. treatment directory. We are not a treatment provider. Always talk with your own doctors about your care.
If you see signs of an overdose, call 911 or go to the nearest emergency room now. Do the same for thoughts of suicide or self-harm, or any other emergency. For suicidal thoughts, you can also call or text 988.
Is It Safe to Seek Care While Pregnant?
Yes. Opioid use disorder can be treated during pregnancy, and getting care is the safest step you can take. Do not wait for your next appointment if you are worried. Call your prenatal provider or an addiction specialist now.
If you aren't sure how to start the conversation, our guide on talking to your OB about treatment gives you words that work.
Effects of Opioids on the Fetus During Pregnancy
When you are pregnant, understanding the effects of opioids on the fetus during pregnancy helps you make informed choices with your care team. Research links opioid use during pregnancy to certain risks. Studies have associated opioid exposure with outcomes including preterm birth, stillbirth, and poor fetal growth.[1]
It is important to remember that these findings describe trends across groups of people. An association does not mean that one person's experience will match those outcomes. Many factors influence a healthy pregnancy, and your clinician can help you understand your specific situation.
Treatment vs. Pain Management
Not all opioid medications serve the same purpose. Medication-assisted treatment for opioid use disorder aims to stabilize brain chemistry and reduce cravings, while prescribed opioids for pain aim to manage acute or chronic discomfort. A diagnosis of opioid use disorder requires a pattern of use leading to problems or distress, with at least two specific symptoms occurring within a 12-month period.[2] Simply taking a prescribed painkiller does not automatically mean you have this disorder.
| Context | Purpose | What to Discuss with Your Clinician | Safety Reminder |
|---|---|---|---|
| Medication for OUD | Stabilize recovery and prevent withdrawal | Benefits of continuing treatment versus stopping abruptly | Do not stop medication without medical guidance |
| Opioid for Pain | Manage physical pain from injury or surgery | The safest painkiller when pregnant options and lowest effective dose for shortest time | Follow prescribing instructions exactly; ask about non-opioid alternatives first |
Is There a Safest Painkiller During Pregnancy?
There is no single painkiller that is universally considered the safest for every pregnancy or every type of pain. The best option depends on your specific health history, the cause of your pain, and how far along you are in your pregnancy. Your prenatal clinician and any specialist prescribing medication can help you weigh the risks and benefits of different options, including non-medication approaches like physical therapy or heat/cold therapy, before deciding on a medication plan.
Never change your medication routine on your own. If you are worried about pain management or substance use, talk openly with your doctor or midwife. They can help weigh the risks and benefits for you and your baby.
How Is Opioid Use Disorder Treated During Pregnancy?
If you are pregnant and have an opioid use disorder, contact a qualified clinician promptly for help.[3] If you have prescribed treatment, ask your prescriber before making any changes. When speaking with a clinician, share your treatment history, health needs, and preferences.
- Share your history. Tell your clinician about any current or past opioid treatment, including medications you've tried before.
- Ask about options. Ask your clinician to explain the medication treatment for opioid use disorder that is available during pregnancy.
- Discuss coordination. Ask how addiction care and prenatal care can work together, and who to contact if you have concerns.
- Agree on a plan. Decide who to contact if you have concerns, and do not change prescribed treatment without guidance from your prescriber.
Medication Treatment vs. Withdrawal Management
Two main approaches exist for managing opioid use disorder during pregnancy. The table below explains what they mean and what questions to ask your care team. This is not a guide on how to take or stop medications; those decisions belong with your prescriber.
| Approach | What it means | What to ask the care team |
|---|---|---|
| Medication Treatment | Using medications like methadone or buprenorphine under medical supervision.[4] ACOG recommends this approach over withdrawal management for pregnant people with opioid use disorder.[5] | "How will this medication affect my prenatal visits?" <br> "What support services are included?" |
| Medically Supervised Withdrawal Management | A process of tapering off opioids under strict medical care. It is generally not the first choice because it is associated with high relapse rates.[5] | "Is this safe for me right now?" <br> "What are the risks of relapse if I choose this?" |
For opioid use disorder, methadone is administered through opioid treatment programs (OTPs), while providers may prescribe buprenorphine during pregnancy.[6][3] Ask a clinician which option may fit your circumstances and how to access care. If you want to learn more about how these medications work, read our guide on understanding medication-assisted treatment.
Finding Coordinated Prenatal and Addiction Care
Getting the right support means connecting two kinds of care: prenatal visits and treatment for opioid use disorder. Research shows that a coordinated team approach gives the best results for mothers and babies.[5] Laws, reporting duties, and confidentiality limits vary by state, so ask providers about these limits and seek state-specific legal information if you have concerns. You do not have to figure out this connection alone.
Start by telling your obstetric clinician, midwife, or primary care provider about your opioid use. Ask them to help connect you with addiction care. If you are considering methadone, ongoing outpatient treatment generally goes through certified opioid treatment programs (OTPs).[6] Limited hospital or emergency exceptions may apply, so if you need immediate help, contact a clinician or emergency department rather than assuming care is unavailable. When you call an OTP, ask directly if they treat pregnant patients and how they work with prenatal doctors.
You can also search for services yourself. SAMHSA’s FindTreatment.gov is a searchable tool for finding substance use treatment facilities near you.[7] Some people feel more comfortable in single-gender settings; you can read about women-only treatment centers to see if that fits your needs. For more background on different types of programs, see our guide on choosing the right level of care.
Use this checklist when you call providers. It helps you compare how well they can handle both your pregnancy and your recovery.
Questions for Prenatal and Addiction-Care Providers
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Mental Health, Trauma, and Practical Support
Getting care for opioid use disorder during pregnancy works best when it also addresses the rest of your life. You do not have to handle anxiety, depression, past trauma, or financial stress alone. If you want support with these things, tell your care team. They can connect you with mental health support during pregnancy or other services.
Your care team should not assume that one issue explains everything. This means you deserve a full look at your health history and current needs.
Trauma-informed addiction care builds trust through transparency, collaboration, and empowerment.[8] You should feel safe and respected in every appointment. If you have experienced trauma, look for providers who understand how it affects health. You can learn more about treating trauma and addiction together.
| Support need | Who to ask | Question to raise |
|---|---|---|
| Anxiety or depression | OB-GYN or primary care provider | "Can we screen for anxiety or depression as part of my prenatal visits?" |
| Past trauma | Addiction counselor or OB-GYN | "Do you provide trauma-informed care? How can we make sure I feel safe here?" |
| Housing, food, or transport | Social worker or case manager | "What community resources can help with housing, food, or getting to appointments?" |
Planning for Labor, Newborn Care, and After Birth
Planning for birth is a conversation with your care team, not a prediction of exactly what will happen. Your team can help you prepare for the choices that come up along the way. It is important to discuss how your ongoing treatment for opioid use disorder will be managed during labor and after delivery, ensuring that pain care is addressed alongside your existing treatment plan. Arranging this continuity of care before you leave the hospital helps keep your support consistent.
During pregnancy
Make a birth plan that includes your opioid treatment. Ask how your prenatal team, addiction clinician and labor-and-delivery team will share updates.
During labor
Follow the clinical plan you agreed on. Talk with your providers about pain care options that work alongside your ongoing treatment.
After birth
The newborn care team watches your baby and decides whether observation or comfort measures are needed. Not every infant needs medication.
Postpartum
Line up ongoing care before you leave the hospital. Discuss feeding choices with your prenatal, addiction and infant-care clinicians together.
What to Expect With Your Baby
Your baby may show signs of neonatal opioid withdrawal syndrome (NOWS), also called neonatal abstinence syndrome. This is an expected and treatable condition that can follow prenatal exposure to opioid medicines, and it calls for close cooperation between your obstetric and pediatric teams.[5] Some babies need only supportive care, such as swaddling, quiet surroundings and frequent small feeds. Others need medication for a short time. Ask your pediatrician what to expect in your case, since newborn needs vary widely.
Staying Connected After Delivery
The weeks after birth bring big changes in hormones, sleep and responsibilities, which can raise the risk of returning to use. Multidisciplinary long-term follow-up should be available for postpartum people with opioid use disorder.[5] That follow-up often includes overdose education and a naloxone prescription kept at home.[5] Before you go home, ask who will manage your treatment going forward and when your first postpartum visits will be. Good postpartum opioid treatment support keeps your medication, counseling and primary care connected instead of scattered across separate offices.
Feeding Choices
Whether to breastfeed is an individual decision that depends on your health history, your medicines and how mother and baby are doing overall. There isn't one right answer for everyone. Bring this question to all three of your teams—prenatal, addiction and infant care—so their advice matches rather than conflicts.
A Safety Check and Urgent Next Steps
This quick check helps you see if your care team is connected. It is not a diagnosis. It does not measure how safe your pregnancy is or how likely withdrawal is.
If you have a seizure, severe confusion, hallucinations, a high fever or racing heart during withdrawal, signs of an overdose, or thoughts of suicide or self-harm, call 911 or go to an emergency room now. For suicidal thoughts, call or text 988.[9] Do not wait for a helpline or a clinic appointment.
Care Coordination Check-In
This check is about care coordination only. It is not a diagnosis and does not assess pregnancy or withdrawal risk.
Frequently Asked Questions
Can opioids be safely prescribed for pain during pregnancy?
There is no single answer for every pregnancy or pain condition. Doctors weigh the benefits to your health against risks to the baby.[1] Talk with your prescriber about what to expect, other options, and your specific situation. Never start, stop, or change a prescribed pain medicine without contacting your prescriber first.
Which opioid is the safest to use during pregnancy?
No one opioid is automatically the safest choice for everyone. Treatment decisions should be individualized based on your medical history and past care.[1] Clarify if you are asking about pain relief or treatment for opioid use disorder. Then, discuss your options with a qualified clinician.
Do opioids pass through the placenta?
Yes, opioids cross the placenta and may cause breathing problems in newborns.[10] Tell your prenatal and addiction-care teams about any opioid exposure or treatment. Transfer across the placenta alone does not predict how your baby will do. Discuss the specific medication and circumstances with your care team.
Does opioid exposure mean my newborn will have NOWS?
Not necessarily. Neonatal abstinence syndrome (NOWS) is an expected and treatable condition that can follow prenatal exposure to certain medications.[5] However, not every infant has the same symptoms or needs the same care. Ask the newborn care team what observation or support may be appropriate for your baby.
Can I continue opioid use disorder treatment while breastfeeding?
Mothers taking methadone or buprenorphine for opioid use disorder are generally encouraged to breastfeed if there are no other reasons not to.[1] Make breastfeeding decisions individually with your OUD, prenatal, and infant-care clinicians. Share all prescribed medicines and any other substance use so the care team can consider the full picture.
Where can I get confidential help finding care?
SAMHSA's National Helpline provides 24-hour free and confidential treatment referral and information about mental and substance use disorders.[11] This helpline is not for emergencies, so call 911 if you need immediate help. When you contact programs, ask about pregnancy-related services, coordination with prenatal care, and costs. You can also read our guide on questions to ask about treatment costs.
