Is Medication-Assisted Treatment Safe For Pregnant Women?

Published on

Medication-assisted treatment (MAT) uses opioid agonists to prevent withdrawal without the use of illicit substances. While MAT does carry some risks for pregnant people and the developing child, it is a much safer alternative to continued drug abuse.

s Medication-Assisted Treatment Safe For Pregnant Women?

Medication-assisted treatment (MAT) that utilizes methadone or buprenorphine is the suggested treatment approach for women who are pregnant and have an opioid use disorder.

It is likely that children born to women who used MAT during pregnancy will be born with neonatal abstinence syndrome (NAS), but this condition is easily managed at birth.

The Risk Of Using Illicit Opioids During Pregnancy

All forms of substance abuse increase the risks of serious pregnancy complications.

Heroin addiction and other forms of opioid abuse are associated with a heightened risk of stillbirth, preterm labor, and maternal mortality.

These risks are compounded by the standard risks associated with opioid drug abuse.

Risks of illicit opioid drug use include:

  • fatal overdose
  • the development or worsening of co-occurring mental health disorders
  • the spread of HIV and other blood-borne diseases through intravenous drug use
  • long-term changes in brain chemistry
  • possible damage to the heart, liver, and other major organs
  • increased sensitivity to pain
  • immunosuppression
  • bowel obstruction

How MAT Is Used To Help Pregnant People

MAT is used as a way to quickly help a pregnant person transition away from using illicit opioids without putting their body through the stress of withdrawal.

The primary drugs used are methadone and buprenorphine. Naltrexone is used in some cases, but the scientific literature regarding its safety during pregnancy is less robust.

All of these drugs are opioid agonists or partial opioid agonists, so they activate the same areas of the brain, preventing withdrawal symptoms without causing other physical effects.

With this support, people who participate in MAT are more likely to stay sober and engage with other evidence-based treatments like behavioral therapy and peer support groups.

The Benefits Of MAT During Pregnancy

The primary benefit of MAT for pregnant people is that this treatment approach allows them to immediately quit using illicit opioids without needing to go through detoxification.

Opioid withdrawal symptoms can be severe, causing changes in heart rate and respiration rate that could, ultimately, be detrimental to the fetus.

Evidence suggests that using MAT also makes a pregnant client more likely to receive adequate prenatal care, which greatly improves health outcomes for both parent and child.

The Risks Of MAT During Pregnancy

MAT is a very low-risk treatment approach that helps countless people. However, there is one downside for pregnant people who use MAT.

Methadone and buprenorphine treatments are not designed to get clients high, but they are still opioids. It is expected that a child whose birth parent uses MAT will likely be born with NAS.

Symptoms of NAS include:

  • tremors
  • seizures
  • excessive crying
  • poor feeding
  • breathing complications
  • fever
  • trouble sleeping
  • diarrhea
  • congestion

The good news is that NAS can be treated at birth, stopping many of the symptoms and reducing the heightened risk of sudden infant death syndrome (SIDS).

Managing NAS And Ensuring Infant Safety

The long-term effects of NAS generally include developmental delays, slowed growth, and issues with vision as well as hearing.

Fortunately, evidence suggests that these risks are drastically reduced when NAS results from MAT and the infant receives prompt treatment in the hospital.

For this reason, it is important that your delivery team is aware that you are using MAT to manage an opioid use disorder and that your child may be born with NAS.

While the initial experience may be traumatic for both you and your infant, a little time with the neonatal intensive care unit (NICU) team is usually enough to help your child.

To better understand these risks and how they apply to you, talk to your obstetrician.

Alternatives To MAT During Pregnancy

While MAT is certainly less threatening to a pregnant person and their unborn child in comparison to continued opioid abuse, many pregnant people may wonder about alternatives.

NAS is treatable, but it isn’t ideal. If you’re exploring alternatives to MAT, you can meet with an addiction treatment specialist to see if you are a candidate for medical detox during pregnancy.

Depending on the nature of your substance use disorder, you may be able to go through carefully controlled withdrawal using medications.

Keep in mind that the stress of withdrawal has its own risks for you and your baby. In some cases, it could result in serious harm to the fetus.

Discuss all of your options and their associated risks with your obstetrician and addiction treatment provider before making the decision that best meets your needs.

MAT And Breastfeeding

If you plan to breastfeed your child, then you should discuss your approach with your healthcare team, as the safety of breastfeeding during MAT is highly specific to the individual.

If you ultimately determine that the risk to your infant is too high, and you still want to breastfeed, then you may consider postpartum detox for breastfeeding.

Keep in mind that the hormonal crash following pregnancy can be severe, so you may want to delay your detoxification and breastfeeding for two to six weeks following birth.

In the meantime, you can “pump and dump,” while giving your child formula or donated breast milk.

When you’re ready, you can go through a medical detox program while your partner or family member cares for your child. The process usually takes three to five days.

Find Addiction Treatment Today

To learn more about MAT and other forms of evidence-based addiction treatment, contact today.


Canton, Massachusetts

Bedrock Recovery Center


Levels of Care:

Payment Options: Insurance Accepted, Self Pay

View Center Profile

Plymouth, Massachusetts

Ohio Recovery Center


Levels of Care:

Payment Options: Insurance Accepted, Self Pay

View Center Profile
Spring Hill Recovery Center


Detox Rehabs Logo