Taking methadone while pregnant can be dangerous if it is taken without the recommended and coordinated care of methadone maintenance combined with the much needed medical and psychosocial services these women need.
Understanding the Reluctance and the Risks
Pregnant mothers who are addicted to opioids like heroin or prescription painkillers have the added risks of harm to their unborn children and yet, many are reluctant to get the appropriate help they need because:
- They fear arrest or prosecution
- They are worried about child custody and the involvements of social services for their other children
- They feel guilty and ashamed of their use and what the effects are on the baby
- They fear domestic violence, are poverty stricken, or homeless
- They may be anxious about the attitudes or stigmas associated with methadone or the involvement of multiple agencies needed to support their needed levels of care
Whatever the purpose of the reluctance for not going into a methadone maintenance program, the risks are much higher. These women have special treatment need and risk miscarriages from infections, withdrawals, lack of support, and elevated use of illicit opiates to deal with the added stress. They also tend to delay seeking obstetrician services or frequently miss their appointments which can compound the risks to them and the fetus.
Accepting Methadone Treatments during Pregnancy
The use of methadone to treat opioid addictions in maintenance programs has been an acceptable practice for pregnant women since the late 1970’s according to the SAMHSA. As of 1998, it has been the NIH consensus panel standard of care.
These programs benefit both mother and child in multiple ways and have proven to decrease the common risks that are associated with illicit opioid use including miscarriages, premature births, low birth weights, and other neonatal complications that would require extensive hospital stays or lead to later death.
It is critically important for these women to be screened and treated for infections or communicable diseases that can be transferred to the child, that they receive the earliest medical services for ongoing pregnancy conditions, and that they are educated and aware of what to expect with resources provided for their individual needs. According to the SAMHSA, “Comprehensive methadone maintenance treatment that includes prenatal care reduces the risk of obstetrical and fetal complications, in utero growth retardation, and neonatal morbidity and mortality.”
Passing It On
Whenever the mother withdraws from illicit opioids, the unborn child does as well and since methadone is a long lasting medication that builds up in the bodily tissues, the risk of withdrawals multiple times a day can be alleviated to prevent the added harms to the fetus.
After the child is born, small amounts of methadone are transferred through breast milk, but, if the mother isn’t breastfeeding, the neonatal withdrawals can be managed effectively with appropriate hospital care which works best when the mother has taken the necessary steps in her methadone maintenance regime and coordinated their care throughout the pregnancy.