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Pregnancy and Opioids
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Substance Use Disorders

Pregnancy and Opioids

While some medications are necessary during pregnancy, opioids carry specific risks that require careful management and medical supervision to protect both mother and baby.

What are Opioids?

Opioids, or narcotics, include strong prescription pain relievers like oxycodone, hydrocodone, fentanyl, and tramadol, as well as the illegal drug heroin. While generally safe when taken for a short time as prescribed, they carry risks of opioid use disorder (OUD) and overdose, especially when misused.

Risks During Pregnancy

Taking opioids during pregnancy can lead to several complications:

  • Neonatal abstinence syndrome (NAS): Withdrawal symptoms in newborns including irritability, seizures, vomiting, diarrhea, fever, and poor feeding
  • Neural tube defects
  • Congenital heart defects
  • Gastroschisis
  • Loss of the baby (miscarriage or stillbirth)
  • Preterm delivery
  • Stunted growth and low birthweight
  • Placental problems

Managing Opioid Use

If your provider suggests opioids, discuss the risks and benefits. If use is necessary, minimize risks by taking the lowest dose for the shortest time, following instructions carefully, and attending all follow-up appointments.

If you are already taking opioids and become pregnant, contact your provider immediately. Do not stop taking them on your own, as sudden withdrawal can cause severe health problems for you or your baby.

Breastfeeding and Treatment

Breastfeeding may be possible depending on the specific medication, but you should consult your provider first. Breastfeeding is not recommended if you have HIV or use illegal drugs.

Treatment for opioid use disorder (OUD) during pregnancy, known as medication for opioid use disorder (MOUD), typically involves buprenorphine or methadone to reduce cravings and prevent withdrawal. Counseling and behavioral therapies are also recommended to support recovery.

Frequently Asked Questions

Both buprenorphine and methadone can pass into breast milk in small amounts. In most cases, breastfeeding is considered safe when the infant is monitored for withdrawal symptoms. Discuss dosing, timing, and infant monitoring with your provider before starting or continuing breastfeeding.
You should not stop your medication abruptly; sudden withdrawal can harm both you and your baby. Call your prescribing provider immediately to discuss a safe taper plan or a switch to a medication with a lower risk profile. Your provider may also refer you to a specialist in maternal–fetal medicine or addiction medicine for close monitoring.
Opioid exposure can increase the risk of neural tube defects, congenital heart defects, gastroschisis, miscarriage or stillbirth, preterm delivery, low birth weight, and placental complications. Early and ongoing prenatal care can help identify and manage these risks.
NAS symptoms typically appear 24–72 hours after birth and include irritability, high-pitched crying, poor feeding, vomiting, diarrhea, tremors, seizures, and a fever. If you notice any of these signs, contact your pediatrician or the hospital immediately for evaluation and possible treatment.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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