Opioid use during pregnancy

Understand the risks posed by opioid use during pregnancy and alternative therapies to help you manage your pain.

By Mayo Clinic Staff

Opioid use poses special concerns for people who are pregnant. Understand the potential risks of opioid use during pregnancy and how opioid use might affect your prenatal care.

What are the concerns about opioid use?

Opioid medications, commonly called narcotics, are derived from the poppy plant. Some opioids are available as prescription medications.

While these medications are an important option for managing pain, repetitive use can lead to dependence, physical tolerance, craving, inability to control use and continued use despite harmful consequences (opioid use disorder). Addiction and overdose are serious risks.

Before using prescription opioids for pain, talk to your doctor about the risks and benefits, as well as your treatment goals. In addition, be sure to tell your doctor if you are pregnant and discuss your family planning goals.

What risks does opioid use during pregnancy pose?

Opioids used during pregnancy might cross the placenta and enter the fetal central nervous system. Although occasional use of opioids during pregnancy doesn't typically pose concerns for the baby, use of opioids close to delivery might cause the baby to experience slow and ineffective breathing (respiratory depression) after birth.

In contrast, many complications have been associated with opioid dependency during pregnancy, including:

  • Placental problems, including placental abruption and placental insufficiency
  • Premature rupture of membranes
  • Preterm labor and premature birth
  • Fetal growth restriction
  • Preeclampsia
  • Miscarriage or fetal death
  • Postpartum heavy bleeding
  • Inflammation of the fetal membranes (intra-amniotic infection)

However, it's difficult to determine the extent to which these complications are due to opioids or opioid withdrawal. Use of other drugs or your own health, nutritional or psychological conditions might play a role.

If you become opioid dependent during pregnancy, your baby could experience the drug withdrawal syndrome known as neonatal abstinence syndrome. Signs and symptoms, which often begin shortly after birth and might last days to weeks, include:

  • Tremors
  • Jitteriness
  • Diarrhea
  • Uncoordinated sucking reflexes that lead to poor feeding
  • Irritability
  • High-pitched cry
  • Poor sleep

Your baby might need to be hospitalized for weeks.

Nov. 11, 2017 See more In-depth