Opioid Use Disorder (OUD) – Pregnancy, Birth, Breastfeeding, and Infant Care

May 31, 2022by admin

Painkillers, called opioids, have analgesic, central nervous system depressant, and euphoric effects. In opioid use disorder (OUD), prescription opioid medications are misused, diverted opioid medications are used, and illicit heroin is used. OUD is usually a chronic relapsing illness, which is associated with increased rates of morbidity and mortality.

Maintaining abstinence through medically supervised withdrawal or other therapy is intended to prevent relapse in people with OUD. An opioid agonist (such as methadone and buprenorphine) or an opioid antagonist (such as naltrexone) can be used in long-term maintenance treatment, as can abstinence-based therapies without medications. There are many best gynecologist in Karachi that are eager to help the females suffering from this disorder.

How Opioid Use Disorder Affects Pregnancy

Opioid use during pregnancy has been connected to a number of negative health outcomes for both mothers and newborns. OUD has been associated with maternal death;1,2 in newborns, maternal OUD or long-term opioid use has been linked to poor fetal growth, premature birth, stillbirth, and particular birth abnormalities, as well as the possibility of neonatal abstinence syndrome.

The long-term implications of prenatal opioid exposure on offspring are uncertain. In some circumstances, like the treatment of OUD during pregnancy, the benefits of continuing to use opioid drugs as recommended outweigh the hazards. Before discontinuing or modifying any prescribed medication, women should speak with their doctor.

Birth outcomes associated with opioid use during pregnancy

Opioid use during pregnancy has been linked to poor birth outcomes. Opioid-exposed babies may have a higher risk of developing addiction later in life.

  • Be born prematurely (before 37 weeks of pregnancy)
  • Have poor fetal growth; 
  • Spend more time in the hospital after birth; 
  • Return to the hospital within 30 days of birth
  • Be born with birth abnormalities.

Breastfeeding

Breastfeeding is often recommended for newborns with NOWS if their mothers are responding well to MOUD. However, breastfeeding is not always advised. Breastfeeding is not encouraged, for example, if moms are using drugs illegally, utilizing multiple substances, or are HIV-positive.

Treatment for Mothers with Opioid Use Disorder After Delivery

After the baby is born, support for women with OUD is critical. Many new variables in women’s life may be causing them to shift. They may, for example, suffer from a lack of sleep and worry about the duties of caring for a newborn.

Women with OUD should continue to take MOUD as prescribed after the baby is born, according to SAMHSA and ACOG. During this period, healthcare providers should keep an eye on the ladies and change the dosage if necessary. MOUD discontinuation for OUD should be avoided in the first few days after the baby is born. It should be avoided at the very least until the infant is sleeping through the night and has finished breastfeeding. However, if the mother is stable, the mother and child are well-bonded, and the mother and child live in a safe and stable home and social environment, terminating MOUD later may be considered, but only under medical supervision and when it is in the best interests of the mother and child.

Plans for preventing MOUD should be developed in collaboration with the healthcare team. To avoid withdrawal, MOUD must be gradually lowered. Before gradually weaning the mother off MOUD, a safety plan for her and her family should be in place, so that plans can be put in place if she relapses. MOUD can be used for as long as a person requires it. This could be a few months or a year for some, while it could be a lifetime for others.

Final Thoughts

Some people may choose to “detox” in order to stop using heroin or prescription pain relievers. Unfortunately, research shows that most people begin using again after a month of “detox.” As a result, most clinicians use methadone or buprenorphine to treat OUD in pregnant women. These are long-acting opioid medications that may help you and your baby’s health while you’re pregnant.

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