Treating opioid use disorder (OUD) with methadone while pregnant is important for keeping both the mother and baby safe.

It can be scary to be pregnant while struggling with a substance use disorder like opioids. Worrying about pregnancy, addiction and harm to the baby from illicit opioids can be overwhelming and overshadow what might otherwise be a joyful time. Fortunately, help is available. Experts recommend medications like methadone to treat OUD during pregnancy to help improve pregnancy outcomes for both the mother and the baby.

Methadone in Pregnancy: An Overview

Methadone is commonly used to treat opioid use disorder (OUD) during pregnancy. The drug is prescribed to reduce the risk to the mother and fetus during pregnancy and breastfeeding, as the risks of untreated OUD outweigh avoiding methadone in pregnancy and after the baby is born. Suddenly stopping opioids during pregnancy is linked to complications like relapse, overdose, fetal death, preterm labor and neonatal abstinence syndrome (NAS). Getting regular prenatal care and treating opioid use disorder under a doctor’s care are important aspects of keeping both mother and baby safe.

Managing Methadone Use During Pregnancy and After Delivery

Methadone use must be closely managed, whether or not the person is pregnant. This is because when prescribed for OUD, methadone must be specially dispensed from methadone clinics, with doses generally given out daily. This necessitates close follow-up between the pregnant woman and her doctor. 

Methadone can be continued during and following pregnancy and while breastfeeding. Experts recommend continuing methadone during breastfeeding, which can also help the baby avoid NAS.

Risks of Methadone Misuse During Pregnancy

Methadone is an opioid that can be misused just like any other opioid. Misusing opioids — any opioids — during pregnancy can be extremely harmful to both the fetus and the mother. For this reason, it is important to have regular prenatal care from an OB/GYN and a doctor experienced in managing OUD during pregnancy.

Women who misuse opioids during pregnancy are at an increased risk of poor outcomes like:

  • Missed prenatal care
  • Poor fetal growth 
  • Placental abruption
  • Fetal death
  • Preterm labor
  • High-risk activities like prostitution, crime and trading sex for drugs

What Happens to Babies Born to Mothers on Methadone?

Babies born to mothers on methadone are at risk of NAS, which experts state can be minimized by breastfeeding while continuing methadone. NAS symptoms include:

  • Stiff muscles
  • Tremors 
  • Exaggerated startle reflex
  • Excessive high-pitched crying
  • Irritability
  • Sneezing
  • Diarrhea

NAS is a treatable condition. Mothers are encouraged to comfort NAS babies via swaddling, cuddling and skin-to-skin contact and continue medication-assisted treatment with methadone. 

Detoxing From Methadone While Pregnant: Is It Safe?

It can be very dangerous to detox from methadone while pregnant, and experts advise continuing methadone for OUD throughout the pregnancy. Any attempt at changing your methadone dose should only be done under strict medical supervision. Stopping methadone can increase your risk of complications like:

  • Relapse
  • Overdose
  • Fetal death
  • Preterm labor
  • NAS

If it is necessary to taper down your methadone dose, your doctor should monitor you closely throughout the process to avoid complications.

Discharge Planning for Mothers on Medication-Assisted Treatment

It is important to have supportive care plans to help mothers and new families transition from the hospital to home after having a baby. When the mother struggles with OUD, having a discharge plan that supports her and her baby is even more important. Many hospitals will provide discharge planning services to help you, with components like:

  • Social workers
  • Parenting support groups
  • Home nursing visits
  • Education on home and health safety
  • Referrals to other healthcare specialists 

Connecting With Health Care Resource Centers

Your doctor wants your baby to be as healthy as possible. For this reason, doctors and hospitals offer many healthcare services to support you during pregnancy and beyond. Your OB/GYN and addiction specialist can refer you to multiple resources to help you and your baby, including:

  • Prenatal care
  • Counseling
  • Medical referrals for care
  • Mental health services
  • Medication-assisted treatment with methadone or buprenorphine

Can Methadone Cause Overdose?

Like any other opioid, methadone can cause an overdose, which can be fatal. In the 12 months ending in January 2023, over 3,100 Americans died from methadone overdoses. For this reason, it is important to follow your methadone prescription exactly:

  • Do not take more methadone than prescribed
  • Do not take methadone more often than prescribed
  • Do not take methadone that has not been prescribed to you

A methadone overdose has symptoms similar to an overdose of other opioids, such as:

  • Constricted pupils
  • Unconsciousness
  • Slow or shallow breathing
  • Choking or gurgling sounds
  • Limp muscles
  • Bluish or cold skin

A methadone overdose is a medical emergency for a woman and her baby. If you suspect someone is overdosing on methadone, call 911 and administer naloxone (Narcan) if available.

Alternatives to Methadone for Pregnant Women Battling Addiction

While methadone is one of the top choices for treating OUD in pregnancy, it is not the only choice. Experts alternatively recommend the opioid buprenorphine for MAT during pregnancy. Non-pharmacologic therapies, including medically supervised withdrawal, are not recommended without MAT due to a relapse rate among pregnant women that can exceed 90%. Your doctor can help you choose the safest treatment for you and your baby.

Counseling Options for Pregnant Women Battling Addiction

Counseling is important for pregnant women struggling with addiction. With counseling and therapy in addition to MAT with methadone or buprenorphine, pregnant women can overcome their opioid addiction and set both themselves and their babies on the road to recovery. Benefits of counseling include:

  • Learning how to manage addictive behaviors
  • Learning coping skills
  • Practicing healthy habits
  • Developing a support system
  • Improving the overall health of mother and baby

Your OB/GYN and addiction specialist can provide counseling resources, as can the U.S. Government’s Substance Abuse and Mental Health Services Administration hotline at 800-662-HELP. The Recovery Village at Palmer Lake is staffed with addiction experts that can help answer your questions about MAT and opioid recovery. Don’t wait; contact us today to see how we can help.

Editor – Theresa Valenzky
Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more
Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more

American College of Obstetricians and Gynecologists. “Opioid Use and Opioid Use Disorder in Pregnancy“>Opioid U[…] in Pregnancy.” 2021. Accessed July 9, 2023.

Drugs and Lactation Database. “Methadone“>Methadone.” April 15, 2023. Accessed July 9, 2023.

Anbalagan, Saminathan; Mendez, Magda D. “Neonatal Abstinence Syndrome“>Neonatal[…]ence Syndrome.” StatPearls, April 29, 2023. Accessed July 9, 2023.

Centers for Disease Control and Prevention. “Preventing An Opioid Overdose“>Preventi[…]ioid Overdose.” Accessed July 9, 2023.

Centers for Disease Control and Prevention. “Vital Statistics Rapid Release – Provisional Drug Overdose Data“>Vital St[…]Overdose Data.” June 14, 2023. Accessed July 9, 2023.

Medical Disclaimer

The Recovery Village at Palmer Lake aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.