Pregnant women who are taking a medically supervised opiate can have safe pregnancies and deliver healthy babies-provided they receive proper prenatal care and substance use treatment services. However, in low resource settings, key elements of proper care for pregnant woman may not be available: The gold-standard of care for pregnant women who use opiates is methadone maintenance therapy-offered most effectively together with psychosocial support and prenatal care-but in many parts of Texas this type of coordinated care does not exist. Furthermore, for many indigent, healthcare providers may not be equipped or willing to treat pregnant women who are actively using opiates. In addition, the available data shows that pregnant women with a history of opiate use tend to have comparatively inadequate access to prenatal care. For these reasons, pregnant opiate users and their babies are likely to have more health problems than non-drug using women, such as abruption, stillbirths, preterm labor, low birth weight, intrauterine growth restriction, postpartum hemorrhage, fetal death, and preterm labor, all resulting in serious physical and emotional consequences for the mother and her child.
Infants born to mothers who are opiate dependent generally suffer from neonatal abstinence syndrome (NAS) characterized by hyperirritability of the central nervous system and dysfunction in the autonomic nervous system, gastrointestinal tract, and respiratory system. When left untreated, NAS can result in serious illness (e.g., diarrhea, feeding difficulties, weight loss, and seizures) and death. Infants with NAS often require prolonged hospitalization, extended pharmacologic intervention, and monitoring. NAS and it’s treatment can interrupt the mother and infant bonding progress, increasing distress and guilt in mothers. Furthermore, the infant is at risk for other psychological and attachment consequences. Additionally, infants face an increased risk of sudden infant death syndrome. Thrombocytosis may occur in the second week of life and may continue until age 4 months.
Families are often not prepared for the physical and emotional challenges of caring for a medically fragile infant; this often leads to distress and conflict in the family unit at a time when support, cooperation and emotional strength is needed. |
There is an overall positive impact on maternal and infant health outcomes when woman taking opiates receive prenatal and postnatal care combined with consistent social service support and assistance. Additionally the family unit experiences less distress and is better able to care for the infant when social service supports are in place. |
