PREGNANCY SERVICES

Being pregnant is typically a very exciting time, though being pregnant while actively using substances or in treatment for a substance use disorder can be cause for concern. It is not ideal to become pregnant while actively using or in treatment, but life obviously doesn’t always go as planned in this regard. What’s important to know is that treatment can be initiated quickly to ensure the health and well-being of both the moms and babies, and Sunrise is here to help.

There is still a lot of stigma surrounding addiction and treatment, and pregnant patients are at risk for experiencing that to a worse degree than others, unfortunately. Regardless of such fears and anxieties, it is critical that you enter treatment as soon as possible after learning of your pregnancy to reduce any possibility of harm to the baby. If you get pregnant while in treatment, it is crucial that you inform the team immediately so that appropriate changes can be made to your treatment plan, treatment medication (if applicable) and monitoring (i.e. medical services).

Though there are always risks to being pregnant, not much else besides what’s already been mentioned necessarily has to change about your experience in treatment. Sometimes due to the added stressors, patients will be best served by participating in the intensive outpatient group program, but it isn’t mandatory for all situations. Whether on treatment medications or not, pregnant patients will visit with the medical providers on a monthly basis in addition to continuing their usual schedule of individual counseling.

Opioid use disorders are serious and life threatening, but because of the availability of safe and effective medications that can also be used in pregnancy, helping pregnant patients with this substance use disorder is in some senses easier and more straightforward for a treatment program. It’s really a struggle to help pregnant patients on an outpatient basis who are struggling with alcohol and other drug disorders given that there aren’t any quick-acting, safe and effective medical interventions approved for use during pregnancy. With that, a referral to a higher level of care like inpatient or residential may be warranted. Fortunately, there are a number of agencies in most communities available to assist with such challenges related to pregnancy. Sunrise clinicians and case managers are well-equipped to make such connections and referrals.

        Though not a guarantee, the best pregnancy outcomes seemed to be achieved under the following circumstances:

• Stable in recovery already when become pregnant

• Stabilized shortly after learning of pregnancy

• No other substances currently being used

• No other medical conditions

• Not currently being treated with any other medications

Specific to opioid use disorder, both methadone and buprenorphine products are approved for use during pregnancy. Methadone has long been considered the gold standard for the treatment of opioid use disorder during pregnancy, but more recent data has been showing the same or better outcomes for moms and babies on buprenorphine instead. Usually, babies born to mothers in treatment on buprenorphine as compared to methadone:

• Have lower withdrawal scores after birth

• Require less medication to manage their withdrawal symptoms

• Spend less days in the hospital after birth

Patients with substance use disorders who become pregnant are considered to be high-risk. This is not to be taken as a judgement against the patient, but just to signify that there are extra considerations to make and precautions to take to achieve the best outcomes. To that end, additional medical specialists will be involved in caring for the moms (Maternal Fetal Medicine/Perinatologist) and babies (Neonatologists). Specific to babies born to mothers with opioid use disorder in treatment on medications, there are some concerns that the babies can be born just a little small and with slight developmental delay, but they usually catch-up quickly with their growth and development milestones within a few months.

Though this hasn’t historically always been a smooth relationship, it is important to allow social services professionals to assess your situation to ensure that you have sufficient social supports and a safe environment to care for your newborn. You should bring it to the attention of the management of the Labor and Delivery unit if you are not taken care of by the social workers in a compassionate and non-judgmental way.