Why do pregnant women need specialized treatment?
Pregnancy changes how substances, and treatment medications, affect the body. It also brings unique fears, like worry about the baby's health or about custody. These fears can keep women from getting help, but treatment during pregnancy leads to better outcomes for both mother and baby.
Specialized needs include:
- Prenatal care coordinated with addiction treatment
- Safe medication choices, especially for opioid use disorder
- Safe withdrawal management for alcohol or benzodiazepines, which can be dangerous for both mother and baby
- Planning for delivery and the newborn, including possible neonatal withdrawal
- Mental health support for depression, anxiety or trauma
- Postpartum support, since the months after birth can be a high-risk time for relapse and overdose
Pregnant and need help now? Call (877) 847-2855 to find programs that serve pregnant women and check your insurance benefits. It's free and confidential.
What is the safest treatment for opioid use disorder in pregnancy?
According to the CDC and SAMHSA, methadone and buprenorphine are recommended for pregnant people with opioid use disorder (OUD). These are medications for OUD, often called medication-assisted treatment (MAT) when combined with counseling.
Here's why medication is preferred over withdrawal:
| Approach | What experts say |
|---|---|
| Methadone or buprenorphine | Recommended. Reduces cravings, prevents withdrawal, improves prenatal care attendance and lowers overdose risk |
| Medically supervised withdrawal ("detox") | Generally not recommended for OUD in pregnancy because of high relapse rates, which raise overdose risk |
| Continued use of illicit opioids | Highest risk, especially with fentanyl in the drug supply |
Some babies exposed to opioids, including methadone or buprenorphine, develop neonatal opioid withdrawal syndrome (NOWS). NOWS is expected and treatable. It doesn't mean the baby is addicted. Learn more on our medication-assisted treatment and methadone clinics pages.
Other substances
- Alcohol. The CDC says there is no known safe amount of alcohol during pregnancy. If you drink heavily, don't stop suddenly on your own. Alcohol withdrawal can be life-threatening. Medically supervised detox helps you stop safely.
- Benzodiazepines. Stopping suddenly can cause seizures. A doctor can guide a safe plan.
- Stimulants. There's no FDA-approved medication, but behavioral therapies such as contingency management and cognitive behavioral therapy (CBT) help.
What do programs for pregnant women offer?
Specialized programs may provide:
- On-site or coordinated prenatal and OB-GYN care
- MAT with methadone or buprenorphine
- Residential programs where women can stay through pregnancy, and some that allow children after birth
- Parenting education and newborn care classes
- Trauma-informed therapy and dual diagnosis treatment
- Help with housing, transportation and benefits
- Postpartum and breastfeeding support
Outpatient options, such as an intensive outpatient program (IOP) with several sessions a week, can work well for women with a safe home. See our page on rehab for women for more.
Treatment shouldn't stop at delivery. Continuing medication and support after birth matters, because the postpartum months carry a higher risk of relapse and overdose. Ask each program how it supports you and your baby in the weeks and months after you go home.
How do pregnant women pay for rehab?
Costs vary widely by setting, length of stay and insurance. Options include:
- Medicaid. Many pregnant women qualify for Medicaid at higher income levels than other adults, and many states have extended postpartum coverage. Learn more on our Medicaid page.
- Private insurance. Addiction treatment and maternity care are both essential health benefits under the Affordable Care Act. Parity law limits stricter rules for addiction care.
- State-funded programs. Publicly funded programs generally give pregnant women priority admission. See state-funded rehab.
Plans may require prior authorization and pay more for in-network providers.
How do you choose the right program?
Ask each program:
- Do you offer methadone or buprenorphine, or work closely with a provider who does?
- How do you coordinate with my prenatal care?
- What happens when my baby is born?
- Can my children stay with me?
- Do you offer postpartum support?
If you're in crisis, call 911. If you're thinking about suicide, call or text 988.
Getting help during pregnancy is a brave and loving choice. To find a program that supports both you and your baby, call our admissions helpline at (877) 847-2855. It's free and confidential.
