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Opioid Use During Pregnancy

Pregnancy can be an emotional and trying time, particularly when coupled with an addiction. CARE (Clinic for Acceptance, Recovery, and Empowerment) in Pregnancy is one of only two programs in St. Louis that offer prenatal care, substance abuse treatment and extended postpartum support for pregnant women facing the challenges of an opioid use disorder. Our personalized treatment plans help support the wellbeing of mother and child not just during pregnancy but for at least one full year postpartum.

About Opioids

Prescription opioids, also known as narcotics, are medications typically prescribed by a doctor to help manage pain for short periods of time. When abused or used long term, these medications carry a high risk for opioid addiction. Examples of prescription opioids include:

  • Percocet
  • Vicodin
  • Morphine
  • Hydrocodone
  • OxyContin
  • Fentanyl
  • Diluadid
  • Demerol

Illicit drugs made from related chemicals include heroin and opium. The abuse of any opiate while pregnant poses serious health risks for both you and your baby.

Opioid Use During Pregnancy: Effects on Baby

Babies who are exposed to opiates during pregnancy are at risk for low birth weight, behavioral problems, developmental delays, learning disabilities, birth defects and stillbirth. Many babies will also suffer from Neonatal Abstinence Syndrome (NAS), a group of problems that occur when a baby withdraws from addictive substances they were exposed to while in the womb. When used during pregnancy, opioids pass through the mother’s system and into the growing baby, causing the baby’s body to become dependent on the drug. Most babies show signs of NAS between 1-7 days after birth. Problems in babies with NAS can include:

  • Body shakes, seizures, overactive reflexes or tight muscle tone
  • Fussiness, excessive crying or a high-pitched cry
  • Poor feeding or slow weight gain
  • Trouble sleeping and lots of yawning
  • Diarrhea or dehydration
  • Stuffy nose, runny nose or sneezing
  • Fast breathing
  • Fever

Newborns suffering from NAS must stay in the hospital for a longer period of time in order to receive treatment for their symptoms in the Newborn Intensive Care Unit (NICU) at St. Louis Children’s Hospital. For more information on NAS, download our informational brochure.


The multidisciplinary care team includes maternal-fetal medicine specialists, specially-trained nurses, neonatologists, social workers, psychiatrists and therapists. Our highly skilled team is dedicated to helping women achieve healthier pregnancies and reduce the risk of both pre- and postpartum complications.

CARE in Pregnancy provides a prenatal and postpartum solution for mothers seeking to overcome their opioid use disorder. Our goal is to help mothers overcome their opioid use disorder in the long-term, not just during pregnancy. During the program, you and your baby will benefit from:

  • Prenatal Care: Women in this program receive comprehensive prenatal care in a comfortable, compassionate environment. Our care team will support the health and development of you and your baby and work to prevent, identify and treat any complications you may experience throughout your pregnancy.

  • Substance Abuse Treatment: We listen to you and work with you to develop a comprehensive, extended treatment plan to treat your opioid use disorder. You may be prescribed buprenorphine (Subutex®) to alleviate the withdrawal of opioids and to treat addiction both during pregnancy and for at least one year postpartum when women are at the greatest risk for relapse. You will also receive therapeutic support to counsel you through recovery.

  • Psychiatric Evaluation and Care: A dedicated perinatal behavioral health specialist will follow you throughout the duration of the program, providing regular evaluation during pregnancy and for a full year after delivery. Your specialist can also provide diagnosis and treatment of perinatal mood and anxiety disorders and other potential psychiatric conditions.

  • Housing, Life Skills and Financial Assistance: Care in Pregnancy takes a holistic approach to helping women overcome their opioid use disorder and achieve a healthier life. Our skilled and empathetic social workers can help you overcome obstacles to good health and sobriety such as housing issues, unemployment and food insecurity. They will help you attain necessary life and parenting skills and work with you to achieve and maintain a healthy lifestyle.

    For many women, lack of insurance or limited coverage prevents them from receiving critical medical care. We are able to accept Medicaid and uninsured patients into our program and provide them with prenatal and postpartum care for up to a year after delivery.

  • Care for Babies After Birth : Babies exposed to substance abuse (including opiates) during pregnancy may experience health complications after delivery. The Newborn Intensive Care Unit (NICU) at St. Louis Children’s Hospital offers state-of-the-art level of care available to newborns in need of specialized treatment. Washington University neonatologists in the NICU are available 24/7 to treat your baby for potential complications after delivery. Care in Pregnancy also gives you access to Newborn medical physicians who will carefully monitor the health and development of your baby throughout the crucial first year of life.


To make an appointment with the CARE in Pregnancy program at the Women & Infants Center, call 888.987.2807.