What We Can Do About Opioid Use Disorder in Pregnancy

Jean Ko, PhD


January 28, 2019

Editorial Collaboration

Medscape &

I'm Dr Jean Ko, an epidemiologist in the Centers for Disease Control and Prevention's (CDC's) Division of Reproductive Health. In today's CDC Expert Commentary series on Medscape, I'm sharing some vital health news: Opioid use disorder during pregnancy is on the rise. Opioid use disorder during pregnancy has been associated with a range of negative health outcomes for both mothers and their babies, including maternal death, preterm birth, stillbirth, and neonatal abstinence syndrome.

A recent CDC analysis of national data[1] showed that the number of pregnant women with opioid use disorder (documented at the time of delivery) more than quadrupled from 1999 through 2014. Additionally, this report revealed significant increases in opioid use disorder among pregnant women in every one of the 28 states with publicly available data.

These findings show the devastating impact of the opioid crisis for mothers and babies. However, working together, clinicians and public health practitioners can advance prevention and treatment efforts to reverse these trends. Recommended strategies for addressing opioid use disorder among pregnant women include:

To address the ongoing epidemic of opioid use disorder, it will take coordinated efforts by communities, healthcare providers, public health, law enforcement, and other sectors. Providers have an important role in combatting the opioid crisis. To provide safer, more effective pain management, talk to your patients about the risks and benefits of opioids and work together toward treatment goals. Below, you'll find resources to help you carry out the complex task of balancing pain management with the potential risks posed by prescription opioids.

Web Resources

CDC Guideline for Prescribing Opioids for Chronic Pain (includes information regarding pregnant women and women who may become pregnant)

Interactive Training Series: Applying CDC's Guideline for Prescribing Opioids

American College of Obstetricians and Gynecologists (ACOG) Committee Opinion: Opioid Use and Opioid Use Disorder in Pregnancy

SAMHSA: Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and Their Infants

Go here to learn more about opioid medication use for substance use disorder treatment and considerations in pregnancy.