The use of
opioids during pregnancy has grown rapidly in the past decade. As
opioid use during pregnancy increased, so did complications from their use, including
neonatal abstinence syndrome. Several state governments responded to this increase by prosecuting and incarcerating pregnant women with
substance use disorders; however, this approach has no proven benefits for maternal or infant health and may lead to avoidance of
prenatal care and a decreased willingness to engage in
substance use disorder treatment programs. A public health response, rather than a punitive approach to the opioid epidemic and
substance use during pregnancy, is critical, including the following: a focus on preventing unintended pregnancies and improving access to contraception; universal screening for alcohol and other
drug use in women of childbearing age; knowledge and informed consent of maternal
drug testing and reporting practices; improved access to comprehensive obstetric care, including
opioid-replacement therapy; gender-specific
substance use treatment programs; and improved funding for social services and child welfare systems. The American College of Obstetricians and Gynecologists supports the value of this clinical document as an educational tool (December 2016).