This sheet talks about using heroin in a pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.
What is heroin?
Heroin is a highly addictive opioid. It is smoked, snorted or injected. Street names for heroin include smack, dope, mud, horse, skag, junk, H, black tar, and skunk among others. In the United States, it is an illegal substance and is not available by prescription.
I take heroin. Can it make it harder for me to get pregnant?
Studies have not been done to see if heroin could make it harder to get pregnant.
I just found out I am pregnant. Should I stop taking heroin?
If you have been taking heroin regularly, please seek help right away. It is important to stop using but you should not stop suddenly (also called “cold turkey”). Stopping an opioid suddenly could cause you to go into withdrawal. More research is needed to know how going through withdrawal might affect a pregnancy. Any reduction in your heroin use needs to be done under the direction of your healthcare provider.
Does taking heroin during my pregnancy increase the chance of miscarriage?
Miscarriage can occur in any pregnancy. There are no published studies looking at whether heroin increases the chance of miscarriage. This does not mean there is an increased chance or that there is no increased chance, it only means that this question has not been answered.
I have heard that opioids may cause birth defects. Is this true?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Overall, the studies of heroin do not support an increased chance of birth defects. However, heroin is often combined with other drugs, medications and even chemicals. This makes it difficult to know the actual risks for each person who uses heroin.
Not every opioid has been studied on its own; therefore, we do not know if these substances increase the chance for birth defects or not. Some studies suggest that opioids as a general group might be associated with birth defects including heart defects and cleft lip and palate. However, these and other studies have not found a specific pattern of birth defects caused by opioids. Based on available studies, if there is an increased chance for birth defects with opioid use in pregnancy, it is likely to be small.
Could heroin cause other pregnancy complications?
Studies involving those who often use opioids during their pregnancy have found an increased chance for pregnancy complications such as poor growth of the baby, stillbirth, preterm delivery (birth before 37 weeks of pregnancy), and fetal distress during labor. This is more commonly reported in those who are taking a drug like heroin or who are using prescribed pain medications in greater amounts or for longer than recommended by their healthcare provider. Use of an opioid close to the time of delivery can result in withdrawal symptoms in the baby (see the section of this fact sheet on neonatal abstinence syndrome.)
Will my baby have withdrawal (neonatal abstinence syndrome) if I continue to take heroin?
Studies have reported an increased chance for neonatal abstinence syndrome (NAS) with some opioids; however, not all opioid medications have been studied. Based on what we know about the chance of NAS with other opioids, it is likely that pregnancies exposed to heroin also have a chance to develop NAS.
NAS is the term used to describe withdrawal symptoms in newborns from medication that a person takes during pregnancy. For any opioid, symptoms can include difficulty breathing, extreme drowsiness (sleepiness), poor feeding, irritability, sweating, tremors, vomiting and diarrhea. Symptoms of NAS may appear at birth and may last more than two weeks. If needed, babies can be successfully treated for withdrawal while in the hospital. If you used heroin in your pregnancy, it is important that your baby’s healthcare providers know to check for symptoms of NAS.
Will taking heroin during pregnancy affect my baby’s behavior or cause learning problems?
There are not enough studies on heroin to know whether there is a chance for long-term problems. Some studies on opioids as a general group have found more problems with learning and behavior in children exposed to opioids for a long period of time during pregnancy. It is hard to tell if this is due to the medication exposure or other factors that may increase the chances of these problems.
Will taking heroin during pregnancy cause pregnancy complications?
Studies have found that people who are pregnant and take opioids in higher doses or for longer than recommended by their healthcare providers (i.e. misuse or “abuse” opioids) have an increased chance for pregnancy problems. These include poor growth of the baby, stillbirth, preterm delivery, and C-section. Some people who misuse opioids also have other habits that can result in health problems for themselves and their pregnancy. For example, poor diet choices can lead to not having enough nutrients to support a healthy pregnancy and could increase the chance of miscarriage and preterm birth. Sharing needles to inject opioids increases the chance of getting diseases like hepatitis C and/or HIV, which can cross the placenta and infect the baby.
Can I take heroin while I am breastfeeding?
The use of heroin during breastfeeding has not been well studied. It is usually recommended that people do not breast feed while using heroin.
Use of some opioids while breastfeeding can cause babies to be very sleepy and they may have trouble latching on. Some opioids can cause difficulty with breathing. If you are using any opioid, talk to your healthcare provider about how to use the least amount for the shortest time and how to monitor (watch) your baby for any signs of concern. Contact the baby’s healthcare provider immediately if your baby has any problems such as increased sleepiness (more than usual), trouble feeding, trouble breathing, or limpness. Be sure to talk to your healthcare provider about all your breastfeeding questions.
I take heroin. Can it make it harder for me to get my partner pregnant or increase the chance of birth defects?
Heroin use may affect the sperm, making it harder to become pregnant. Also, if the father or sperm donor has an infection such as hepatitis C or HIV, it can be passed on from the semen to the person who is pregnant and then to the baby. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.
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