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Clinical, Ethical, and Legal Considerations in Pregnant Women With Opioid Abuse

Kremer, Mallory E., MD; Arora, Kavita Shah, MD, MBE

doi: 10.1097/AOG.0000000000000991
Current Commentary

The rising prevalence of women with opioid addiction in pregnancy necessitates understanding of medical, ethical, and legal considerations on the part of obstetricians. In addition to briefly reviewing the medical care of opioid abuse in pregnancy, we offer a careful consideration of the stigmatization of addiction and resultant medicolegal sequelae. We advocate for improved access to opioid maintenance therapy and social services as a means of improving healthful pregnancy outcomes and decry recent trends in the criminalization of addiction nationwide.

Management of opioid abuse in pregnancy requires careful consideration of clinical, ethical, and legal complexities.

Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.

Corresponding author: Mallory E. Kremer, MD, 2500 MetroHealth Avenue, Cleveland, OH 44109; e-mail:

The authors thank Jennifer Bailit, MD, MPH, for her expertise and assistance with drafting the manuscript.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2015 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.