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Care and Treatment Recommendations for Pregnant Women with Opioid Use Disorder

Reising, Virginia A. DNP, MSN, RN, PHNA-BC; Bergren, Martha Dewey DNS, RN, NCSN, PHNA-BC, FNASN, FASHA, FAAN; Bennett, Amanda PhD, MPH

MCN: The American Journal of Maternal/Child Nursing: July/August 2019 - Volume 44 - Issue 4 - p 212–218
doi: 10.1097/NMC.0000000000000538

Background: Recent data suggest a significant increase in use of opioids among pregnant women. In the United States, reported rates of neonatal abstinence syndrome increased from 1.5 per 1,000 to 6.0 per 1,000 live births from 2000 to 2013. Use of opioids, both pharmacologic and nonpharmacologic, during pregnancy exposes women and babies to increased risks of adverse health outcomes. Professional organizations recommend addressing the complex needs of women who use opioids during pregnancy.

Objective: The purpose is to review the role of nurses in the prenatal setting caring for pregnant women with opioid use disorder.

Methods: We conducted a literature search using the CINAHL, PubMed, and PsycInfo electronic databases through January 2018 to identify best practices for referring women to treatment from the prenatal care office. Search terms included “substance use disorder,” “pregnancy,” “prenatal care,” “referral,” and “referral pathway.”

Results: From our search, 68 abstracts were identified as relevant for review. Eight articles were selected for the analysis based on our focus. The findings assisted in development of our recommendations for nurses.

Clinical Implications: During prenatal care, nurses can screen for opioid use disorder, develop positive relationships, and refer to treatment. This care should be based on values-neutral strategies to promote healthy outcomes for pregnant women and their babies.

Opioid use among pregnant women in the United States has increased significantly over the last decade. A review of care and treatment recommendations from the literature and professional organizations is provided. Non-judgmental, non-biased care and knowledge of local referral services are essential for nurses to help women who are affected in order to promote healthy outcomes for mother and baby.

Virginia A. Reising is a Clinical Assistant Professor, College of Nursing, University of Illinois, Chicago, IL. The author can be reached via e-mail at

Martha Dewey Bergren is the Director, Advanced Population Health, Health Systems Leadership & Informatics, College of Nursing, University of Illinois, Chicago, IL.

Amanda Bennett is a Senior Maternal and Child Health Epidemiologist, Illinois Department of Public Health, Chicago, IL.

The authors declare no conflicts of interest.

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