Drug Dependence During Pregnancy and the Postpartum Period

The chaotic lives of women who are drug dependent and their frequent lack of consistent prenatal care put them at risk for many medical problems during pregnancy. Illicit drug use during pregnancy also places women at increased risk for obstetrical complications. The complexity of medical problems in the pregnant drug abuser is complicated by the attendant psychosocial problems and psychiatric comorbidities seen in this population. Psychiatric diagnoses, treatment, and patient compliance are often hindered when the main focus of attention is on drug-related problems. The stigma associated with maternal drug use and difficult life circumstances are additional burdens to successful treatment entry and adherence for women. The basis for stabilizing most opioid-dependent pregnant women is agonist maintenance therapy in the context of comprehensive services, and the treatment of psychiatric comorbidities is a key component in optimizing pregnancy and child outcomes.