Quick Answer: Yes, methadone is a recommended first-line treatment for opioid use disorder (OUD) during pregnancy, as long as a medical team supervises it. Stopping suddenly is the bigger risk, because withdrawal can lead to preterm labor, fetal distress, and miscarriage. Your provider will adjust your dose as your pregnancy moves along.
Methadone is an opioid medication that helps treat a patient’s dependence on opioids without withdrawal symptoms. It’s usually recommended for people who want to recover from heroin misuse. Pregnant women who use heroin during pregnancy can suffer premature births or miscarriages.
To help them, methadone is approved for use during pregnancy in a medication-assisted treatment (MAT) program. However, using MAT medications such as methadone can still have serious health consequences for newborns if not medically supervised.
All drugs taken by a pregnant woman can flow through the placenta and reach the fetus in the womb, so the dose must be closely monitored and managed. Let’s look further at the effects of taking methadone while pregnant.
Is It Safe to Get Pregnant While on Methadone?
Yes. Many people get pregnant while on methadone and go on to have healthy pregnancies. However, taking methadone while pregnant heightens the risk of neonatal abstinence syndrome (NAS). NAS may occur when a baby is born to any mother utilizing an MAT program.
Taking methadone or Suboxone outside a supervised program raises the risk, especially at doses above the recommended amount, and a baby can be born physically dependent on the medication.
While medication-assisted treatment in a medically supervised program may lead to minor NAS symptoms for a newborn, it is far less risky than being born with heroin withdrawal symptoms. NAS is treatable, and it isn’t the same thing as a birth defect.
If you’re pregnant and have opioid use disorder, starting a supervised treatment plan right away lowers the risk of complications for you and your baby.
Are There Risks Involved in Taking Methadone While Pregnant?
Methadone can affect the baby too. A baby may become dependent on it and show withdrawal symptoms shortly after birth, and a higher dose raises that risk. Taking less than recommended can also bring on withdrawal for the parent, which is stressful for the baby.
These symptoms could be harmful to the mother and the fetus. Thus, methadone or other treatment medications should be taken in a medically supervised program.
It’s vital to monitor methadone use for pregnant individuals, especially during the final trimester. During this period, the mother’s metabolic needs usually rise, and the fetus is in its final stage of development. Doses must be carefully adjusted for the baby’s health and the mother’s well-being.
What Happens to Babies Exposed to Opioids Before Birth?
Babies exposed to opioids during pregnancy can show withdrawal symptoms within the first couple of days after birth. With methadone, you might see:
- Respiratory symptoms such as a stuffy nose, fast breathing, and repeated sneezing and yawning.
- Nervous system issues, including decreased sleep, being jittery and irritable, and becoming startled due to sound or touch.
- Digestive system problems such as slow weight gain, loss of appetite, poor feeding, dehydration, and vomiting.
The baby may also experience seizures if the expectant mother frequently takes an abnormally high amount of opioids.
Are There Alternatives to Methadone During Pregnancy?
Buprenorphine, one of the two ingredients in Suboxone, is the other first-line medication for OUD in pregnancy. Research on Suboxone itself during pregnancy is still growing, so your provider can walk you through how it compares with methadone for you.
Suboxone contains buprenorphine and naloxone. Buprenorphine is a partial opioid agonist, which means it eases withdrawal and cravings without the strong high of other opioids. As a result, Suboxone:
- Has a lower risk of misuse than other opioids
- Reduces your cravings for opioids
- Can dull the effect of other opioids while it’s in your system
The Centers for Disease Control and Prevention (CDC) lists buprenorphine, along with methadone, as a first-line treatment option for pregnant people with OUD, paired with behavioral therapy and medical care. Your provider can talk you through whether Suboxone or another buprenorphine product fits you best.
Here’s how the two medications compare during pregnancy.
| Topic | Methadone | Buprenorphine |
| Recommended in pregnancy? | Yes, a first-line option | Yes, a first-line option |
| Newborn withdrawal (NAS) | Possible, and treatable | Possible, and treatable; usually starts around 2 days after birth |
| Breastfeeding | Generally encouraged when you’re stable on treatment | Encouraged; only small amounts pass into breast milk |
| How you get it | Through a certified opioid treatment program | Prescribed or dispensed by a qualified provider |
Neither one is the right fit for everyone, so your provider can help you choose based on your history and how your pregnancy is going.
Other alternatives to methadone treatment include:
- Behavioral therapy
- Peer support groups
- Lifestyle changes
- Other forms of counseling
That said, these alternatives usually complement rather than substitute MAT.
Can Methadone or Suboxone Cause Birth Defects?
Between 2% and 3% of babies are born with a birth defect, and most studies find that methadone and buprenorphine don’t raise that background risk. Research on Suboxone is still limited, so it’s hard to say for certain whether it changes that risk, and your provider can go over what’s known.
Other birth problems may occur if you take more methadone than your doctor recommends during pregnancy. These birth problems may include low birth weight or preterm delivery.
Methadone Maintenance During Pregnancy
OUD treatments like methadone or buprenorphine work best when paired with complementary therapies. Complementary treatments include substance use counseling and other healthy habits. Here are some ways to make the most of your treatment:
Counseling Options During Pregnancy
Substance use counseling includes group, family, and individual options. Each option offers unique benefits that help individuals recover from the effects of opioid use disorder. Some benefits of individual counseling include:
- Helping you change your thoughts and behaviors toward opioids and other substances by attending to the emotions you feel with them
- Teaching helpful strategies for healing and rebuilding relationships damaged by your experience with substance misuse
- Finding effective coping mechanisms for handling stress and hard times
- Learning how OUD works and using that knowledge to prevent relapse
- Developing a relationship with your counselor, which establishes a safe environment to discuss previous traumas, family issues, and other troubles you’re facing
- Applying what you’ve learned in counseling to contribute to the community and workforce
Group counseling offers similar benefits, but the unique setting allows for different outcomes. Some unique benefits of group counseling include:
- Providing the opportunity to share your experience with and learn from others in recovery
- Feeling less shame and guilt when you hear others share similar experiences
- Developing accountability among other like-minded individuals as you work toward recovery
- Building a strong support network of people who face similar challenges and can help you keep going
Health Tips for Pregnant People in Recovery
A few steps can support you and your baby during treatment:
- Stay informed about how opioid use and treatment can affect you and your baby
- Build, nourish, and lean on strong support groups
- Exercise regularly and eat a healthy diet
- Try counseling or cognitive-behavioral therapy (CBT)
- Remove substances from your home
- Find healthy ways to cope and make them part of your routine
- Forgive yourself if a relapse happens, and try again
If you need extra support during pregnancy, treatment is available. BAART has treatment centers across the United States, including Arizona, California, Colorado, Louisiana, Nebraska, North Carolina, Utah, Vermont, and Washington state.
We provide outpatient MAT care with methadone and buprenorphine for individuals with opioid use disorder. We also provide substance use counseling to help you find success on your journey to recovery.
If you or your loved one needs support, call us for a confidential, zero-obligation chat
FAQs About Methadone and Pregnancy
Will My Baby Have Withdrawal if I Take Methadone?
Possibly. Some babies show signs of neonatal abstinence syndrome (NAS), usually within the first couple of days after birth. It’s treatable, and care often starts with simple comfort measures like swaddling, a quiet room, and keeping your baby close. Some babies need medication for a short time, and the risk of NAS shouldn’t keep you from treatment.
Can I Breastfeed While Taking Methadone?
Usually, yes. If you’re stable on methadone, breastfeeding is generally encouraged, and your baby gets only a small share of your dose through your milk. Tell your baby’s pediatrician about your medication, and call right away if your baby seems unusually sleepy, limp, or has trouble breathing. Breastfeeding isn’t recommended if you’re using other drugs, so be open with your care team.
Contact Your Local BAART Program Center
If you’re pregnant and want to talk through your treatment options, contact us or find a location near you. We’re here to support you and your loved ones with compassionate, personalized care.
Sources and Citations
- Kelly, L. et al. (2016) Buprenorphine-naloxone use in pregnancy: Retrospective cohort study of 30 patients. Canadian Family Physician, 62(4), pp. e194–e200. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4830675/ (Accessed October 14, 2026).
- Edge, R. and Butcher, R. (2019) Buprenorphine for Opioid Use Disorders during Pregnancy: A Review of Comparative Clinical Effectiveness, Safety, Cost-Effectiveness, and Guidelines. CADTH Rapid Response Report: Summary with Critical Appraisal. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health. Available at: https://www.ncbi.nlm.nih.gov/books/NBK545816/ (Accessed October 14, 2026).
- Cleveland Clinic (2023) Birth Defects. Available at: https://my.clevelandclinic.org/health/diseases/12230-birth-defects (Accessed October 14, 2026).
- MotherToBaby, Organization of Teratology Information Specialists (2025) Buprenorphine (Buprenex®). Available at: https://mothertobaby.org/fact-sheets/buprenorphine/ (Accessed October 14, 2026).
- Centers for Disease Control and Prevention (2026) Treatment of Opioid Use Disorder Before, During, and After Pregnancy. Available at: https://www.cdc.gov/opioid-use-during-pregnancy/treatment/index.html (Accessed October 14, 2026).
- Centers for Disease Control and Prevention (2026) Treat and Manage Infants Affected by Prenatal Opioid Exposure. Available at: https://www.cdc.gov/opioid-use-during-pregnancy/treatment/infants-opioid.html (Accessed October 14, 2026).
- National Institute of Child Health and Human Development (2026) Methadone. In: Drugs and Lactation Database (LactMed®). Bethesda (MD): National Institute of Child Health and Human Development. Available at: https://www.ncbi.nlm.nih.gov/books/NBK501233/ (Accessed October 14, 2026).
