1. Opioid use in pregnancy has increased dramatically in the past decade, leading to increased rates of neonatal abstinence syndrome (NAS). The American Academy of Pediatrics (AAP) supports a public health-based approach to engage and protect these maternal-infant dyads.
2. A punitive strategy is neither helpful nor recommended by the AAP as an effective strategy of limiting the rates of substance use among pregnant women. Moreover, the AAP suggests that these policies may lead to avoidance of prenatal care and decreased willingness to engage in substance abuse treatment.
Policy Rundown: Opioid use in pregnancy is an increasingly common issue, with rates of infants with NAS growing fivefold over the past 10 years. Furthermore, the rate of unplanned pregnancy among women with substance addiction is as high as 85%. The AAP, with the support of the American College of Obstetricians and Gynecologists, outlines a public health-based approach to minimizing these rates and offering support and care to these infant-mother dyads. The AAP continues to affirm that a punitive approach towards mothers is not in the best interest of either the mother or her infant. Primary prevention strategies, such as addiction treatment and access to effective contraception, should be strengthened. Validated screening measures should be used at multiple stages of pregnancy to identify women at risk of delivering infants with NAS. Pregnant women suffering from opioid addiction should have improved access to gender-specific substance abuse treatment and medication-assisted treatment. Given that a high proportion of these women have concomitant psychosocial stressors such as trauma and abuse, these issues should also be addressed as part of treatment. Providers must be knowledgeable about state-specific mandated reporting laws in their area of practice and inform patients of these laws. The AAP also calls for additional funding to social support services and child welfare systems, to ensure the safety of these infants and their mothers.
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