If you’re pregnant and struggling with opioid addiction, you may feel scared, isolated, and unsure where to turn.
You’re not alone — and you’re not beyond help. Addiction is a medical condition, not a moral failure. Thousands of women have been in your shoes and found safe, supportive paths forward.
You don’t have to face this alone. If you’d like to speak with someone confidentially, reach out today.
At American Adoptions, we offer judgment-free help for pregnant women in all situations, including those coping with substance use. Together, we’ll help you make the healthiest choice for you and your baby.
Understanding Opiate Addiction During Pregnancy
Opiate addiction — also called opioid use disorder — is a medical condition, not a choice. It happens when your body becomes dependent on opioids like prescription painkillers (oxycodone, hydrocodone, fentanyl) or drugs like heroin.
When you’re pregnant and using opioids, those substances pass through the placenta. Your baby can develop the same physical dependence — not because you mean harm, but because addiction affects both of you.
What matters most right now is safety. Suddenly stopping opioid use during pregnancy can be dangerous, leading to withdrawal, preterm labor, or pregnancy loss. With medical care and support, though, recovery and a healthy pregnancy are possible.
Treatment with prescribed methadone or buprenorphine is safer than street drugs or quitting suddenly, reducing overdose risk and supporting a healthy pregnancy.
What Happens to the Baby: Neonatal Abstinence Syndrome (NAS)
When babies are exposed to opioids in the womb, they can develop Neonatal Abstinence Syndrome (NAS)—also called Neonatal Opioid Withdrawal Syndrome (NOWS)—after birth.
NAS occurs because the baby was receiving opioids through the placenta, and after birth, they experience withdrawal as the drug leaves their system. Symptoms typically begin within one to three days after birth and can include fussiness, tremors, difficulty feeding, diarrhea, sweating, and rapid breathing.
Neonatal Abstinence Syndrome (NAS) can sound frightening, but it’s important to know it’s temporary and treatable.
Babies with NAS receive gentle, specialized care in the hospital—starting with comfort-based treatments like swaddling, skin-to-skin contact, and a quiet environment.
Most babies recover in two to three weeks and go on to grow and develop normally. With the right prenatal and postnatal care, babies exposed to opioids in the womb can thrive. The most important step is getting medical support for both you and your baby as soon as possible.
Getting Help: Treatment Options for Pregnant Women
If you’re pregnant and struggling with opioid addiction, getting medical treatment is one of the best things you can do for yourself and your baby.
Medication-Assisted Treatment (MAT)—using prescribed medications like methadone or buprenorphine under medical supervision—is the safest, most effective option during pregnancy. It helps prevent dangerous withdrawal, reduces cravings, lowers overdose risk, and improves both prenatal care and birth outcomes.
MAT isn’t “replacing one drug with another.” It’s real medical care for a real medical condition—just like taking insulin for diabetes.
Treatment programs often include prenatal care, counseling, and support groups where you can connect with others who understand what you’re going through.
Most importantly, seeking treatment doesn’t automatically mean losing custody.
Laws about reporting and child protective services vary by state, which we’ll cover next.
Your Legal Rights and What to Expect at the Hospital
It’s normal to worry about what will happen when your baby is born — especially if you’ve been using opioids. You might wonder: Will the hospital take my baby? Will I be reported?
The answer depends on where you live and your situation. Laws about substance use during pregnancy vary widely by state.
Understanding Reporting Laws
Federal law (the Child Abuse Prevention and Treatment Act) requires hospitals to notify Child Protective Services (CPS) when a baby is born affected by substance exposure. But how this plays out differs from state to state:
- Some states automatically report all substance-exposed newborns, even those exposed to prescribed treatments like methadone or buprenorphine.
- Others report only cases involving illegal drug use.
- Many states now use a “Plan of Safe Care” approach, focusing on support instead of punishment.
- A few have no specific reporting rules beyond general child welfare laws.
Research shows that harsh reporting policies often discourage women from seeking prenatal care — leading to worse outcomes for both mother and baby.
What You Can Do
- Stay in treatment. Being in a prescribed treatment program is viewed far more positively than using drugs without medical care.
- Attend prenatal visits. Consistent care shows commitment to your baby’s wellbeing.
- Know your rights. CPS involvement doesn’t automatically mean losing custody. In many cases, CPS connects families to support and services.
- Keep records. Make sure your medical team documents your prescribed treatment. Being open and honest helps you and your baby get the right care.
Can I Choose Adoption If I’m Addicted?
Yes — adoption is absolutely possible if you’re struggling with opioid addiction. Many women in recovery choose adoption because they want their baby to have the stability, love, and opportunities they can’t yet provide. It’s not giving up — it’s a deeply selfless decision.
Agencies like American Adoptions work with women in all situations, including those facing substance use.
You’ll receive judgment-free support, financial assistance for living expenses and medical care, and free counseling throughout your pregnancy.
You’re always in control of your plan — you choose the family, decide how much contact you want, and create an adoption experience that feels right for you.
Choosing adoption allows you to focus on recovery while giving your baby the best possible start. It’s an act of love — one that can lead to healing for both you and your child.
Are Addicted Babies Hard to Adopt?
This is a common misconception, and the answer is no—babies who were exposed to opiates in utero are not “unwanted” or “hard to adopt.”
Many loving, prepared families are specifically open to adopting babies who may have been exposed to substances during pregnancy.
These families understand that with proper medical care, babies with NAS can thrive. They’ve educated themselves about the condition and are ready to provide whatever support their child needs.
The reality is that there are many more families waiting to adopt than there are babies available for adoption. Families who work with adoption agencies undergo extensive preparation and screening.
They understand that all children—including those exposed to substances prenatally—deserve love, stability, and a safe home.
Your baby will not be rejected or unwanted because of prenatal substance exposure. Adoptive families see beyond the circumstances of pregnancy to the beautiful child who deserves a loving home.
How Adoption Works for Mothers with Addiction
The adoption process through American Adoptions is designed to support you regardless of your circumstances.
Here’s how it works:
- each out confidentially. Call 1-800-ADOPTION or fill out our form anytime. Your conversation is private, safe, and judgment-free.
- Create your plan. Work with an adoption specialist to outline what you want — the type of family, contact after placement, and your hospital preferences.
- Choose the family. Review profiles and videos of waiting families until you find the one that feels right. You’re always in control of this decision.
- Begin receiving assistance. Once your plan is in place, you can access medical care, counseling, and financial help for living expenses throughout your pregnancy.
- Birth and post-placement. When you give birth, your hospital plan will be followed, and your baby will join the adoptive family you chose. You’ll continue receiving emotional support and counseling as you focus on recovery and healing.
Throughout this process, you’re not alone. Your adoption specialist, counselors, and medical team are all working together to support you.
Open Adoption: Staying Connected with Your Baby
One of the most comforting aspects of modern adoption is that you don’t have to disappear from your child’s life.
Open adoption lets you stay connected with your child in ways that feel right for you. That might include:
- Photos and letters a few times a year
- Texts or emails with updates and milestones
- Video calls to see your child grow
- In-person visits, if everyone is comfortable
The level of contact is up to you and the adoptive family—there’s no right or wrong amount, only what feels right for your situation.
Many birth mothers find that open adoption brings peace of mind. You can see your child is safe and loved while having the space to focus on your own healing and recovery.
The adoptive family raises the child, but you’ll always be part of their story—and they’ll grow up knowing how deeply you cared.
Next Steps: How to Get Help and Talk to a Counselor
If you’re pregnant and struggling with opiate addiction, taking the first step toward help can feel impossible. But you don’t have to do this alone.
American Adoptions provides free, confidential counseling 24/7 to any woman facing an unplanned pregnancy—including women dealing with substance use. You are a woman facing an incredibly difficult situation, and you deserve compassion, support, and real help.
Whether you’re considering adoption or simply need someone to talk to about your options, we’re here. Reach out to speak with a specialist today.
