Buprenorphine and Pregnancy: What You Need to Know

When you're pregnant and managing opioid use disorder, buprenorphine, a partial opioid agonist used to treat addiction and manage withdrawal. Also known as Subutex or part of Suboxone, it's one of the two FDA-approved medications for treating opioid dependence during pregnancy. Unlike methadone, it doesn’t require daily clinic visits, and studies show it leads to less severe withdrawal in newborns. But it’s not a simple yes-or-no decision — it’s about balancing safety for you and your baby.

One major concern is neonatal abstinence syndrome, a group of problems a baby experiences when withdrawing from exposure to drugs like buprenorphine in the womb. The good news? Babies born to mothers on buprenorphine typically have milder symptoms than those exposed to heroin or prescription opioids. They often need shorter hospital stays and less medication to manage withdrawal. Still, this doesn’t mean it’s harmless. The baby will still need monitoring after birth, and you’ll need a care team that includes an OB, addiction specialist, and pediatrician.

Another key point: medication-assisted treatment, or MAT, which includes buprenorphine, is the standard of care for pregnant women with opioid use disorder. Stopping opioids cold turkey during pregnancy is dangerous — it raises the risk of miscarriage, preterm labor, and fetal distress. MAT doesn’t replace one addiction with another. It stabilizes your brain chemistry, lets you focus on prenatal care, and improves your chances of having a healthy baby. The CDC, ACOG, and SAMHSA all agree: buprenorphine is safer than continuing to use street drugs or misusing prescriptions.

What about breastfeeding? Yes, you can usually breastfeed while on buprenorphine. The amount that passes into breast milk is very low, and studies show no negative effects on infant development. In fact, breastfeeding may help reduce the severity of withdrawal symptoms in the baby. But always talk to your doctor first — especially if you’re taking other medications or using substances.

You might also hear about naloxone, an opioid blocker added to buprenorphine in products like Suboxone to prevent misuse. If you’re pregnant, your provider will likely switch you to buprenorphine alone (Subutex) because naloxone hasn’t been studied as thoroughly in pregnancy. It’s not because it’s dangerous — it’s because we don’t have enough data yet. Always take exactly what your doctor prescribes.

There’s no perfect solution, but buprenorphine gives you a real shot at a healthy pregnancy. It’s not about being ‘clean’ — it’s about being safe. The goal isn’t to eliminate all medication, but to reduce harm and give your baby the best start possible. If you’re pregnant and using opioids, getting on buprenorphine is one of the most important steps you can take.

Below, you’ll find real-world insights from posts that cover everything from how buprenorphine compares to other treatments, to what happens after birth, to how to navigate the system when you’re pregnant and on medication. These aren’t theoretical opinions — they’re based on clinical data, patient experiences, and current guidelines. You’re not alone in this. The right information can make all the difference.