# Suboxone and Pregnancy: Safety for You and Your Baby

> Suboxone and pregnancy: why guidelines favor staying on buprenorphine, what newborn withdrawal means, birth defect data, breastfeeding and who to tell.

URL: https://foundationmedicalgroup.org/suboxone-and-pregnancy/
Published: 2026-10-08
Updated: 2026-10-08

For most pregnant women with opioid use disorder, staying on buprenorphine treatment such as Suboxone is safer than stopping. National guidelines recommend medication over withdrawal in pregnancy because the risk of relapse is high. Your baby may have withdrawal after birth, which is expected and treatable. Never stop on your own. Tell your prescriber and your OB.
Finding out you’re pregnant while you take Suboxone can be scary. Take a breath. Here’s what the research and the guidelines say, in plain words.
What Is Suboxone, and Why Is It Used in Pregnancy? Suboxone is a prescription medication that combines two drugs: buprenorphine and naloxone. SAMHSA describes buprenorphine as an opioid partial agonist. It eases withdrawal and cravings without the same high as other opioids. Naloxone is added to the product to reduce misuse.
Together, these two drugs treat opioid use disorder, also called opioid dependence or addiction. Curious how the medication acts on the opioid receptors in your brain? Our guide on how Suboxone works explains it step by step. Here we focus on pregnancy.
So why would doctors keep pregnant women on a medication like this? Because the alternative is often riskier. According to SAMHSA, buprenorphine and methadone are the treatments of choice for opioid use disorder in pregnant and breastfeeding women. Both are opioid agonists, which means they act on the same receptors as other opioids, but in a steady, controlled way.
ACOG, the national group for obstetricians, says the same thing in its Committee Opinion 711. It calls opioid agonist pharmacotherapy, also known as medication assisted treatment, the recommended therapy for opioid use disorder in pregnancy. In short, buprenorphine isn’t something doctors use in pregnancy by accident. It’s part of standard treatment.
Is It Safe to Take Suboxone While Pregnant? This is the question most people ask first: is Suboxone safe for my baby? The honest answer is that no medication is free of risk in pregnancy. That isn’t the whole story, though. For pregnant women, doctors weigh Suboxone use against the risks of untreated opioid use, and the guidelines find those risks much higher.
ACOG lists what is linked with untreated heroin addiction in pregnancy.
Lack of prenatal care Fetal growth restriction, which means the baby does not grow as expected Placental abruption, when the placenta pulls away from the wall of the womb too early Fetal death Preterm labor That’s a hard list. A 2023 systematic review in PubMed Central also links untreated opioid use disorder in pregnancy with fetal growth restriction and preterm labor. These are serious outcomes, and they’re the reason guidelines favor treatment.
Thankfully, the good news is also from ACOG. Opioid agonist treatment, when it’s paired with prenatal care, reduces obstetric complications. It also helps expectant mothers keep up with their prenatal visits.
Many people also ask about the difference between illicit opioids and prescription opioids in pregnancy. Whatever opioids you’ve taken, tell your OB and your prescriber about all of it, including pain pills and street drugs. That can feel hard to say out loud. They aren’t there to judge you, though. They need the full picture to keep you and your baby safe.
So is it safe? It’s not risk free, and no one should promise that. But for most people with opioid use disorder, staying on treatment is the safer path.
Can Suboxone Cause Birth Defects? Current data don’t show a higher risk of major birth defects from buprenorphine. That’s the short answer, and it comes from two sources.
The FDA label, found on DailyMed, says the data in pregnancy are limited. But it also says those data do not indicate an increased risk of major malformations specifically due to buprenorphine. Malformations is the medical word for birth defects.
A 2023 systematic review looked at buprenorphine-naloxone in pregnancy. It found that rates of congenital anomalies, which are health problems present at birth, were comparable to the general population. The review also found no significant differences in gestational age, which means how far along the pregnancy was at birth, compared with other groups.
Many parents worry about low birth weight, too. On birth size, the same review found no significant differences in birth weight, length or head circumference between babies exposed to buprenorphine-naloxone and the comparison groups. Rates of preterm birth did not differ significantly between the groups either. These neonatal outcomes are reassuring, and for a worried parent that’s a real relief.
You may also read about fetal distress or miscarriage online. The trusted sources we use for this guide don’t give numbers on those topics for this medication, so we don’t quote any. Got a worry about your own pregnancy? Your OB is the right person to ask.
Buprenorphine and Naloxone vs Buprenorphine Alone in Pregnancy You may have heard that pregnant women should take buprenorphine alone instead of Suboxone. There’s a reason that advice exists.
ACOG explains that in the past, doctors often recommended buprenorphine monotherapy, a product with no naloxone, during pregnancy. The goal was to avoid any naloxone exposure before birth, especially if the medication was injected instead of taken as directed.
Naloxone is an opioid antagonist, which means it blocks opioids. ACOG notes that naloxone is not orally active. When you take the film under your tongue as directed, very little naloxone gets into your body. So it doesn’t cause opioid withdrawal.
Newer research has eased the old worry. ACOG says recent studies of the combination product found no adverse effects compared with buprenorphine alone. The 2023 systematic review agreed. It found no evidence of maternal or neonatal safety concerns with buprenorphine-naloxone in pregnancy.
So should you stay on Suboxone treatment or switch to a buprenorphine-only product, sometimes known by the brand name Subutex? That choice belongs to you, your prescriber and your OB together. For example, the Foundation Medical Group clinic in Decatur, GA lists both Suboxone and Subutex. Please don’t switch medications on your own.
Buprenorphine vs Methadone: How Do Neonatal Outcomes Compare? SAMHSA names buprenorphine and methadone as the two treatment options of choice in pregnancy. Both buprenorphine and methadone are opioid medications that steady the body. Foundation Medical Group does not list methadone as a service. If methadone may be right for you, your OB or prescriber can point you to a program that offers it.
The best-known study that compares the two opioid drugs in pregnancy is the MOTHER trial, published in the New England Journal of Medicine in 2010. It compared newborns exposed to buprenorphine with newborns exposed to methadone. The buprenorphine group needed much less morphine to treat neonatal abstinence syndrome, spent fewer days in the hospital and needed fewer days of treatment.
Outcome (MOTHER trial) Buprenorphine Methadone Total morphine to treat NAS 1.1 mg 10.4 mg Newborn hospital stay 10.0 days 17.5 days Days of NAS treatment 4.1 days 9.9 days Women who stopped treatment 33% 18% There’s a balance to keep in mind. More women stopped treatment in the buprenorphine group, 28 of 86 or 33%, than in the methadone group, 16 of 89 or 18%. The trial found no significant difference in maternal or neonatal adverse events between the two groups. The authors concluded that buprenorphine is an acceptable treatment for opioid use disorder in pregnancy.
The 2023 systematic review adds to this picture. It linked buprenorphine-naloxone with reduced severity of neonatal abstinence syndrome compared with methadone.
What does this mean for you? Neither opioid medication is wrong. Methadone may suit one person, and buprenorphine may suit another. In practice, the best choice tends to be the one you can stay on, chosen with a prescriber who knows your history.
What Is Neonatal Abstinence Syndrome, and Is It Treatable? Neonatal abstinence syndrome, often shortened to NAS, is withdrawal in a newborn after opioid exposure in the womb. The baby’s body got used to the medication during pregnancy. After birth, the supply of opioids stops, and the baby can show opioid withdrawal symptoms. The FDA label calls this neonatal opioid withdrawal syndrome, or NOWS. The two names describe the same problem.
Hear this clearly: neonatal abstinence syndrome is expected and treatable. ACOG says it is seen in 30% to 80% of infants born to pregnant women on opioid agonist therapy. The Suboxone label also calls neonatal opioid withdrawal an expected and treatable outcome of prolonged use of opioids during pregnancy. SAMHSA lists NAS as a serious side effect in newborns, which is why your baby’s care team watches for it.
What does it affect? ACOG describes problems in the baby’s digestive system and nervous system, including the part that runs automatic body functions. Your baby’s doctor will know what signs to look for and what treatment may help.
No one can promise that your baby will have no withdrawal. That’s not easy to hear. Many babies exposed to opioids, including buprenorphine and methadone, will have some neonatal abstinence syndrome. The point is that doctors expect it and know how to care for it.
You can help by planning ahead:
Tell your delivery team that you take buprenorphine-naloxone, and at what dose. Ask the hospital how they watch and care for newborns with opioid exposure. Ask your baby’s doctor what you can do to comfort your baby in the first days. This way, your baby can get care right away if neonatal abstinence syndrome appears.
Should You Stop Suboxone If You Find Out You Are Pregnant? No. Please do not stop or taper Suboxone on your own. Tell your prescriber and your OB right away.
It’s natural to want to protect your baby by stopping every medication. But with buprenorphine, stopping suddenly can bring back strong opioid cravings and withdrawal. ACOG reports that relapse rates after medically supervised withdrawal in pregnancy range from 59% to more than 90%.
Relapse during pregnancy carries real dangers. ACOG lists overdose, because your body loses its tolerance and a dose that once felt normal can now be deadly. It also lists obstetric complications and a lack of prenatal care. Relapse can also bring a return to opioid misuse or illicit drug use, which puts both of you at risk.
That’s why guidelines say that pregnant individuals with opioid dependence do better staying on buprenorphine or methadone. Any change to your buprenorphine dose is a decision for your prescriber, not something to try alone. Pregnant patients who have questions about their dose can ask their prescriber to review it at any visit.
If you want to know what tapering means in general, our guide on how to taper off Suboxone explains it. But pregnancy isn’t the time to start a taper on your own. That’s a talk to have with your prescriber and your OB together.
Can You Breastfeed While Taking Suboxone? For many mothers, yes. ACOG says breastfeeding should be encouraged for women who are stable on opioid agonists, who are not using illicit drugs and who have no other reasons not to breastfeed, such as HIV.
The FDA label, in section 8.2, gives more detail. It says buprenorphine is present in low levels in human breast milk. Available data have not shown adverse reactions in breastfed infants. The label also notes there are no data on the combination product, buprenorphine and naloxone, during breastfeeding. But oral absorption of naloxone is limited, which means very little of it is taken in by mouth.
SAMHSA also says buprenorphine and methadone are the treatments of choice for breastfeeding women, not only for pregnant women. So staying on buprenorphine after birth doesn’t by itself mean you can’t nurse your baby.
Still, every mother and baby are different. Your baby may have their own health needs, and you may have other medications to think about. Make this choice with your baby’s doctor and your prescriber. Ask them what to watch for in your baby and who to call with questions.
Building Your Prenatal Care Team for Opioid Use Disorder Treatment Good care in pregnancy is a team effort. For most people, the team looks like this.
The prescriber who manages your Suboxone or other medication Your OB or midwife, who leads your pregnancy care Your baby’s doctor, who cares for your baby after birth Sometimes it grows. ACOG notes that prenatal care for women with opioid use disorder may add consultations with other types of providers. SAMHSA publishes national clinical guidance for treating pregnant and parenting women with opioid use disorder and their infants. That guidance supports treatment decisions made for each person, not one plan for everyone.
Want your team to work well together? Share these three things.
Every medication you take and the dose Any other opioids or substances you use, now or in the recent past Your plans for delivery and for feeding your baby Foundation Medical Group prescribes medication for opioid use disorder. When you start MAT with us, we check for medication interactions at the first visit, so that list matters here too. We do not provide OB, prenatal or newborn care, so your OB and your baby’s doctor stay a key part of the team.
Where Can You Get Suboxone Treatment During Pregnancy at FMG? Foundation Medical Group offers medication assisted treatment with Suboxone at all four of our clinics:
Richmond, VA: 11600 Busy Street, Suite 203, Richmond, VA 23236. American Fork, UT: 456 E State Street, Suite 1400, American Fork, UT 84003. Decatur, GA: 160 Clairemont Ave, Suite 200, Decatur, GA 30030. Dallas, TX: 8390 Lyndon B Johnson Freeway, Suite 500, Dallas, TX 75243. Our Decatur clinic lists both Suboxone and Subutex. You can learn more on our Georgia page and in our guide to the Suboxone clinic in Decatur. For an overview of this care, see our MAT and Suboxone service page.
If you’re pregnant, tell the clinic when you call. Ask whether they can care for you during pregnancy and how they would work with your OB.
Please know what we do not offer. Foundation Medical Group does not provide detox, IOP, PHP, residential care or 24/7 supervision. We also do not provide OB, prenatal or newborn care.
Insurance plans vary by state. Please call to confirm coverage for any plan before your visit:
Georgia: Cigna, CareSource Georgia, Peach State Health Plan and Amerigroup Community Care. Call to confirm coverage. Virginia: Virginia Medicaid (called Cardinal Care), Aetna, Anthem, Cigna and UnitedHealthcare. Call to confirm coverage. Medicare is not accepted in Virginia. Texas: Texas Medicaid, Aetna, Cigna and Blue Cross Blue Shield. Call to confirm coverage. Utah: Blue Cross Blue Shield, SelectHealth and Aetna. Call to confirm coverage. Key Takeaways Guidelines from ACOG and SAMHSA favor keeping pregnant women on buprenorphine or methadone rather than stopping. The FDA label and a 2023 review do not show a higher risk of major malformations from buprenorphine. Newborn withdrawal, called neonatal abstinence syndrome, is expected in many babies exposed to opioids, and it is treatable. Breastfeeding is encouraged for mothers who are stable on treatment and have no other reasons not to nurse. Never stop Suboxone on your own. Tell your prescriber and your OB as soon as you know you are pregnant. FAQ Can Suboxone cause miscarriage or hurt a pregnancy? The trusted sources we use for this article do not give a miscarriage rate for Suboxone, so we do not quote one. What ACOG does describe clearly are the risks of untreated opioid use in pregnancy, such as missed prenatal visits, poor fetal growth, placental abruption and labor that starts too early. Your OB can talk with you about your own health history and your own risks.
What are the risks of Suboxone during pregnancy for the baby? The main expected risk is newborn withdrawal, called neonatal abstinence syndrome or neonatal opioid withdrawal syndrome. ACOG and the FDA label both describe it as expected and treatable. The label says the data do not show a higher risk of major malformations specifically due to buprenorphine, and a 2023 review found rates of congenital anomalies similar to the general population.
What is the Suboxone pregnancy risk category? The current Suboxone label does not use a letter category such as A, B, C or X. Section 8.1 of the label gives a Risk Summary instead, which explains what the data show and what they do not. You can read it on DailyMed, or ask your prescriber to walk you through it.
What do medical guidelines say about Suboxone and pregnancy? ACOG Committee Opinion 711 calls opioid agonist medication, such as buprenorphine or methadone, the recommended therapy in pregnancy and says it is preferable to medically supervised withdrawal. SAMHSA’s 2018 clinical guidance for pregnant and parenting women with opioid use disorder (SMA18-5054) supports individual treatment decisions. You can bring both documents to your OB visit.
Sources American College of Obstetricians and Gynecologists (ACOG), Opioid Use and Opioid Use Disorder in Pregnancy (Committee Opinion 711). SAMHSA, Buprenorphine. DailyMed, U.S. National Library of Medicine, SUBOXONE (buprenorphine and naloxone) sublingual film prescribing information. New England Journal of Medicine via PubMed Central (NIH), Neonatal Abstinence Syndrome after Methadone or Buprenorphine Exposure (MOTHER trial, NEJM 2010). PubMed Central (NIH), Safety and Efficacy of Buprenorphine-Naloxone in Pregnancy: A Systematic Review of the Literature (Pathophysiology, 2023). SAMHSA, Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants (SMA18-5054).