Where We Stand
Section: Substance Use Disorder
Policy: Oregon Pregnancy and Opioids Work Group 2017-2018 Recommendations

Oregon Pregnancy and Opioids Work Group 2017-2018 Recommendations

The OMA supports the Oregon Pregnancy and Opioids Work Group 2017/18 recommendations.

Primary Prevention (for all women) 
  1. Ask all women of reproductive age about their pregnancy intentions prior to medication-assisted treatment (MAT) for an opioid use disorder (OUD).
  2. Ask all pregnant women and women seeking pregnancy or preconception care about opioid use.
  3. For all pregnant women without an OUD, avoid prescribing opioids when possible but, if necessary, do so with safeguards in place.
  4. Prevent opioid overdose.
  5. Upon discharge after a delivery, encourage all women without an OUD who need ongoing pain treatment to use non-opioid therapies (i.e., NSAIDs). If opioids are indicated, they should receive a limited number of opioid pills to last until a scheduled follow-up visit and no more than seven days of treatment.
    6.            
Secondary Prevention (for women with an opioid use disorder and their infants)
  1. Coordinate care for pregnant and parenting women with an OUD.
  2. Manage OUDs during pregnancy by following evidence-based approaches.
  3. Include additional screenings and services when caring for pregnant women with an OUD.
  4. Provide appropriate pain control for women with an OUD during labor.
  5. Provide necessary postpartum services and support for women with an OUD.
  6. Encourage breastfeeding for women with an OUD on MAT.

System and Policy Recommendations
  1. Closely monitor an infant born to a mother who used opioids during pregnancy. Manage care with a standardized protocol for the assessment and treatment of infants at risk for neonatal abstinence syndrome (NAS). System and policy recommendations.
  2. The Oregon Health Authority, in partnership with the Oregon Maternal Data Center, should implement a surveillance strategy for in utero opioid exposure and NAS. The strategy should be mindful of any unintended negative consequences and seek a balance between patient confidentiality and the state’s ability to truly understand the scope of the problem.
  3. Oregon health care leaders and policy makers should work to advance systems change that supports families affected by OUD.

Adopted by the Board of Trustees, September 2018.

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