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PostPosted: Fri Mar 11, 2011 2:37 pm 
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Hi guys!

So...let's say I were pregnant.....okay well I am but I just found out and it's super early. I am not telling most of my family and friends for a little while but I have important questions!

I have been reading and researching pregnancy and suboxone for a while now and this is why I decided it would be ok if I became pregnant while on sub. But now I am a nervous wreck!!!! I take 4 mg a day of suboxone and I know I will need to switch to subutex asap. I plan to talk to my sub dr's.

Does most Dr's who prescribe Suboxone also prescribe subutex? Will most prescribe to someone who is pregnant or will I need to find an obgyn who approves it first?

My next question is if there is an easy way to find an OBGYN who is familiar with sub patients?

Since I still have basically 9 months to go and only take 4mg, should I slowly ween down to like 1 or 2?

I know I will get answers from the Dr's but I would rather ask women who have gone through it!

Thank you guys!!!!!

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PostPosted: Fri Mar 11, 2011 5:09 pm 
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I haven't gone through it, but I've been around here for two years so I've learned a lot. First of all, congratulations.
To answer some of your questions, yes, a suboxone doc can prescribe subutex. Whether your sub doc will continue to treat you now that you're pregnant really depends on her/him. Did you happen to sign a contract that you wouldn't get pregnant? Some sub doctors have patients do that. Regarding your dose, from what I know - and I'm no doctor - I would say, yes, it's probably best to taper down as low as you can go. You don't know what kind of pain relief you'll need when the time comes (on the off-chance that you'll need a c-section). BUT - make sure you are at a high enough dose so that you're not having cravings and at risk of relapse. Yes, sub is an opiate, but the baby is safe and will be even safer with a mom who's not going to relapse. I hope I've expressed myself well.

Now, unfortunately, from reading many, many stories, I think it might be difficult to find an OB/GYN who knows about sub. Not impossible though, and I'm sure it just depends on your area. I'd ask your sub doc for a referral if possible then I'd start making calls to OB's. If I remember correctly, being on sub puts you in the high-risk category. Again, I'm not sure of this.

The situation could be complicated and it may take some legwork and/or phone calls to get the right people lined up, but remember, many, many women have very positive experiences delivering healthy babies while on sub. So please don't let any of this discourage you. I hope nothing I've said has done that either. This is a time for you to be happy and hopeful.

Again, congratulations. I'm sure some others with more personalized experiences will come along and chime in. And remember, what I've said is based on what I've learned from reading others' experiences only.

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PostPosted: Fri Mar 11, 2011 6:38 pm 
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Thank you Hatmaker! I

I have seen you be a part of many posts and appreciate your insight. All of this is good to know. I didn't sign anything saying I wouldn't get pregnant, so hopefully that will all go smooth! They are very nice, flexible people and I hope this means they will be able to help me. I will keep you updated.

I appreciate you taking the time to write to me!

Jessica

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 Post subject: high risk
PostPosted: Fri Mar 11, 2011 6:40 pm 
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I also wanted to add.....anyone who does have information on if they were a high risk category, I would like to hear what that means and any experiences.


Thank you all

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PostPosted: Fri Mar 11, 2011 8:42 pm 
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Hi -

Congrats on your pregnancy - what an exciting time this will be for you! I have a child but she was born long before my addiction, so I don't have first hand experience with being on Sub while pregnant. I would encourage you to read through the stories posted here by moms who have been through it though, and you might try PMing some of them to see if they are still around.

One thing that I would suggest based on my reading of our pregnant mama member stories would be to find out the policy of the hospital where you plan to give birth. It seems that some hospitals require that any babies born to moms on Sub stay in the NICU after birth, while others let the baby stay with mom. Some hospitals seem really gung-ho on medicating babies born to moms on Sub while others not so much. Some hospitals automatically involve CPS socal-workers and others don't or only do so under certain circumstances. I seem to remember that a few of our mamas here were caught off-guard by these policies and protocols and if I was going to be in your situation, I would want to know what to expect.

You might contact your area hospitals and find out if they have had any moms on Suboxone deliver there. Many hospitals are familiar with moms on MMT and they base their protocols around that, but it really isn't the same. My understanding is that there is a lower chance of your baby having neo-natal absinence syndrome (withdrawals) when you're on Suboxone (as compared to methadone). If your hospital has some experience with Suboxone moms, they may be able to refer you to a doctor as well.

As far as being in the high risk delivery category...I think if you are considered high-risk you have to have an OBGYN rather than a midwife or CNM and you might have some additional doctor appointments or tests. I'm not really sure; definitely something to talk over with your doctor.

If you read through the forum and Dr. Junig's blog I think you will find links to articles about the safety of Suboxone during pregnancy and the rates and severity of NAS among newborns of moms on Suboxone, as well as pain relief for Suboxone patients. Getting really educated about these issues is a good way to prepare yourself for dealing with the doctors and nurses. Knowing what your about and what your rights are as a patient is important for any expecting mom, but I think even more so for expecting mom's on opiate-replacement therapy. There is unfortunately still a lot of stigma, lack of education and misinformation/misunderstanding about Suboxone in the medical community, so it will be your job to advocate for yourself and your baby.

Good luck and welcome to the forum. We have a great community here and I hope you'll stay with us and update as things progress.

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PostPosted: Mon Mar 14, 2011 5:46 pm 
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missH--congrats on your pregnancy! I thought I'd answer your high risk question. Any pregnant woman who has a history of substance abuse along with being on a pain med, or Suboxone, is considered "high risk". So like someone else mentioned, you most likely will have to be seen by an MD or DO, and not by a midwife, unless there is a midwife who practices under and in the same office as an acutal ob doctor (we have a clinic here in town who does this). They consider it high risk mostly because of the possible risk of withdrawal to the baby once it's born. Here at our hospital, they keep the baby for up to three days to make sure it doesnt show signs of withdrawal, and if not, baby goes home with mom. But that process is more involved with the Pediatrician for your baby instead of the OB doctor. But don't be intimidated by the "high risk" label, it does not mean there is a huge threat to you or your baby. Good luck, dear!


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PostPosted: Tue Mar 15, 2011 8:01 pm 
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Just wanted to update everyone!

I saw my sub doctor yesterday and as scared as I was to tell them I was pregnant, I was completely honest! The only reason I was scared to tell them was not knowing what their policy was. But they switched me to subutex and gave me an OBGYN name for someone they work closely with! ANd she would deliver at the same hospital where my sub DR (who is a pediatrician) also works. He also said he has "say" over a lot of things!!!! I feel like things are falling together perfect!

Thank you ALL for your help...I know I will be asking lots of questions and keeping you updated!!!

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