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PostPosted: Sat Jun 05, 2010 11:13 pm 
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I have read and certianly done my research on everything about suboxone and preganacy, but I'd like some first hand advice. I'd like to hear your stories so I feal fully informed about what care I should be having.


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PostPosted: Mon Jun 07, 2010 10:55 am 
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I would imagine that the official 'doctor' answer is going to be 'it depends....'
Remember, there is still not a lot of well-documented research on Sub & pregnancy b/c it is still such a new medication. I know they are actually doing research right now at Johns Hopkins, but a lot of the doctors seem to follow their own educated guesses---at least that is what I have seen.

I can tell you that I am 24 weeks and I have three doctors who are guiding my care.

1) My 'normal' ob/gyn practice--they are well aware of the subutex and referred me to a high-risk specialist/perinatology practice for evaluation due to 'medication usage' even before i got pregnant to get the 'greenlight'. I see them every month (and then I believe I go to every two weeks in month 7, then every week in month 9....) for the 'routine' care -- checking urine, BP, asking questions, hearing heartbeat, measuring uterus, etc. Assuming I have a 'normal' delivery, they will be handling the labor and delivery.

2) The high-risk/perinatology group -- As stated above, I met with them before I got pregnant to make sure it was OK. I'm actually their first subutex patient, which shocks me, but it is what it is! They have no concerns about me being on sub but did want to follow me a bit more closely and do a bit more planning before labor. I see them for specialized ultrasounds and tests that I opted for (ie the 12 week nuchal translucency, Level 2 ultrasound) and at the end of my pregnancy they will also be doing weekly non-stress testing and checking the fluid levels. They will also work with me to consult with the anesthesia dept. at the hospital pre-labor and delivery to have a pain control plan set in place.

3) My sub doctor (although he's abruptly leaving his practice, so I'm freaked and feel like I'm about to sway in the wind...). He is obviously the sub expert, but knows diddly about pregnancy, so he serves to continue to monitor my sub each month, write prescriptions, consult when asked w/ the ob and w/ the perinatologist, and he would have served as the pain control expert in advising the hospital about what narcotics to give me during/after birth, and in what doses. Again, he's leaving before Sept. so I'm in a scramble to find a new sub doc....but hopefully whomever I find will continue to fill this role!

Another important piece of this puzzle is 4) the pediatrician. I can't speak to this part yet as I haven't found one...I need to do that soon, though! They need to be brought in before birth to understand that this is a baby born to a mom who is taking Subutex, and hopefully they will be understanding and professional. I will be looking for a pediatrician who is willing to sit down with me and develop a plan....ie what will happen after birth, how does he/she assess for NAS, how will my child be treated any differently from a baby born to a mom who is not taking sub, etc.

I am considered "high-risk" because of my Subutex use -- which I actually like as it does mean a bit more attention and monitoring. As this is my first pregnancy and I'm scared to death, I LIKE the additional monitoring. And thus far, I have been treated with nothing but respect by all of my doctors. None of them have made me feel like a 'bad person' or have shunned me. Unfortunately, many of them also had/have NO idea what subutex even is, so that worries me!

I'm a big fan of getting everyone on board with your care as soon as possible, and being completely upfront with all doctors so that you set the tone from the beginning of wanting/needing good quality care and showing that you are not ashamed of your disease and won't tolerate anyone making you feel ashamed.


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
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