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reduce the transmission of HIV infection, however it is not effective
at preventing transmission of Hepatitis B and C.

Abrupt cessation of opioid use produces a constellation of effects that
are dangerous for a pregnancy and a fetus. Withdrawal causes
muscles to be overly active; the uterus is a muscle, so this can result in
premature labor and/or delivery. Babies who are premature and/or
small at birth are at much higher risk of infection, breathing, cardiac
and feeding problems and SIDS (Sudden Infant Death Syndrome).
When the body has become used to having opioids around constantly,
sudden cessation results in a whole cascade of neuro-hormonal
activity. The increased activity of the nervous system and stress
hormone system creates an adverse in utero environment, which can
slow fetal growth or result in fetal death.

Medical Management of Pregnant Women with Opioid Addiction

In view of the medical risks posed by opioid addiction during
pregnancy, prompt and effective medical treatment is needed.
Methadone Maintenance Treatment is the standard of care (in other
words, the treatment of choice) for any opioid addicted pregnant
woman. Attempting to wean a pregnant woman off of an opioid is
medically contraindicated.

In Santa Clara County opioid addicted pregnant women seeking
methadone treatment are admitted the day they call or the next
business day. Women who are incarcerated in Santa Clara County and
found to be pregnant and opioid dependent are started on methadone
maintenance while in jail and referred to the Perinatal Substance
Abuse Program and Central Valley Methadone Clinic upon discharge.

Eligibility criteria for admission to methadone maintenance are of
necessity more lenient for pregnant women. Under California
Regulations, any pregnant woman, with a history of opioid addiction,
who is currently physically dependent on an opioid, is eligible for
methadone maintenance treatment regardless of the duration of
dependence.