Preconception Health Services for Women With Opioid Use Disorder (OUD): A Review and Best Practice Recommendation

Rates of unintended pregnancy are high among women with opioid use disorder (OUD), and opioid use during pregnancy is associated with a host of negative maternal and infant outcomes. Prior work has focused on the provision of contraception to prevent unintended pregnancies; however, less is known about interventions for women with OUD who desire or intend to become pregnant in the future. This review provides a general overview of opioid use during pregnancy, highlighting the need for a best practice approach of comprehensive preconception health services offered to all women in the context of OUD. Given the potentially chronic and relapsing nature of OUD paired with numerous challenges women with OUD experience in relation to reproductive health services, we recommend the integration of preconception health services in the various settings where women with OUD present. Special considerations include medication for OUD and the testing and treatment of sexually transmitted infections. Finally, a description of our current work that includes adaptation of a motivational interviewing intervention is discussed, with the aim of improving reproductive health and pregnancy outcomes among women with OUD and their infants.