Key Content • • • • • The UK has one of the highest rates of opioid misuse in Europe, with dramatic escalation over the last decade Much of this drug use in women will coincide with childbearing age and continue into pregnancy Opioid misuse in pregnancy is associated with significant obstetric and neonatal complications Management of women with opioid misuse in pregnancy requires a multidisciplinary approach with specialist input from drug services Opioid substitution regimes with methadone or buprenorphine during pregnancy have been shown to improve perinatal outcomes and the woman’s compliance with care Learning objectives • • • To be familiar with the obstetric and neonatal complications that can arise as a result of opioid misuse in pregnancy; in particular, neonatal abstinence syndrome To appreciate the wider needs of women who misuse opioid medication and how we can support them during the antenatal, intrapartum and postpartum period To understand how opioid substitution regimes with methadone or buprenorphine can lead to an