A Complete Guide to Inpatient Rehab For Pregnant Women

A Complete Guide to Inpatient Rehab For Pregnant Women

Learning you’re pregnant can bring a million emotions all at once, including hope, fear, excitement and panic (all of it). And if there’s substance use in the picture, it can seem a lot more overwhelming. Most people fear being judged, reported or told that they’ve already messed up. But what’s done is done, and seeking help is the bravest and right thing to protect both yourself and your baby. This is where inpatient rehabs for pregnant women play a vital role. 

What is Inpatient Rehab

Inpatient typically means you stay at the facility for some period of time,  sometimes a few weeks to a few months, while undergoing structured treatment each day. It’s also known as residential treatment. In the inpatient rehab system, you will receive a level of care that provides 24 hour support in a safe environment, which is crucial for pregnant women going through rehab. 

It differs from outpatient treatments where you live at your home and attend treatment sessions either daily or a few times a week. However, this setup doesn’t provide 24/7 medical care. 

Both setups have their pros and cons, and neither is better. The best option for you is the one that aligns well with your medical needs, safety and support system. 

When Is Inpatient Rehab The Best Option During Pregnancy

Inpatient rehab for pregnant women is usually recommended when one or more of the following apply:

• You are subject to withdrawal complications (particularly for opioids, alcohol or benzodiazepines)
• Home is not stable or safe. For example, pressure leading to substance use, unsafe relationships and housing instability
• You’ve done the outpatient thing before, but couldn’t keep going
• You require frequent medical oversight, medication assistance or pregnancy care management
• You’re suffering from mental health issues like crippling anxiety, depression, and symptoms of trauma.

Importance of Detox During Pregnancy

Withdrawal is hard enough in normal situations, but it can be dangerous during pregnancy for both you and your baby. Therefore, experts suggest not trying to quit addiction during pregnancy without medical advice. For opioid use disorders specifically, the CDC reports have shown that methadone and buprenorphine can be safe medications to prescribe during pregnancy and that treatment increases the likelihood of a healthy pregnancy. 

What you need is a program that can help you with medical professionalism and make treatment plans to address both addiction care and prenatal care simultaneously. 

What Can You Expect in Inpatient Rehab During Pregnancy

Every facility is different, but here’s what a good pregnancy-appropriate program generally looks like:

Intake and medical assessment 

As soon as you enrol on the program, you should expect a medical checkup, including medication review and all. Once done, the staff holds a screening for mental health issues like anxiety, depression, PTSD, etc. Then you will undergo pregnancy-related medical screening like OB care, prenatal vitamins, and labs if necessary. 

Once the initial assessment is done, your therapist will ask you about your aims and what feels safe for you. A good program always does more than just ask, ‘What are you using?’ They want to know: ‘What’s been happening in your life?’ and that makes all the difference

Stabilization

If the management of withdrawal symptoms is part of your management, the rehab facility will monitor your vitals and symptoms regularly while using pregnancy-safe protocols and coordinate with prenatal care providers. As we discussed before, if opioids are implicated, inpatient care might comprise initiating or continuing medications for opioid use disorder (MOUD), such as methadone or buprenorphine, both of which CDC and NIDA recommend during pregnancy.

Daily therapy that fits pregnancy and real life

Most inpatient rehab programs for pregnant women include:

• Private therapies for trauma, stress, triggers, and coping skills. 
• Therapist-facilitated support, relapse prevention and shame reduction groups
• Education sessions (on how addiction affects the brain, how to manage cravings, and how to create a plan)
• Family sessions (if safe and desired)

A pregnancy-specific program will also explicitly address things such as:

• Hormonal changes and, in turn, cravings
• Relationship dynamics and boundaries
• Toilet parturition prep
• Parenting support if you have children already

Factors to Consider Before Choosing A Program

Rehab treatment means you’re handing the control of your life to someone else. Therefore, you must ask direct questions even if someone thinks you’re being difficult. Here’s some important factors that you must consider before choosing a program. 

Find out how they’ll handle your medical and prenatal needs and ask if they have had any prior cases like yours. If yes, ask for the details regarding what therapy was given and how well the recovery was. Then what treatment approaches will they be using for you, and how will they adapt if you don’t get better by the initial approach? 

Also, ask for medical support in case of opioid dependency. Ask what their approach to MOUD in pregnancy is. If they’re shaming MOUD or calling it ‘replacing one drug with another’ that may be a red flag. 

What comes after inpatient treatment, and Why Postpartum Planning Matters

The postpartum experience is beautiful, but it can also be brutally hard. You not only crave more, but other cues can also lead to cravings that aren’t typically triggered by hunger, which is why a good program doesn’t kick you out with a handshake and a pamphlet.

You must look for a program that provides aftercare, including:

• An outpatient provider who knows you
• A plan to continue MOUD if you are already on it
• Counselling or mental health follow-up
• Peer support options
• Tangible help, if possible, with housing, transportation or child care

If any program doesn’t mention postpartum support, make sure to ask about it. If they don’t have an actual plan from the get-go, you’re better off choosing any other program that does. 

Bottom line

You don’t have to have it all figured out; you just have to take the next step. Just make sure that the inpatient rehab program you choose during pregnancy ticks all the right boxes before enrolling for one. 

References

• https://www.cdc.gov/opioid-use-during-pregnancy/treatment/index.html
• https://www.fda.gov/drugs/information-drug-class/information-about-medications-opioid-use-disorder-moud
• https://www.cdc.gov/maternal-infant-health/pregnancy-substance-abuse/index.html
• https://www.bjaed.org/article/S2058-5349(25)00076-9/abstract

Guest Article.