You might have some pains during pregnancy as the body adjusts to the growing baby. While mild aches can be managed with non-medical measures such as adequate rest, exercise, massage, or a hot shower, physiotherapy, some become chronic and affect the to-be mom’s physical and mental well-being. During such times, painkiller medications seem to be a viable option.
But is it safe to take painkillers during pregnancy? If yes, then what painkillers are safe for pregnant women? Read on as MomJunction tells you when you can take painkillers during pregnancy, and also gives you the safety profile of various pain medications.
Is It Safe To Take Painkillers During Pregnancy?
Pregnant women should avoid taking medications unless it is absolutely necessary. In situations of chronic pain and medical conditions like migraine, you can take certain pain medications but after talking to the doctor about the frequency and dosage.
Over-the-counter (OTC) pain medications might have components, which may not be safe during pregnancy. So, always check with your doctor before taking a pill to alleviate pain.
Can Painkillers Affect Your Pregnancy?
An animal study by the University of Edinburgh and Copenhagen University Hospital suggested that the long-term usage of painkillers during pregnancy can alter the DNA formation in the baby, which could affect their future fertility. This research, however, did not consider the influence of other factors. The study ‘raises concerns’ and recommends the use of painkillers with caution during pregnancy (1).
Which Painkillers Can You Take When Pregnant?
Pharmaceutically, painkillers are classified into two categories — systemic non-opioid (over-the-counter painkillers) and opioid analgesics. Let us look at the safety profile of various drugs from each group.
1. OTC Painkillers/ non-opioid analgesics
Most of the drugs, which fall under this category, are sold as OTC medications. However, not all OTC drugs can be taken during pregnancy. So, read the labels carefully and seek your doctor’s advice before using any of the below painkillers.
Acetaminophen (Tylenol): Also known as paracetamol, acetaminophen is considered the safest painkiller during any stage of pregnancy. Data from the US National Birth Defects Prevention study found out that single-ingredient-acetaminophen used during the first trimester did not increase the risk of any major birth defects.
The study also stated that it might decrease the risk of selected malformations when used for febrile illness (2). However, some studies suggest that long-term usage of acetaminophen during pregnancy can increase the risk of attention deficit hyperactivity disorder (ADHD) in the child (3).
Nonsteroidal anti-inflammatory drugs (NSAIDs): Drugs like ibuprofen (Mortin, Advil), naproxen (Aleve, Naprosyn), and ketorolac fall under this category. According to a scientific impact paper by the Royal College of Obstetricians, NSAIDs, such as ibuprofen, should be avoided within the first trimester and after 30 weeks of gestation unless prescribed by the doctor. Studies found that the use of ibuprofen during the first 30 weeks of pregnancy might increase the risk of miscarriage, heart problems, gastrointestinal (digestive) problem in the baby, and reduced quantity of amniotic fluid (4).
Aspirin: It is not advised to take aspirin as a painkiller during pregnancy unless your doctor prescribes it. Aspirin, when used in the later stages of pregnancy, may cause premature closure of fetal ducts, delay labor, and childbirth (5). So, it is safe to avoid aspirin for pain during pregnancy.
2. Prescription painkillers/ opioid analgesics
Drugs that fall under this category are sold only on prescription.
Drugs like morphine, hydromorphone, hydrocodone, codeine, and oxycodone are known as opioid analgesics. Studies indicate that the use of these drugs during pregnancy has not been linked with an increased risk of major or minor malformations (6).
However, the US Center for Disease Control and Prevention (CDC) found that women who took NSAID and opioid pain medicines during the early stages of pregnancy could have babies with birth defects such as gastroschisis (holes in the baby’s abdominal wall), cleft palate, spina bifida (developmental abnormalities in the spinal cord), and congenital heart defects (7). They may increase the possibility to produce a premature birth, or preterm labor or a stillbirth.
Also, prolonged usage of these drugs, especially in the latter stages of pregnancy, might pose a risk of maternal addiction and neonatal withdrawal (6). producing neonatal abstinence syndrome or NAS (too small baby or baby with breathing problems). So always check with your doctor before taking these pain medications.
Precautions To Be Taken When Consuming Opioid Painkillers During Pregnancy
If your doctor prescribes these opioid painkillers during pregnancy, then:
- Discuss with your doctor to take the lowest, effective dose for the shortest period.
- Adhere to the doctor’s instructions regarding the dosage of these medicines.
- If you have observed any side effects, then contact your doctor.
- Your doctor might monitor the impact of medications on the growing baby (8).
Can Painkillers Cause Miscarriage?
Some NSAIDs, such as ibuprofen, diclofenac, and misoprostol, may cause miscarriage, serious bleeding, or premature birth if taken during pregnancy (9).
Quitting Painkillers When Pregnant
If you have been using OTC painkillers and found out that you are pregnant, then talk to your doctor about it and stop their use if advised by them.
Opioid painkillers should not be discontinued abruptly as that can have an adverse effect. Consult your doctor and discuss how to taper the dosage and duration of these medications, and stop the medication gradually (8).
Pain during pregnancy can cause certain discomfort, but it is not wise to pop painkillers until it is necessary. Try non-drug measures such as relaxation, breathing exercises, massage, hot douches, etc., to manage mild pain and visit a doctor if these alternatives are not helping. Use painkillers only if your doctor prescribes them.
What is your take on having painkillers during pregnancy? Share your views with us in the comment section below.
2. Feldkamp ML, Meyer RE, Krikov S, Botto LD; Acetaminophen use in pregnancy and risk of birth defects: findings from the National Birth Defects Prevention Study; NCBI (2010)
3. Prenatal Exposure to Acetaminophen and Risk of ADHD; AAP
4. Can I take ibuprofen when I’m pregnant?; National Healthcare System
5. Prescribing medicines in pregnancy; Australian Drug Evaluation Committee
6. Malaika Babb, PharmD, Gideon Koren, MD FRCPC FACMT, and Adrienne Einarson, RN; Treating pain during pregnancy; NCBI (2010)
7. Use of Pain Medicine During Early Pregnancy May Be Related To Birth Defects; Centers for Disease Control and Prevention
8. Pregnancy and Opioids; MedlinePlus; US National Library of Medicine
9. Diclofenac and Misoprostol; MedlinePlus; US National Library of Medicine
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