What Happens If You Take Painkillers During Pregnancy?

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Pregnancy brings about several bodily changes that could sometimes be painful. While some women may consider popping a painkiller in pregnancy to soothe the pain, not all pain killer medications are safe during pregnancy. Moreover, mild pains and aches can be easily manageable with sufficient rest, a warm bath, physical exercises, massages, and physiotherapy.

However, painkiller medications may be recommended for expectant moms who suffer from long-lasting pains to lessen their discomfort and painful conditions. In any case, they should only be taken as per your doctor’s prescription.

Read on as we discuss the safety profiles of various painkillers and more details about taking these medications during pregnancy.

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:

  1. Discuss with your doctor to take the lowest, effective dose for the shortest period.
  1. Adhere to the doctor’s instructions regarding the dosage of these medicines.
  1. If you have observed any side effects, then contact your doctor.
  1. 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).

Any pain during pregnancy can cause significant discomfort to the expectant mother. However, it is not wise to pop painkillers during pregnancy for every pain you feel unless medically prescribed or necessary. Instead, you may try alternatives, such as massage, gentle exercises, and relaxation techniques like listening to music or meditating. If these strategies do not yield any results and the pain becomes chronic or severe, it is best to consult your doctor, who may suggest you the appropriate medications to relieve the pain and discomfort.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
1. Prescription Opioids in Pregnancy and Birth Outcomes: A Review of the Literature, ; NCBI
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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Dr. Irene (Eirini) Orfanoudaki

(PhD, MD)
Dr. Irene (Eirini) Orfanoudaki is a gynecologist-obstetrician, having a private practice in Heraklion, Crete, and collaborating with private health clinic 'MITERA' - Euromeda in Heraklion. With more than two decades of experience as a gynecologist-obstetrician, she specializes in ultrasound, colposcopy, minimal and advance gynecologic surgery, aesthetic gynecology, fertility consulting, menopause consulting, operative obstetrics, high-risk pregnancy, normal deliveries, antenatal, intra-parum, postnatal... more

shreeja pillai

Shreeja holds a postgraduate degree in Chemistry and diploma in Drug Regulatory Affairs. Before joining MomJunction, she worked as a research analyst with a leading multinational pharmaceutical company. Her interest in the field of medical research has developed her passion for writing research-based articles. As a writer, she aims at providing informative articles on health and pharma, especially related to... more

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