Pain Medication While Pregnant: Everything You Need to Know

Along with the many joys of pregnancy comes a plethora of aches and pains like none you’ve ever experienced before. Your body is creating a new normal as it adapts to accommodate another whole person within. Even before the baby has reached an impressionable weight, it is natural to feel subtle pains such as headaches, back pain, pelvic pain and soreness of the breasts early on in pregnancy because of all the changes happening inside of you.

Before you reach into the medicine cabinet for your usual pain medication though, you may wonder: is it safe to take pain medication while pregnant? Just as you’ve had to adjust your pregnancy diet to protect the growing human inside of you, you may have to adjust your own tried and true pain relief methods.

Today we are looking at three common over the counter medications used for pain relief to help you find a safe pain medication in pregnancy that works for you.

By: Dr. Tara Kelly, MD & Dr. Adam Brown

Is Ibuprofen Safe During Pregnancy?

No, Ibuprofen is not a safe painkiller in pregnancy.

Ibuprofen can affect the development of the baby’s kidneys, especially during the second and third trimesters, and can lead to a reduction in the amount of amniotic fluid that surrounds and cushions the baby. This, in turn, can affect the development of the baby’s lungs and respiratory system.

Near term, Ibuprofen can lead to premature closure of what is known as the patent ductus arteriosus, an important part of the fetal heart and circulation, making the end of pregnancy an especially important time to avoid ibuprofen, or other non-steroidal anti-inflammatory medications (NSAIDs).

Ibuprofen has also been shown in multiple experiments to be associated with low birth-weight and asthma in 18-month-olds (Nezvalova-Henriksen et al., 2013). The association was even stronger late in pregnancy (second or third trimester) between Ibuprofen use and these serious side effects.

Don’t Be Fooled by the Brand Names

The following pain medications are simply Ibuprofen branded under a different name, and should also be avoided during pregnancy:

  • Advil
  • Motrin
  • IBU

What Pain Medication Can I Take While Pregnant?

The exercise guidelines discussed in this article are generally based on a moderately healthy mother of average weight. Guidelines will be different for an overweight or obese person. This must be taken into consideration before starting or continuing physical activity while pregnant.

Acetaminophen

Acetaminophen is safe to take while pregnant to relieve pain.

If you’ve heard differently, that might be because a number of researchers have set out to understand acetaminophen’s relationship to birth defects and future behavioral problems in childhood. For example, in one study, experimenters looked at the effects of acetaminophen and its possible relation to spina bifida and cleft palate as well as heart and eye disorders. In the study, it was found that there was NO correlation between these specific abnormalities, as well as others, in 26,424 children whose mothers took acetaminophen (Rebordosa et al., 2008).

Prescription Pain Medication During Pregnancy

Occasionally, your doctor may prescribe stronger pain medications during pregnancy, such as opioid medications. Some examples of opioid medications are Tylenol with codeine, oxycodone or hydromorphone. Generally speaking, these medications would only be prescribed for you if your doctor feels that the benefits outweigh any risks to the pregnancy, such as in the management of pain after surgery.

There is some concern regarding long term (greater than a one month duration) opioid use in pregnancy leading to neonatal withdrawal syndrome, but this is very unlikely if these medications are used as prescribed by your physician.

Risks of short term opioid use in pregnancy are less clear. Some scattered and small studies suggest a possible increased risk of neural tube defects (spina bifida), but these studies are mostly animal-based studies and are of poor quality. Currently, the FDA warns against interpreting any of these studies as representative of a true risk association. More research needs to be done in this area.

In Conclusion

Skip Ibuprofen for pain relief during pregnancy, especially in the second and third trimesters. Stick with acetaminophen. Acetaminophen is a decent alternative for Ibuprofen and even diclofenac to relieve pregnancy aches and pains.

Sources

  1. Nezvalova-Henriksen, K., Nordeng, H., Spigset, O. (2013). Effects of ibuprofen, diclofenac, naproxen, and piroxicam on the course of pregnancy and pregnancy outcome: a prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 120(8), 948-959.
  2. Czeizel, E., Kogevinas, M., Morales, M., Nørgård, B., Olsen, J., Puhó, E., Rebordosa, C. (2015). Acetaminophen use during pregnancy: effects on risk for congenital abnormalities. American Journal of Obstetrics and Gynecology, 198(2), 178.e1-178.e7.
  3. FDA Drug Safety Communication: FDA has reviewed possible risks of pain medication use during pregnancy. US Food and Drug Administration, 2015.