Pregnancy is often associated with discomfort and pain. Some painkillers, also called analgesics, are safe to take during pregnancy. However, they should be used with caution. Dosage and timing while taking pain medication are important.
Some painkillers may be safe during a particular trimester, whereas others may be safe during other times during pregnancy. Some medications can cause birth defects or serious and even fatal complications for both mother and baby.
Uses and risks of painkillers during pregnancy
Acetaminophen is available OTC and generally safe to use during pregnancy, although you should talk to your doctor before taking them. It can primarily be used for headaches, fever, aches, pains, and sore throat.
However, some studies have shown there is an increased risk of behavioral problems in the child. The child may have attention deficit hyperactivity disorder (ADHD), autism, etc. if you have been taking large amounts of acetaminophen during pregnancy.
Nonsteroidal anti-inflammatory drugs (NSAIDs) include aspirin, ibuprofen, naproxen, etc. Ibuprofen and naproxen are also available OTC and have a lower risk of gastrointestinal symptoms and other side effects. They are considered safe up to 20 weeks of gestation. All NSAIDs, however, must be avoided in the second half of pregnancy.
The FDA recommends avoiding NSAIDs after 20 weeks of pregnancy because it can result in low amniotic fluid volume (the fluid surrounding the baby in the uterus). This condition is called oligohydramnios. If oligohydramnios occurs, the amniotic fluid levels generally return to normal. However, NSAIDs can cause complications for the fetus, such as kidney, heart, or developmental problems. These complications can be fatal.??
Both ibuprofen and naproxen should be used with caution during pregnancy and only after consulting with your doctor.
Aspirin is usually not recommended during pregnancy unless specifically prescribed by your doctor.
Aspirin may sometimes be prescribed to treat certain other medical problems during pregnancy, such as preeclampsia (high blood pressure and signs of damage to another organ system, such as increased urine protein levels.) Daily low dose aspirin after the 12th week of pregnancy is considered safe and effective. It can prevent complications in pregnant women who are at the risk of preterm labor due to preeclampsia, decreasing the risk of fatal blood clots.
Strictly following your doctor’s instructions regarding dosage and timing is crucial. If aspirin is taken a day or so before delivery, it can lead to heavy, uncontrollable bleeding during labor.
Stronger prescription painkillers
Stronger prescription painkillers are categorized as opioids, which are considered narcotics. These painkillers are only prescribed for intense pain due to injuries, surgery, dental work, or intense migraine headaches during pregnancy.
Some prescription analgesics in this category include codeine, OxyContin (oxycodone), morphine, fentanyl, hydrocodone, etc. These drugs are rarely prescribed due to their potential risks, such as miscarriage, premature birth, low birth weight, stillbirth, and breathing problems in the baby. They are used only when the benefits of the medication outweigh the potential risks.
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Price HR, Collier AC. Analgesics in Pregnancy: An Update on Use, Safety and Pharmacokinetic Changes in Drug Disposition. Curr Pharm Des. 2017;23(40):6098-6114. https://pubmed.ncbi.nlm.nih.gov/28847300/