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Pain Relief During Pregnancy -- Which Painkillers Are Safe?

By Maureen Salamon

Updated March 02, 2009

(LifeWire) - Pregnancy and discomfort often go hand in hand. But when discomfort progresses to pain, what medications can expectant mothers use for relief? Luckily, safe painkiller options exist, but as with everything else during pregnancy, diligence is necessary.

Pain medications, also called analgesics, can be obtained either over-the-counter (OTC) or by prescription. Naturally, prescription-strength painkillers are usually more potent than OTCs, but they also present more potential dangers to the developing fetus. OTC analgesics, however, are not risk-free. Certain drugs in both categories can increase the likelihood of birth defects or complications during labor and delivery.

Here's a breakdown of pain relievers, along with guidelines for those safe to use and those that should be avoided during pregnancy. Be sure to consult your doctor before taking any medication during pregnancy, whether OTC or prescription strength.

OTC Painkillers

These come in two categories, based on their active ingredient:

  1. Acetaminophen, the active ingredient in Tylenol, is considered safe during pregnancy. Well researched by scientists, acetaminophen is used primarily for headaches, fever, aches, pains and sore throat. It can be used during all three trimesters of pregnancy.
  2. Nonsteroidal anti-inflammatory drugs (NSAIDs) include aspirin, as well as Advil or Motrin (ibuprofen) and Aleve (naproxen).

    Aspirin, which has salicylic acid as its active ingredient, should not be taken by expectant mothers because it can cause problems for both the mother and the fetus. Also, if aspirin is taken a day or so before delivery, it can lead to heavy bleeding during labor. There are occasions when aspirin may be prescribed for women who have certain other medical problems (such as preeclampsia, for risk of blood clots).

    Ibuprofen and naproxen are safer options, but both of these should be used with caution during pregnancy. They are considered safe in the first two trimesters, but they are ill-advised in the final three months because they can also increase bleeding during delivery.

    Prescription Painkillers

    The more common ones are categorized as opioids, which are derivatives of the poppy plant. All are considered narcotics, which are controlled substances and illegal to use without a doctor's authorization. Painkillers of this strength are typically used for intense pain resulting from injuries, surgery, dental work or migraine headaches.

    These analgesics are available in several different forms and brand names, including codeine (available without prescription in low doses in some states at pharmacies behind the counter), OxyContin (oxycodone), Percocet (oxycodone and acetaminophen), Roxanol (morphine), Demerol (meperidine), Duragesic (fentanyl) and Vicodin (hydrocodone and acetaminophen). Doctors allow the use of these drugs sporadically in pregnant patients when the benefits of the drug outweigh the potential risks.

    However, there is no known safe level of narcotic use during pregnancy. Risks to the fetus include miscarriage, stillbirth or premature delivery. At birth, the baby is also at increased risk of low birth weight (i.e., below 5.5 pounds), breathing difficulties and extreme drowsiness, which can lead to feeding problems.

    Sources:

    "Is It Safe for My Baby? - Pain Medications." camh.net. 28 Mar. 2008. Centre for Addiction and Mental Health. 9 Feb. 2009 <http://www.camh.net/About_Addiction_Mental_Health/Drug_and_Addiction_Information/Safe_Baby/safe_baby_substance_pain_meds.html>.



    "Medication Exposures During Pregnancy and Breastfeeding: Frequently Asked Questions." cdc.gov. 29 Oct. 2004. Centers for Disease Control. 3 Feb. 2009 <http://www.cdc.gov/ncbddd/meds/faqs.htm>.



    "Narcotic Painkillers." kaiserpermanente.org. 30 Oct. 2007. Kaiser Permanente Hospital Network. 9 Feb. 2009 <http://members.kaiserpermanente.org/kpweb/healthency.do?hwid=zx1135>.



    "OTC Medicines and How They Work." familydoctor.org. March 2008. American Academy of Family Physicians. 3 Feb. 2009 <http://familydoctor.org/online/famdocen/home/otc-center/basics/otc.html>.



    "OTC Products and Certain Patient Groups." aafp.org. 2009. American Academy of Family Physicians. 3 Feb. 2009 <http://www.aafp.org/online/en/home/publications/otherpubs/afpmonographs/otc/objectives/products.html>.



    "Over-the-Counter Medicines: What's Right for You?." fda.gov. 7 Mar. 2006. US Food and Drug Administration. 3 Feb. 2009 <http://www.fda.gov/cder/consumerinfo/WhatsRightForYou.htm>.


    LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Maureen Salamon is a New Jersey-based freelance writer whose work has appeared in a variety of online and print publications.

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