What you need to know about pain medication and pregnancy

March 15, 2019

According to the Centers for Disease Control and Prevention (CDC), more than 191 million opioid prescriptions were American patients in 2017. Prescription opioids are painkillers often used to treat pain after an injury or surgery. Codeine, oxycodone, hydrocodone and tramadol are some types of opioids.

Although opioids help treat and relieve pain, they also release chemicals in the brain that can make you feel calm and very happy (known as euphoria). This combined effect makes opioids highly addictive (easy to get addicted to). For women who are pregnant or thinking of getting pregnant, taking opioids can be dangerous to an unborn baby.

Opioids and preconception health

More than half of all pregnancies in the United States are unplanned. This means that lots of women may get pregnant without really being ready for it. If you’re taking a prescription opioid and not ready to get pregnant or planning to get pregnant, use effective birth control until you’re no longer taking the medicine. If you’re thinking about having a baby, tell your health care provider about any prescription opioid you take, even if it was prescribed to you by another provider. Don’t start or stop taking any prescription medicine without your provider’s OK.

Opioids can cause problems for your baby during pregnancy and after birth

Using opioids during pregnancy can cause babies to have withdrawal symptoms from the drug after birth. This is a condition called neonatal abstinence syndrome or NAS, and it’s a growing problem in the United States. Signs and symptoms of NAS may include:

  • Body shakes (tremors), seizures (convulsions), overactive reflexes (twitching) and tight muscle tone
  • Fussiness, excessive crying or having a high-pitched cry
  • Poor feeding or sucking or slow weight gain
  • Breathing problems, including breathing really fast
  • Fever, sweating or blotchy skin
  • Trouble sleeping and lots of yawning
  • Diarrhea or throwing up
  • Stuffy nose or sneezing

Using opioids during pregnancy may cause other problems, too, including:

If you’re breastfeeding and are using prescription opioids for pain relief with your provider’s supervision, you can still breastfeed depending on the medicine you take. Make sure the provider who prescribes you the opioid knows you’re breastfeeding. Take the medicine exactly as your provider tells you to, and ask about switching to a safer pain reliever.

Opioid use disorder

Addiction to opioids is called an opioid use disorder. Most people who take prescription opioids don’t become addicted to them. But you may have an opioid use disorder if:

  • You take more opioids than your provider says you can take.
  • You have cravings (a strong desire) for opioids.
  • You have problems at home, work or school caused by taking opioids.

Quitting opioids suddenly (also called going cold turkey) during pregnancy can cause severe problems for you and your baby. If you’re pregnant and taking opioids, don’t go cold turkey without talking to your health care provider. Quitting opioids suddenly may increase your risk of placental abruption, growth problems in your baby, and stillbirth.

Visit the CDC’s Treating for Two: Safer Medication Use in Pregnancy initiative, for more information about medication use during pregnancy.