Pregnancy is a special time during your life, but let’s face it, being pregnant can be really uncomfortable at times. If you need to take pain medication during pregnancy, you should try to find out the root cause of what is causing your pregnancy pain, as well as considering the safety of your baby.
Pregnancy lasts for three quarters of a year. In any given year, injuries and illness can occur, and unfortunately being pregnant doesn't make us exempt from them.
Ideally, pregnant mothers want to avoid pain medications, but sometimes that isn't an option.
Pain Medication During Pregnancy
Learning about your pain relief options – both medicinal and natural – and the benefits and risks of each can help you make an informed decision. Here are some of the most common reasons you might seek out pain medication during pregnancy, listed by trimester.
Pain In The First Trimester
During early pregnancy, your body changes rapidly, as your baby implants and begins growing and developing. Pain you could experience during this time might be:
- Tenderness of the breasts
- Uterus stretching
- Corpus luteum cyst, which may have formed after your ovary released your egg
In most cases, these pains are short lived and will go away. If you need relief you could try heat therapy, massage or even relaxation therapy. Seek medical assistance if you have severe pain, bleeding, pain with fever or if you have any concerns.
Is pregnancy massage safe in the first trimester?
Sarah Goldberg, massage therapist of 17 years, doula and childbirth educator says absolutely yes. “Pregnancy massage is safe in the first trimester, but only with a qualified pregnancy massage therapist who can provide safe and effective massage. Many clients come to me after seeing other therapists who were too afraid to apply any pressure, so they found it didn't provide any relief. It's so important to be nourished and nurtured during pregnancy, but only with someone who knows what they're doing and thoroughly understands the physiological changes a pregnant woman goes through.”
Pain In The Second Trimester
The second trimester is usually the time you feel the best but your body starts to stretch as your baby grows. This can cause pain when the ligaments in your abdomen and pelvis start to loosen and stretch. This will help your baby fit through your pelvis at birth, but it can literally be a pain during pregnancy!
Other pain you might experience:
- Aches and pains due to changes in sleeping posture
- Your centre of gravity shifting
- Ligaments and joints loosening and stretching.
Pregnancy-specific yoga, massage and gentle exercise can all help to alleviate these pains. Warm baths (add in two cups of epsom salt for extra relaxation, to boost your magnesium levels and to help with aches and pains) as well as heat packs can also be very soothing and comforting.
Pain In The Third Trimester
The last three months of pregnancy can be quite hard on your body and you may experience a lot of aches and pains. They include:
- Back ache as your belly grows
- Feet might be swollen and ache, as the joints loosen
- Carpal tunnel syndrome
- Sinus congestion
- Varicose veins
Pain in the third trimester should be discussed with your caregiver if it doesn’t ease. Therapies such as support belts or stockings, massage, acupuncture and osteotherapy may help relieve pain.
Many women are afraid to use pain medication during their pregnancy, and prefer to suffer than treat their pain. Some pre-existing conditions can be made more painful due to pregnancy, such as rheumatoid arthritis or injuries from past accidents. If the pain is ongoing and severe, it can lead to anxiety and increased stress.
What If I Need Pain Medication?
If you have an existing medical condition and pain presents as part of that condition, discuss a pain management plan with your doctor that takes into consideration your pregnancy and the safety of medication you are currently taking.
Current research into the safety of pain medication during pregnancy is limited and results are varied. Therefore, you should always discuss the use of pain medication with a health professional, or seek advice from a specialist in drug information and pregnancy. The InfantRisk Center at Texas Tech University Health Sciences Center seeks to keep up-to-date information regarding the safety of medication – a helpful resource for you and your maternity care provider.
Paracetamol – Also Known As Acetaminophen
Most widely used as pain relief in Australia, paracetamol is an over the counter (OTC) medication that treats mild to moderate pain and fever.
The mechanism of action of paracetamol is unknown, but we do know it can cross the placenta. Current evidence shows standard doses of paracetamol are safe to use during pregnancy and do not affect babies in utero.
Some data has shown a link between use of paracetamol and cryptorchidism (undescended testis in male babies) and caregivers should take this is into consideration if pain relief is required for long periods.
You should only use paracetamol at the lowest effective dosage for the shortest possible time. Never exceed the recommended daily dosage. You should see your caregiver if you are not receiving any pain relief, so you can discuss other options.
Ibuprofen – A Type of NSAID
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that works by reducing hormones that cause inflammation and pain in the body. It's used to treat mild to moderate pain associated with conditions such as toothache and fever.
Ibuprofen should only be taken during pregnancy on the advice of your doctor. During the first trimester, there is an increased risk of miscarriage, heart defects and other abnormalities such as cleft palate. During the second trimester, ibuprofen is believed to be safer but it is best to opt for paracetamol where possible.
It's not recommended to take ibuprofen during the last 3 months of pregnancy as the drug can cause premature closure of vessels in your baby’s heart, increasing the risk of high blood pressure.
The drug also acts on your baby’s kidneys and reduces their urine output. This can reduce the amount of amniotic fluid surrounding your baby. Ibuprofen during the last trimester can also delay the labour and birth of your baby.
Voltaren – Also Known As Diclofenac
Another NSAID, Voltaren is used to treat pain and reduce inflammation (swelling and redness). It may be used to treat types of arthritis, muscle strains and period pain, and is commonly offered as pain relief after giving birth.
Voltaren is available in different forms, such as tablets, creams and gel or suppositories. The active ingredient in Voltaren is diclofenac and it has the same risks as ibuprofen.
If you are pregnant and want to ease muscle aches and pain, you might like to try massage or acupuncture.
Aspirin For Pain And Low Dose Therapy
Not used as commonly used these days, aspirin belongs to the NSAID group of drugs and has similar risks as ibuprofen and Voltaren.
Usually used to treat mild pain and fever, aspirin is sometimes prescribed in low doses to women who have blood-clotting disorders that lead to miscarriage.
If you are at risk of developing pre-eclampsia, your doctor may prescribe low dose aspirin therapy.
Codeine For Pain And Colds
Used to treat moderate to severe pain, codeine is included in many OTC cough and cold medications and given for post surgery pain.
Evidence has shown the standard dosage use of codeine during pregnancy doesn’t increase risk of birth defects or other adverse outcomes. However, it may increase your risk of constipation, which you are already more prone to during pregnancy. See our self help tips for constipation.
The action of codeine is a mild narcotic. Prolonged use can lead to the mother becoming dependent on the medication and her baby suffering withdrawals after the birth. These symptoms include inability to breastfeed, tremors and digestive disturbances, particularly diarrhea. These symptoms have been seen in babies born to women who have used codeine at therapeutic doses during late pregnancy.
It may not be possible to get through pregnancy without some pain. Using non-medicinal methods of pain relief should be tried when possible. Always ask the advice of your midwife, doctor or pharmacist if you are considering pain medication for any reason during your pregnancy.