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We really don't know. Opioid pain relievers are sometimes prescribed for short periods during pregnancy. For example, if you get injured or need to have surgery during pregnancy, your doctor may prescribe an opioid during your recovery.
Discuss the risks and benefits of the medication with your doctor to come up with a plan for pain relief that best meets your needs. Some doctors may have you try nonopioid pain relievers first, adding opioids only if those medications are not sufficient to relieve your pain. You may also want to try heat, cold, and other pain management therapies.
If you do take opioids, it's important to use them with caution because they can be addictive. Taking them at too high a dose or for too long during pregnancy increases your risk of becoming dependent on or addicted to them.
If that happens, your baby may go through withdrawal from the drugs after birth. Symptoms may last days or weeks and may include tremors, irritability, poor sucking reflex, and trouble sleeping. This is called neonatal abstinence syndrome (NAS).
Experts warn that there are likely to be other negative effects from untreated prescription opioid addiction during pregnancy, although no good studies have yet proven any. A recent literature review cautions that addiction to prescription opioids could lead to many of the same serious problems as addiction to street narcotics, such as heroin. These include:
- Miscarriage or stillbirth
- Placental abruption or placental insufficiency
- Preterm labor or birth
- Birth defects, including heart defects and spina bifida
- Fetal growth restriction
- Low birthweight
(If you are addicted to opioids during pregnancy, it's not safe to stop taking them abruptly. The American College of Obstetricians and Gynecologists – ACOG – recommends that you get into a treatment program to help you transition to a medication like methadone or buprenorphine that will prevent opioid withdrawal symptoms that can harm you and your baby. This is called opioid agonist therapy.)
According to ACOG, a cautious approach to prescribing opioids should be balanced with the need to address pain in pregnant women. Concern about opioid misuse or NAS is not a reason to avoid treating acute pain with these medications during pregnancy.
If you follow appropriate precautions and take only as much opioid medication as you need to control your pain, you're less likely to cause problems for your baby or become addicted to the drug. See our article on precautions to take if your doctor prescribes you an opioid medication when you're pregnant.