Pain relief

What are the benefits of using painkillers in pregnancy?

Painkillers can help to keep you well and may prevent pregnancy complications. Pain can affect your quality of life and make it hard to sleep. If your pain isn’t managed, it can affect your mental health and may raise your heart rate and blood pressure.

What are the risks of using painkillers in pregnancy?

The risks depend on the type of painkiller and the stage of pregnancy.

Paracetamol is the medicine of choice for mild-to-moderate pain throughout pregnancy. It has been well-studied and has a good safety profile. 

For more information, please see the bump leaflet on Paracetamol.

NSAIDs, such as ibuprofen, diclofenac and naproxen might be prescribed by your doctor for use up to 20 weeks of pregnancy. You should not use any NSAIDs after 20 weeks of pregnancy as they may affect the wellbeing of your baby. 

For more information, please see the bump leaflets on Ibuprofen, Diclofenac, and Naproxen.

Codeine can be used throughout pregnancy if your doctor prescribes it. It is usually used if other treatment options have not worked or are unsuitable. If codeine is used around the time of delivery, it can cause withdrawal symptoms in the baby for a few days after birth. 

For further information, please see the bump leaflet on Codeine.

Opiates/opioids are a group of painkillers to treat severe pain and include morphine, tramadol, oxycodone, fentanyl, diamorphine, buprenorphine and meptazinol. If you are treated with an opiate/opioid during pregnancy you will usually be cared for by an obstetrician. Use of an opiate/opioid around the time of delivery may mean that your baby needs some help with breathing after birth. These medicines can also cause withdrawal symptoms in the baby which may require some short-term treatment.

For specific information, please see the individual bump leaflets on Morphine, Tramadol, and Fentanyl.

Neuropathic pain treatments
Neuropathic pain (nerve pain) is often severe and does not usually improve with standard painkillers such as paracetamol and ibuprofen. If you need treatment for neuropathic pain in pregnancy you will usually be cared for by an obstetrician and pain specialist. Medicines that may be used include amitriptyline (often tried first) and then possibly duloxetine, gabapentin, or pregabalin. 

Use of some of these medicines around the time of delivery can cause withdrawal symptoms in the baby which may require some short-term treatment. 

For specific information, please see the individual bump leaflets on Amitriptyline, Duloxetine, Gabapentin, and Pregabalin.

Are there any alternatives to taking a painkiller in pregnancy?

This depends on the severity of your pain and the underlying cause. Where appropriate, your doctor may initially recommend trying non-drug methods to improve pain, such as:
•    Relaxation and deep breathing techniques
•    Gentle exercise
•    Physiotherapy
•    Acupuncture
•    Application of hot and cold packs
•    TENS
•    Pain management programmes

What if I prefer not to take medicines in pregnancy?

If you want to avoid using medicines, you can use the non-drug methods described above to improve pain. However, if your pain is affecting your quality of life or sleep, then it is important to speak to your doctor about treatment options.