ects that medicines, recreational drugs, and chemicals may have on the developing baby during pregnancy.

General information

Pain in pregnancy is joint. There are no specific guidelines on the treatment of pain in pregnancy. If a painkiller (sometimes call an analgesic) is require, the choice will depend on the type and severity of the pain and the stage of pregnancy. A doctor may assess your pain on a scale to help you decide the most suitable treatment. Pregnant women with long-term conditions associate with pain may care for by a specialist.

For specific information on the treatment of migraine in pregnancy, please see the bump leaflet on migraine.

Is it safe to use painkillers in pregnancy?

When deciding whether to use a painkiller during pregnancy. It is essential to weigh up how necessary the treatment is against any possible risks to you or your baby, some of which might depend on how many weeks pregnant you are. The non-steroidal anti-inflammatory drug (NSAID) family of painkillers (including ibuprofen, naproxen, and diclofenac) is not suitable for use in the third trimester of pregnancy (see below).

Other painkillers, such as paracetamol and Codeine, can safely use anytime during pregnancy.

What are the recommend treatments for pain in pregnancy?

It is mainly dependent on the type and severity of the pain.

Mild/moderate pain

Where appropriate, your doctor may initially recommend trying non-drug treatment options, such as:

• Relaxation, deep breathing techniques
• Gentle exercise
• Physiotherapy
• Acupuncture
• Application of hot and cold packs
• TENS

• Pain relief management program

Paracetamol is regard as the medicine of choice for mild-to-moderate pain relief in pregnancy. It has a good safety profile base on many pregnant women study. Although possible links with autism and ADHD in children expose in the womb have suggest, these findings are consider by some experts to unconvincing and remain unproven. For more information, please see the bump leaflet on Paracetamol use in pregnancy.

NSAIDs doctors might prescribe NSAIDs such as ibuprofen, diclofenac, and naproxen in the first and second trimesters. NSAIDs should not use after 30 weeks of pregnancy as they may affect the baby’s well-being. For more information, please see the bump leaflets on Ibuprofen, Diclofenac, and Naproxen.

Codeine has several side effects, and its use in pregnancy, especially in the weeks leading up to delivery. It can result in withdrawal symptoms in the baby after birth. It may, therefore, only offer by your doctor if the previous treatment options have not work, are not suitable for you, or could not use, Further information on the fetal effects of use in pregnancy can found in the bump leaflet on Codeine Codeine.

Severe pain

Opiates/opioids

The opiate/opioid family of painkillers (including morphine, tramadol, oxycodone, fentanyl, diamorphine, buprenorphine, and meptazinol) relieve severe pain, and some are use during labor. Repeat use can lead to these drugs becoming less effective, and they are also addictive. However, their use may considered necessary by some people. Pregnant women who require ongoing treatment with opiates/opioids will usually care for by an obstetrician. Only small numbers of pregnant women taking these medicines have study. When deciding whether to use an opiate/opioid during pregnancy, your doctor will help you weigh the benefits of treatment against any possible risks to you and your baby. Use of any opiate/opioid medicine around the time of delivery may mean that the baby needs some help with its breathing after birth and can cause withdrawal symptoms in the baby which may require some short-term treatment.

For specific information on using some of these medicines in pregnancy, please see the individual bump leaflets on morphine, tramadol, and fentanyl.

Treatment of neuropathic pain in pregnancy

Neuropathic pain (nerve pain) is often severe and is generally not relieve by standard painkillers such as paracetamol and ibuprofen. Conditions that because neuropathic pain include diabetic neuropathy, shingles, and sciatica. There are no specific guidelines for treating neuropathic pain in pregnant women. Treatment should usually overseen by an obstetrician and pain specialist, and medication options may include amitriptyline (usually offer first) and possibly duloxetine, gabapentin, or pregabalin. Amitriptyline is quite commonly use in pregnancy, whereas duloxetine, gabapentin, and pregabalin are less widely use to pain relief in pregnancy.

When deciding which medicine to use, your doctor will help you weigh the benefits of each treatment against any possible risks to you and your baby. Using some of these medicines around delivery can cause withdrawal symptoms in the baby, which may require some short-term treatment. For specific information on these medicines, please see the individual bump leaflets on amitriptyline, duloxetine, gabapentin, and pregabalin.

What if I have already use a painkiller during pregnancy?

Paracetamol is the painkiller of choice for pregnancy, and it does not require medical supervision. It is not uncommon for women to have use other painkillers early in pregnancy before finding out they are pregnant. This type of use is not expect to harm the baby. Women who take an NSAID long-term and become pregnant must consult their doctor as, if possible, their medicine must alter before week 30 of pregnancy. 

Pregnant women with long-term pain and specific pain conditions should consult their doctor about appropriate pain relief options. Women taking opiates/opioids and painkillers for neuropathic pain around delivery may advise to have their baby at a hospital with facilities for treating the baby after birth for any withdrawal symptoms.