Pregnancy and Chronic Pain Management

Managing chronic pain while pregnant can be challenging. It becomes even more complex when deciding whether to forego the use of pain medication during pregnancy. The legitimate concern of taking pain medication during pregnancy is based on potential harm to the unborn child. However, untreated severe chronic pain is often not conducive to a healthy pregnancy either as it can cause high blood pressure, anxiety and depression.

Consulting a doctor

It is important to find a doctor and an obstetrician who will work collaboratively to provide the best care for the mother and the baby. Discerning if pain medications are safe to take during pregnancy is imperative; a health care provider should always be consulted. Also, a pregnant woman should not abruptly stop taking pain medication for chronic pain. Sudden discontinuation of these medications can cause harm to both the fetus and the mother. It is imperative that a health care professional is consulted for a proper tapering plan.

Over-the-counter pain medications

Some over-the-counter pain medications are considered safe during pregnancy; however, others pose health risks to the mother and baby.

• Acetaminophen at the standard dosage is generally considered safe during all stages of pregnancy; however, it is important to note that studies show that daily use of acetaminophen for an extended period (28 days or longer) during the second trimester of pregnancy increases the likelihood of wheezing or asthma in the child.
• Aspirin should not be used during pregnancy as it is linked to maternal and fetal bleeding and increases the risk of vascular disruption.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, should only be taken with the approval of a physician. They should be completely avoided during the last trimester due to an increased risk of premature closure of the blood vessels in the developing baby's heart, which induces high blood pressure in the baby's lungs. NSAIDs can also reduce the level of amniotic fluid that surrounds the baby, making it more difficult for the mother to go into labor.

Non-medicinal treatment options

Non-medicinal options are also available to help a pregnant woman manage pain. For instance, something as simple as eliminating personal pain triggers is beneficial. Other pain management options include massage therapy, chiropractic services, exercise, physical therapy, temperature therapy, and dietary changes. In addition, acupuncture is growing in popularity, and many find it relieves chronic pain during pregnancy. Yoga is also a good choice as it promotes healthy circulation and is generally safe for both mother and baby. Yoga is particularly effective in easing pain associated with the neck, back, and arthritic joints. It’s important to note that a health care professional should be consulted before implementing any new treatment into a pain management plan, especially during pregnancy.

Some women with autoimmune conditions discover that their pain levels naturally decrease during pregnancy. The immune system may be dampened so that the body does not see the fetus as a foreign object. The immune system may not act as it did before becoming pregnant which can reduce inflammation levels, resulting in reduced pain.

The bottom line

Chronic pain management during pregnancy should be discussed in detail with an obstetrician. A physician should be informed of any medications or herbal remedies a pregnant woman is either currently using or considering using. The goal is to implement a pain management plan that is safe for both mother and baby. If an obstetrician approves the use of over-the-counter pain medications during pregnancy, taking the lowest effective dose for the least amount of time possible is the safest option.