Note: The Pregistry website includes expert reports on more than 2000 medications, 300 diseases, and 150 common exposures during pregnancy and lactation. For the topic Prescription Opioids, go here. These expert reports are free of charge and can be saved and shared.
You would think by now that all pregnant women would be aware of the danger from opioid medications during pregnancy. Certainly, doctors must be aware. However, a report from the Centers for Disease Control and Prevention (CDC) is a warning that too many women are still getting opioid prescriptions, endangering their pregnancies and their babies.
According to pharmacy and health insurance data, up to 22 percent of women fill at least one prescription for an opioid during pregnancy. The new report is in the CDC’s July 2020 Morbidity and Mortality Weekly Report (MMWR). The MMWR reports on a 2019 survey of over 20,000 pregnant women in 32 different areas of the country.
Other Findings From the Report
This report adds that among women who self-reported the use of a prescription opioid during pregnancy, over 20 percent got their opioid without a valid prescription, including using pills from an old prescription or using someone else’s medication. That adds up to a significant number of women taking prescription opioids during pregnancy.
The report also found that over 30 percent of women who received an opioid prescription from a health care provider did not receive any warning or counselling about the dangers of opioids during pregnancy. Women at highest risk for using a prescription opioid also smoked during pregnancy or had depression. Close to 30 percent of women who reported using prescription opioids wanted or needed help to stop using them.
What We Know About Opioids During Pregnancy
Women who received a prescription from a health care provider without counselling were not told these dangers of opioids during pregnancy:
- Having a baby born with opioid addiction and opioid withdrawal syndrome
- Birth defects of the brain and spinal cord
- Congenital heart defects
- Digestive tract defects
- Loss of pregnancy after 20 weeks (stillbirth)
- Preterm delivery (before 37 weeks)
According to the CDC, codeine and hydrocodone are the most frequently prescribed opiates during pregnancy. The most common reasons are surgical procedures, long-term diseases, and injuries. Opioids are also included in cough medications.
Weigh the Risks and Benefits
Although there may be times when the benefit of an opioid prescription outweighs the risks, it is always important to discuss these risks and benefits with your prescriber anytime, but especially during pregnancy.
The CDC and the American College of Obstetricians and Gynecologists recommend that doctors and pregnant women carefully discuss the use of opioids for long-term (chronic) pain management and seriously consider alternative therapies. Many studies now show that over-the-counter pain medications work as well for chronic pain as opioids. Doctors also need to consider the risk of opioid abuse. If you have a history of smoking during pregnancy, depression, PTSD, or anxiety disorder you may be at higher risk.
A final thought, if you have been using opioids with or without a prescription during pregnancy, you need to let your pregnancy care provider know. Opioid use that has caused dependence, which can develop quickly, may be difficult and dangerous to stop suddenly on your own. In some cases, it is more dangerous for a pregnancy than using the opioid. You can find out more about treatment of opioid dependence here.