According to the Centers for Disease Control, nine in 10 women in the United States take medication during pregnancy. Whether it’s prescription or over the counter, many pregnant women wonder about pregnancy-safe pain relief: Which medications are safe to take when you’re pregnant? Which should be avoided? Do we really know?
You’ve likely noticed that the FDA doesn’t require pregnancy categories be published on product labels for over-the-counter medications, which makes it hard to navigate the pharmacy shelf when you’re experiencing pain and need relief. Unfortunately, many medications haven’t been tested for their effect on pregnancy. According to one report, 90 percent of the medications approved by the FDA from 1980 to 2000 did not have sufficient data to determine whether they’re safe for expectant or breastfeeding mothers to take. At the end of the day, taking medication during pregnancy may be safe for you, but the effects on your baby may not be fully understood by medical science.
That’s largely because pregnant women are poorly studied (they’re usually excluded from clinical trials), and on top of that, few researchers are comfortable pushing the limits of the risk line with such a population. At the same time, pregnant women tend to experience more pain, which makes the question of pregnancy-safe pain relief even more acute. Some women find their migraine symptoms abate during pregnancy, while others have worse migraines than before pregnancy. Some women experience round ligament pain, rib pain (hello, kicking baby!), and a whole host of other ailments.
Note, too, that risk is different depending on one’s stage of pregnancy, and different risks are carried when nursing as opposed to while pregnant (which we’ll unpack in a separate piece). It’s worth noting that no medicine can be considered 100 percent safe.
Pregnancy-safe pain relief based on trimesters
A medication’s risk can vary based on how far along you are in your pregnancy. In short, some medications can increase risk of miscarriage if taken in the first trimester. Others impact fetal development based on what’s happening with your babe. And still others are to be avoided in the third trimester because they can impact labor and delivery. The bottom line is that pain-relief medications enter your bloodstream in order to do their jobs, and they can then be carried through the placenta and impact your developing babe.
Pregnancy risk categories
Since 1979, the FDA has classified medication into categories A, B, C, D, and X based on their so-called pregnancy risk, often boiling down to how well a medication was studied and whether it was known to cause birth defects if used during pregnancy. Although the FDA replaced these guidelines in 2015, they’re still pretty commonly referenced. So we’ll describe them in brief here:
- Category A: Medicines classified as Category A pose no risk to the fetus in the first trimester of pregnancy (and there’s no evidence of risk later in pregnancy, either.)
- Category B: Animal studies have failed to demonstrate Category B medications as posing a risk to the fetus, but there aren’t any well-controlled studies in pregnant women.
- Category C: Animal studies have shown an adverse effect on the fetus. Although there aren’t any adequate studies in humans, potential benefits of the drug may outweigh the potential risks.
- Category D: Investigational or marketing studies in humans have found positive evidence of human fetal risk, but potential benefits may warrant use of the drug despite potential risks.
- Category X: Studies in animals and/or humans have demonstrated fetal abnormalities and/or fetal risk. The risks involved clearly outweigh potential benefits.
It’s also important to note that these categories are assigned at the time of marketing approval—and are not updated as new studies are done.
When researching pregnancy-safe pain relief or other types of medication you can take during your pregnancy, always talk to your doctor first. Don’t start a new medication, even if it’s over the counter, without clearing it with your OB-GYN. This article is not a replacement for medical advice.
In this article, you’ll find publicly available info on what pain medications are safe to take while pregnant. As always, we believe being informed can empower you to make the best choices for you and your baby—and even to ask the right questions of your medical provider. Here’s an overview of this important pregnancy health topic.
Natural pain relief remedies
First, you might want to consider some of the many natural remedies for pregnancy-safe pain relief. Unless you have underlying health conditions or allergies, these remedies are safe for any phase of your pregnancy:
- Ginger for nausea and stomach cramping
- Gargling with salt water for a sore throat
- Witch hazel for skin irritations and hemorrhoids
- Hot baths for stiff muscles and cramps
- Ice packs and heating pads for general aches and pains
If you have a doula, she can also assist you with natural home remedies. Although natural remedies are no substitute for medication, you may be able to find pregnancy-safe pain relief from many common ailments without visiting the pharmacy.
Increasing your exercise—if you’re able—can also reduce the likelihood of needing medications during pregnancy. Try to get at least 20 minutes of cardiovascular exercise each day, such as walking or jogging. Activities like yoga are also great hobbies to adopt, which you can continue to practice during your pregnancy.
Medications thought to be safe
If you need to take medication while pregnant, WebMD offers a helpful list of over-the-counter brands. Currently, these medications are classified as Category A:
- For headache: Tylenol aka acetaminophen
- For heartburn: Maalox, Mylanta, TUMS, Gaviscon, Riopan, Titralac
- For first aid: Neosporin, Bacitracin, J & J
This is not a comprehensive list of pregnancy-safe pain relief and medications. As more medicines are studied for their effects on pregnancy, this list may change. However, the current data about the above medicines suggests that they do not have adverse effects on pregnancy. Again, always consult with your doctor before starting a new medication.
Pain-relief medicines to avoid while pregnant
Finally, according to WebMD, here are some common medications to avoid while pregnant. Unless otherwise directed by your doctor, common advice is to avoid these medicines:
- Aspirin
- Ibuprofen (Advil, Motrin)
- Naproxen (Aleve)
- Ben-Gay/menthol topicals and patches
A note on pregnancy-safe pain relief
Unfortunately, there is so much that’s unknown about pregnancy-safe pain relief and what kind of impact certain medications may have on your baby. Although there aren’t a lot of studies being performed on medications and pregnancy, data is constantly changing.
If you’re not pregnant yet but you and your partner are trying to conceive, it’s a good idea to make an appointment with your doctor to talk about any prescription medications you’re already taking. If one of these medications will negatively impact you or your baby, your doctor can help you explore other options. They may change your prescription or wean you off the medication before you become pregnant. For one woman’s story about what she wished she’d known about meds for her chronic pain, click here.
Ultimately, speak with your doctor if you’re concerned about a particular medication and work with him or her to make the choice that’s right for you and your baby.
Disclaimer: The information herein is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment.