Pregnancy and Pain Management: New Mothers and Painkiller Use

Newswise — Nearly half of American women having a baby in the last decade received a prescription for a powerful opioid painkiller as part of their birth experience, a new study shows.

And one or two in every hundred were still filling opioid prescriptions a year later – especially those who received birth-related opioid prescriptions before the birth, and those who received the largest initial doses.

In a study of records from more than 308,000 women who gave birth from 2008 to 2016, researchers from the University of Michigan find the percentage of women filling opioid prescriptions in the days and months after giving birth declined over time. This may have resulted from growing awareness of the broader national epidemic.

But they note that there is still ample room for providers to adopt effective pain control strategies – for both vaginal and Caesarean births – that don’t include giving new mothers opioid pills if other pain treatments work for them.

Writing in the new issue of JAMA Network Open, U-M obstetrician and health services researcher Alex Friedman Peahl, M.D., and her colleagues explore opioid prescribing to women with private insurance who hadn’t received opioids for a year before delivering. They limited the study to women who didn’t suffer major birth complications or have any other procedures in the year after a birth.

“Overall, we see rates of opioid persistence higher than previously documented for women having C sections, at about two percent,” says Peahl. “For women who delivered vaginally, one-quarter received opioid prescriptions, although current guidelines call for a step-wise approach to pain management, starting with non-narcotic medications such as ibuprofen and acetaminophen. One percent of vaginal birth mothers were still receiving opioids months later.”

Peahl and her colleagues hope their findings bolster efforts by national groups to help birth care teams adopt opioid-sparing pain care methods. Birth care at Von Voigtlander Women’s Hospital, part of the U-M academic medical center Michigan Medicine, already includes such approaches.

Peahl says she tells her birthing patients, “Pain after birth is like a mountain: once you’re at the peak, it is harder to get down. Using non-narcotic pain medications before opioids can help better manage your pain by preventing you from reaching that peak.”

Alternatives to opioids

Peahl’s experience treating birth pain...

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