Ready for some crazy stats? One in five women have taken an opioid (a heavy-duty painkiller like codeine or hydrocodone) during pregnancy, according to a recent Obstetrics & Gynecology study that looked at pregnant Medicaid recipients. And 14 percent of of commercially-insured women did the same, according to a study published in Anesthesiology.
“Opioids may double the risk of neural tube defects, like spina bifida,” says Keith Eddleman, M.D., director of obstetrics at The Mount Sinai Hospital in New York City. These painkillers are especially risky early in pregnancy: “Defects happen when the ends of the neural tube fail to close at around 23 to 28 days of embryonic life,” says Dr. Eddleman. (Almost 40 percent of the women who took an opioid in the Anesthesiology study did so in their first trimester. Yikes.)
FYI: The neural tube is the hollow structure of cells that eventually make up your baby's brain and spinal cord. Neural tube defects are birth defects of the brain, spine or spinal cord, and they occur in the first month of pregnancy. These defects can also include anencephaly (when part of the brain doesn’t develop), which usually results in a stillborn baby or a baby who dies shortly after birth.
The million-dollar question: If we know that these painkillers put babies at risk, why are doctors prescribing them? Dr. Eddleman has a theory, especially considering one of the study's related findings: “There was a disparity between opioid use in the Northeast versus the South, suggesting that it’s more culturally acceptable to take these medications in some parts of the country than others.” There’s no reason to believe that women in the South (where opioids were the most common) have more pain than women in the Northeast (where opioids were the least common), he says.
Luckily, opioids aren’t the only way to relieve the pain and discomfort that comes along with pregnancy. Consider heat and physical therapy for back pain, take frequent breaks from standing or sitting for sciatica pain (lying down takes pressure off of the nerve), and go for a prenatal massage, suggests Dr. Eddleman.