From Tylenol to Vicodin, an uptick in opioid prescriptions during pregnancy
To do pregnancy the “right” way, to follow all the rules and recommendations, requires sacrifice on the part of the expectant mother. The list of no-nos is long: caffeine, alcohol, ibuprofen, sushi, deli meat, soft-serve ice cream, runny egg yolks, skiing, stomach-sleeping . . . just to name a few.
One of the hardest parts for me when I was wading through my first pregnancy (besides forgoing the soft-serve and stomach-sleeping), was being limited to acetaminophen for the various and sundry aches and pains I encountered as my hips widened and my ligaments stretched. Having found Tylenol to be quite ineffective in my younger years, my M.O. was to grin and bear it. Advil or bust, was my attitude. But not all pregnant women have the same tough-it-out mentality. And when they complain to their physicians, they’re getting something a lot stronger than Tylenol.
An alarming rate
Despite a dearth of research regarding the impact of opioids on fetal health and safety, doctors are prescribing opioid narcotics to pregnant women at an alarming rate, primarily to treat back pain and abdominal pain.*
- Of 1.1 million pregnant women enrolled in Medicaid nationally, nearly 23 percent filled an opioid prescription in 2007, up from 18.5 percent in 2000, according to a study published in the journal Obstetrics & Gynecology. (Narcotics prescriptions for pregnant women were highest in Utah [42 percent] and Idaho [37 percent]. What’s up with those Mormons?!)
- In February, a study of 500,000 privately insured women found that 14 percent were dispensed opioid painkillers at least once during pregnancy.
In both studies, the opioids most prescribed during pregnancy were codeine and hydrocodone. Oxycodone was among the top four.
There’s speculation as to whether these script-happy doctors have done their due diligence, as fewer than 10 percent of medications approved by the FDA since 1980 have sufficient data to determine fetal risk. In fact, opioid use in the first trimester may double the risk of fetal neural tube defects. The question of addiction in just-born infants is also an issue to be addressed, as prolonged use while pregnant can lead to dependence – in mother and child.
America’s pain-averse mentality
A miracle cure in pill form has come to be expected for whatever might ail us – and that mentality doesn’t simply disappear during pregnancy. After all, taking painkillers is certainly an easier solution than suffering through it or seeking more time-consuming alternative help, such as physical therapy or acupuncture. But it still boggles the mind how women who try to be so careful in so many ways will eagerly accept an opioid prescription. “If the doctor’s giving it to me, it must be safe . . . right?”
Ultimately, this seems to be merely another manifestation of the trend of opioid painkillers being recklessly over-prescribed – and to inappropriate patients. It’s a main contributor to pharmaceutical and opioid abuse and addiction in the U.S., and now there’s yet another subgroup to whom these pills are becoming more – and more easily – available.
*For more information, see Catherine Saint Louis’s April 13, 2014, article, “Surge in Narcotic Prescriptions for Pregnant Women,” in The New York Times.