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Key takeaways
Avoid NSAIDs like ibuprofen during pregnancy. These meds increase the risk of miscarriage, congenital abnormalities, kidney injury to the fetus, decreased amniotic fluid, and other harm to fetal development.
Acetaminophen is considered safe for use during pregnancy but should be taken in moderation and under a healthcare provider’s guidance.
Safe non-medication pain management options during pregnancy include yoga, heat and cold application, massage, exercise, mindfulness, physical therapy, and the use of a belly band.
Pregnant individuals should consult a healthcare provider for advice on a safe and effective pain management plan.
People often talk about the glow that pregnant women get, but the reality of pregnancy is often a little less romantic. During pregnancy, women can and often do experience all sorts of aches and pains from carrying around a little—or a lot—of extra weight. Plus, they’re not immune to regular old headaches.
Unfortunately, during pregnancy, you can’t just pop over-the-counter painkillers like ibuprofen to knock out back pain or headaches like you did before. Because only certain medications are safe during pregnancy, it’s important to know what you can and can’t take. Here’s what you need to know before you head to the medicine cabinet.
Can you take ibuprofen while pregnant?
“We do not recommend ibuprofen for use during pregnancy,” says Monte Swarup, MD, an OB-GYN in Chandler, Arizona. Sold under the brand names Advil and Motrin, ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). If you’re thinking, you could just grab another pain reliever, not so fast: Ibuprofen isn’t the only NSAID that is off-limits.
“We typically do not recommend any medication in the NSAID family, including ibuprofen and naproxen, as they are associated with harmful effects to the fetus,” says Zeinab Kassem, MD, a maternal-fetal medicine fellow at Tufts Medical Center in Boston, Massachusetts. This means you will also need to avoid aspirin (brand names Bayer and Excedrin) and naproxen (brand names Aleve and Anaprox). Aspirin is occasionally prescribed in low doses to prevent preeclampsia, but should only be taken at the direction of a healthcare provider—and not to manage pain.
What are the risks of taking ibuprofen while pregnant?
If you take ibuprofen when pregnant, the potential risks to the fetus vary, depending on the stage of pregnancy. For example, the risks are different in the first trimester than they are in the third trimester.
“At the time of conception, ibuprofen use has been associated with increased risk of miscarriage,” Dr. Swarup says. “During the first trimester, it is associated with congenital anatomical abnormalities. Later in pregnancy, though, there is some risk of kidney injury to the fetus, decreased amniotic fluid, and premature closure of the patent ductus arteriosus, which is an essential structure in the circulation of the blood flow in the fetus.”
Additionally, research suggests that NSAIDs may interfere with the work of a hormone-like substance called prostaglandin, which is an important component during pregnancy and to the regulation of fetal development. Other studies suggest that using ibuprofen in early pregnancy might slightly increase the risk of gastroschisis, a birth defect where the baby’s intestines protrude through a hole in the abdominal wall; however, other studies haven’t produced the same results. Additionally, ibuprofen use during pregnancy is associated with intracranial hemorrhage (brain bleeding).
“Caution should always be exercised during pregnancy when it comes to taking pain medication and always under a doctor’s guidance,” says Michael Green, MD, an OB-GYN and co-founder of the anti-aging wellness center Winona.
What can I take instead of ibuprofen during pregnancy?
Tylenol (acetaminophen) is considered safe during pregnancy by most healthcare providers—but the American College of Obstetricians and Gynecologists (ACOG) says women should take it only as needed, in moderation, and in consultation with a healthcare provider.
In 2021, a group of scientists and doctors published a statement in Nature Reviews Endocrinology cautioning against the use of acetaminophen (or paracetamol, as it’s called in Europe) during pregnancy because it could be an endocrine disruptor and interfere with the healthy growth of the fetus.
ACOG released a response saying there was “no clear evidence that proves a direct relationship between the prudent use of acetaminophen during any trimester and fetal developmental issues.”
Pain may be a symptom that something is wrong, so it is important to see your healthcare provider even for headaches or other aches or pains. Pain can also cause you and the fetus stress, so a relatively safe pain medication, such as acetaminophen, may be beneficial.
What pain management options are safe during pregnancy?
Outside of medication, there are other ways to relieve aches and pains during pregnancy. However, before you try a new therapy or treatment, even a medication-free strategy, you should always talk with your OB-GYN. They will be able to let you know if they have concerns about the safety or efficacy of those treatments, or if they have other recommendations for you to try. Here are a few ways they may suggest you manage pain without medication.
Yoga
A 2020 systematic review of research published in the European Journal of Obstetrics & Gynecology and Reproductive Biology suggests that yoga is safe during pregnancy—and may even improve pregnancy outcomes while reducing pain, stress, and symptoms of depression and anxiety. You may have to modify some poses to accommodate your pregnancy, but research suggests you may be able to do more of your practice than you might expect.
Heat and cold
A heating pad or a warm bath may relieve some pain and tightness in your back, shoulders, and hips, but take care not to put a heating pad on your belly or make the water hotter than lukewarm. Raising your body temperature is dangerous during pregnancy. Similarly, it’s generally considered okay to use a cold pack on sore areas, such as your head or neck to make a throbbing headache go away or an ankle to relieve swelling.
Massage
Generally speaking, massage is safe for relieving aches, pains, and stress during pregnancy. It can help you relax and even sleep better. But ideally, it’s best to seek out a practitioner who is certified in prenatal massage and understands all the right safety precautions to take. You might also talk to your provider before you go for a massage, too, especially if you have certain medical conditions, such as high blood pressure.
Exercise
If you’re feeling tight and sore in your hips and legs, getting some gentle exercise might help you feel better. Try swimming, walking, or gentle stretches. Some research, including a small study in Complementary Therapies in Clinical Practice, has even found that practicing pilates helped relieve pain in some pregnant women. Additionally, staying fit promotes a healthy pregnancy.
Mindfulness
A systematic review of research in Mindfulness has found that mindfulness-based interventions can be helpful for people during pregnancy, with the ability to lower perceived levels of stress, anxiety, and even pain. However, more research is needed.
Physical therapy
In some cases, physical therapy may be appropriate to manage certain painful pregnancy conditions like symphysis pubis dysfunction. Your provider will refer you to see the appropriate specialist if you need this type of treatment. Exercise can help to strengthen muscles and reduce pain.
Belly band
Dr. Kassem notes, “If the pregnant individual is complaining of pelvic pressure or lower back pain, a belly band is sometimes helpful to alleviate some of those symptoms.” These flexible, tube-like garments fit over the torso to provide slight compression and support the abdominal muscles and back.
The bottom line: Find the right, safe pain treatment
Research suggests that relief from pain contributes to physical and psychological well-being—which are important during all trimesters. If you do have pain during your pregnancy and feel that you need some type of treatment, talk to your provider. Your provider can discuss your needs and the risks and benefits of specific treatments to the fetus, including over-the-counter medications.
“My main advice is to try different methods that are available and safe and find the right combination or ‘cocktail’ that works for each specific individual,” Dr. Kassem says.
Although ibuprofen is not considered safe during pregnancy, your provider should be able to help you find a treatment plan that will help you get through all nine months to delivery.
Sources
- 8 non-invasive pain relief techniques that really work, Harvard Health (2017)
- ACOG response to consensus statement on paracetamol use during pregnancy, American College of Obstetricians and Gynecologists (2021).
- FDA recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later because they can result in low amniotic fluid, U.S. Food and Drug Administration (2020)
- Is a common pain reliever safe during pregnancy? Harvard Health (2021)
- Is massage safe during pregnancy? UT Southwestern Medical Center (2017)
- Mindfulness-based interventions during pregnancy: a systematic review and meta-analysis, Mindfulness (2017)
- Mother to baby fact sheets: Ibuprofen, National Library of Medicine (2020)
- Over-the-counter analgesics during pregnancy: a comprehensive review of global prevalence and offspring safety, Human Reproduction Update (2021)
- Paracetamol use during pregnancy — a call for precautionary action, Nature Reviews Endocrinology (2021)
- Pilates workouts can reduce pain in pregnant women, Complementary Therapies in Clinical Practice (2018)
- Pregnancy, breastfeeding and fertility while taking or using ibuprofen, NHS (2021)
- A systematic review: The effects of yoga on pregnancy, European Journal of Obstetrics & Gynecology and Reproductive Biology (2020)
- Yoga in pregnancy, Harvard Health (2015)
- Yoga in pregnancy: an examination of maternal and fetal responses to 26 yoga postures, Obstetrics and Gynecology (2015)