What Pain Relievers Are Safe During Pregnancy?

Medically Reviewed by Nivin Todd, MD on December 12, 2022
4 min read

When you’re pregnant, you’re not immune to aches and pains. In fact, you might feel some new twinges that are caused by hormone changes and your growing belly.

Your doctor has likely told you that you shouldn’t take any medicine without checking with them first. You might wonder: Do you need to check with them even if you just want to pop a pain reliever?

The simple answer is: yes. You should ask your doctor before you take any medication, even if it’s just an over-the-counter pill designed to relieve pain. Such medicine may seem harmless enough, but the rules change when you’re carrying a baby.

Some medicines aren’t safe to take when you’re pregnant -- even over-the-counter ones.

This common over-the-counter medication may be your pain reliever of choice if you have a fever, a headache, or joint or muscle pain. You can buy acetaminophen over the counter by itself or in combination with other medicines. Your doctor can also prescribe it at higher doses, alone, or combined with other medications as well.

Most pregnant women can take acetaminophen if their doctor gives them the thumbs-up. It’s the most common pain reliever that doctors allow pregnant women to take. Some studies have found that about two-thirds of pregnant women in the U.S. take acetaminophen sometime during their nine-month stretch.

Just steer clear of acetaminophen if you’re allergic to it, if you have liver problems, or if your doctor says it’s not safe for you.

Even if your doctor says it’s OK to take acetaminophen, take as little of it as you can for as short a time as possible. Acetaminophen isn’t linked to big problems like miscarriage or birth defects, but studies suggest that babies could later feel the effects.

Some research suggests that taking acetaminophen daily for long periods (28 days or longer) could put your baby at greater risk of mild developmental delays or attention deficit hyperactivity disorder (ADHD).

Other research has shown that taking acetaminophen daily, or almost daily, during the second half of your pregnancy increases your baby’s odds of wheezing or having asthma.

None of the research proves that acetaminophen causes these problems and further studies are necessary to understand the link.

You may have taken ibuprofen plenty of times in your adult life, but your doctor will likely ask you to take something else to treat fever, headaches, and muscle pain when you’re pregnant. Non-steroidal anti-inflammatory drugs (NSAIDs) are sold over the counter and by prescription, but there are safer choices for pregnant women.

Some studies have found that taking NSAIDs (ibuprofen, naproxen, aspirin, celecoxib) during the early part of pregnancy may increase your risk of miscarriage.

Research has also looked at the connection between NSAIDs and birth defects. Some studies suggest that there may be a slight increase in the chances of a problem with your baby’s heart or gastrointestinal (digestive) system if you take NSAIDS early in your pregnancy.

But more research is needed to prove that NSAIDs cause these problems. Even though the link hasn’t been proven, your doctor may suggest you take acetaminophen instead.

NSAIDs are definitely not recommended during the last 3 months of your pregnancy because they can cause a blood vessel in your baby’s heart to close before it should. If this happens, it can cause high blood pressure in your baby’s lungs.

Taking NSAIDS can also make it harder for you to go into labor or can reduce the level of amniotic fluid that surrounds your baby in your womb. For these reasons, you should only use NSAIDs under your doctor’s supervision to ensure no problems crop up.

Opioids (codeine, morphine, oxycodone) are a class of strong medicines that doctors can prescribe to treat pain. They’re also the most commonly abused prescription medications in the U.S.

Some studies suggest that opioid use can increase your odds of having a baby with certain birth defects, such as a heart problem. They also may raise your chances of premature birth, preterm labor, or even having a stillbirth.

If you already take opioids, your doctor may not want you to stop taking them once you’re pregnant, because a sudden stop could harm your health or your pregnancy. Instead they may want to reduce the amount of medicine you take at a gradual pace to prevent any withdrawal symptoms.

But if you take opioids during your pregnancy, your baby will be exposed to them in the womb and could become addicted. They will go through withdrawals from them after they're born. This is called neonatal abstinence syndrome, or NAS. NAS can be serious, and could cause your baby to be too small or have breathing problems, even if you take the opioid exactly as prescribed.