In recent years, doctors have started prescribing opioid painkillers to pregnant women at an alarmingly high rate–especially since risks to the developing fetus from narcotic painkillers are generally unknown.
In 2007, 23% of the 1.1 million pregnant women enrolled in medicaid filled a prescription for a narcotic painkiller. This is up from 18.5% in 2000.
Of most concern, however, is the variation of prescribing rates throughout the country. Rates of opioid prescriptions were highest in the South, and lowest in the Northeast. In the study of women enrolled in Medicaid, 41.6 percent of pregnant women in Utah were prescribed opioids, and 35.6 percent in Idaho. Oregon had the lowest, at 9.5 percent, with New York at 9.6 percent. Does this mean that women in Utah have more painful pregnancies than women in NY? Doubtful, say experts. Instead, it is likely that attention has not been paid to the statistics regarding addiction and misuse potential in these areas. This is especially troubling since most prescription drugs approved by the FDA do not have sufficient data to determine fetal risk. According to Cheryl S. Broussard, a health scientist at the National Center on Birth Defects and Developmental Disabilities, this number is actually fewer than 10 percent of all medications approved since 1980. At a time when pregnant women are taking more prescription drugs now than at any time in the last three decades this certainly raises a red flag.
In the past 30 years, the use of prescription medicine by pregnant women in their first trimester has increased more than 60 percent, while the use of four or more medications has more than tripled, according to a 2011 study published in The American Journal of Obstetrics and Gynecology. Some doctors and scientists say they are concerned about recent research demonstrating an association between first trimester use of opioids and neural tube defects, which are malformations of the brain, spine or spinal cord. Mothers of children with neural tube defects reported more use of opioids early in their pregnancies — 3.9 percent — than mothers of children without such congenital defects — 1.6 percent.
It is unclear why the demand for painkillers during pregnancy is on the rise. Some argue that America’s attitude toward pain management has shifted dramatically in the last 20 years–patients expect immediate relief from pain and as such, have adapted a very low tolerance to pain levels.