Back pain, headaches and aching legs are all common ailments which can become even more painful when you're pregnant or breastfeeding. But many mums and mums-to-be are too scared to take any drugs to relieve the pain for fear of harming their baby.

Armed with the right information, you'll find there are options. Dr Debra Kennedy, Director of MotherSafe – a free counselling service for NSW women and their healthcare providers – says pregnant and breastfeeding women should not suffer pain unnecessarily. In fact, leaving pain untreated can actually do more harm than good.

"Inadequately managed persistent pain can result in depression and anxiety," says Dr Kennedy. "These may impact on a woman's physical and psychological wellbeing and can potentially have an adverse effect on her pregnancy."

Dr Kennedy advises pregnant and breastfeeding women to talk to a healthcare professional about their pain treatment options.

Paracetamol during pregnancy

Paracetamol is the most widely used pain reliever in Australia, and it's the over-the-counter option pregnant women are most likely to opt for. Although paracetamol crosses the placenta, at recommended doses it does not appear to increase the risk of birth defects.

The risks

  • Taking more than the recommended dose of paracetamol may cause harm to the mother or baby's kidneys, endangering both lives.
  • It should be noted that a recent study found a link between paracetamol use in pregnancy and an increased incidence of ADHD in children, but it has not prompted medical experts to change the current recommendations given that the finding could be random and has not yet been replicated.

Aspirin and ibuprofen during pregnancy

Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen have not been associated with structural birth defects or malformations, or other adverse outcomes such as pre-term delivery or low birth weight.

The risks

  • NSAIDs should not be used in the third trimester without specialist advice. They may harm the baby during this stage of pregnancy by closing one of their blood vessels too early, raising blood pressure in their lungs and delaying labour and birth.
  • High doses of these medicines in the third trimester may also impair the function of the baby's kidneys.
  • NSAIDs can also increase the risk of bleeding complications in the baby or mother.

Codeine during pregnancy

Opioid pain relievers such as codeine have not been associated with an increase in birth defects or miscarriage.

The risks

  • The main concern is that persistent use may lead to dependence and tolerance in the mother, with resultant drug withdrawal effects in the newborn.
  • Use of opioid pain relievers may also impair the baby's lung function.

Advice on taking pain relief drugs during pregnancy

"We recommend paracetamol to treat fever and pain during pregnancy," says Dr Kennedy. "Codeine or another opioid analgesic can be added to treat more severe pain. Inadvertent use of non-steroidal anti-inflammatory medicines [eg aspirin and ibuprofen] in the first trimester is not usually harmful but these medicines should not be used in the third trimester."

The best thing you can do is to talk to your doctor before taking any medications or drugs while pregnant or breastfeeding.

Helpful contacts

The following organisations can provide more information on the safety of medications and other exposures during pregnancy and breastfeeding.

All states/territories

NPS Medicinewise
NPS Medicines Line: 1300 MEDICINE (1300 633 424)

ACT

ACT Drug Information Service
The Canberra Hospital
02 6244 3333

NSW

Mothersafe
Royal Hospital for Women, Randwick
02 9382 6539 (Sydney metropolitan area)
1800 647 848 (non-metropolitan Area)

Northern Territory

Northern Territory Drug Information Centre
Royal Darwin Hospital
08 8922 8424

South Australia

Drug Information Centre
Women's and Children's Hospital
08 8161 722

Victoria

Drug Information Centre
Royal Women's Hospital
03 8345 3190

Drug Information Centre
Monash Medical Centre
03 9594 2361

Western Australia

Women's and Children's Health Service
08 9340 2723