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Chronic Pain and Pregnancy

Aug 07, 2010 - 20 comments
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Chronic Pain

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Pregnancy

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chronic pain and pregnancy

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opiods and pregnancy

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opiates and pregnancy

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benzodiazepines

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benzodiazepines and pregnancy

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anti-depressants and pregnancy

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medications and pregnancy



I wanted to post something on the topic as I am a Chronic Pain patient who has become pregnant.  I'm currently in my 23rd week of the pregnancy and am having trouble finding a Pain Management Provider who will see a pregnant woman, or a high-risk OB who will treat Chronic Pain.  I have been told that Maternal-Fetal Medicine Speicalists will provide pain relief for pregnant chronic pain patients, however I been told that mine will not.  
There appears to be A LOT of misinformation about Opiod Analgesics in Pregnancy, or no information at all.  I wanted to post this link to a study that was done on the affects of Opiods/Opiates, Benzodiazepines, Anti-Depressants, and other Medications in Pregnancy.  
There are a high percentage of women who have to take medications during their pregnancy.  All things being equal, most pregnant women would rather not have to take anything during the pregnancy.  Most doctors would rather a woman not take anything, however, in this world of advanced medicine, no woman should have to suffer in pain, stress, or otherwise out of fear for her child.  Of course, everything should be done to minimize exposure to the baby, and post-birth withdrawl.  
I just want to make it clear that there is help for pregnant women, there is information.  We just need to make sure everyone involved in our care is informed.
If you are having issues with this, please contact me.  You're not alone in taking medication while pregnant.  
I am posting a link to the information as it's a PDF and it seems a little complicated to cut and paste. (lazy, lol)

http://www.anesthesia-analgesia.org/content/85/5/1074.full.pdf

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1240706 tn?1331602111
by brigadiva, Aug 07, 2010
This is my third pregnancy.  During each of my pregnancies I develop severe kidney problems that cause excruciating pain (in 2001 the pain went away after birth, but after my pregnancy in 2006, the pain was chronic in my left kidney so I knew it was going to be even worse when I got pregnant this time).  My urologist would not provide any pain medication after my first surgery of this pregnancy.  Fortunately I was able to get some from my Ob because it is either that or go to the ER every time the pain becomes unbearable... not possible when raising kids and your hb has to work.  
You're absolutely right; we would NEVER want to expose our unborn child to harm.  During my first pregnancy I was so afraid of it that I would just double over and take the pain; a crying, sleepless, and useless mass.  Then, one day, my Ob pretty much yelled at me about how being in that kind of pain all the time was actually MORE harmful to the development of the baby than the medication they prescribed.  I never take it when I don't need it.  But one does feel like the doctor's think we are some kind of addicts because we ask for it.  This time around I have two other children to take care of, and it is exceedingly difficult to deal with all this pain and have energy for them.  Hopefully my new urologist is more understanding of that.  My urologist in 2001 and 2006 was actually trying to throw the stuff at me at every visit/call; I declined many prescriptions when I had enough to get me through (not something that someone who was trying to abuse the stuff would do).
My frustration is with the contradictions in the medical field.  Why are we told one minute that these medications will not harm our unborn children, and then another minute treated like we are bad people for trying to manage our pain that way?  I've been told that Acetaminophen is more harmful than the opiates and narcotics, and that the only major concern is that the baby will become addicted.  Both of my children were born healthy, with no indication of any ill-effects from the medications.  They remain healthy and happy today (praise God! :o)


Avatar universal
by JadedSweetheart, Aug 08, 2010
Thank you for sharing your story, Brigadiva.  You have been through a lot with your pregnancies and your husband having to be deployed near the baby's birth!  I'm so sorry you have such kidney problems.  I have had pain in my kidneys a couple of times when not pregnant and it's some of the most miserable pain we can experience!
I have heard from many pregnant women that their doctor told them it was worse for them to experience the stress and pain than it was to take the meds.  I'm so glad your children were born healthy and there were no ill-effects of the meds, it is such a worry for us when we're pregnant!
I had my first two before I was injured in '08.  Before then I had occassionaly pain in my shoulder, but didn't know why.  I found out in '08 that I have Degenerative Disc Disease and while most of the Cervical Discs are buldging, two are seriously herniated and pressing on nerves, one is touching my spinal cord.  It has been, to use a pun, a pain in the neck!  I didn't intend to become pregnant this time, and was recovering from a miscarriage when I became pregnant this time around.  I also have two brain aneurysms that don't cause pain, and because of them, can't take hormonal BC.
I have sought out support and information from women on much higher doses of pain medication than I have been on who have also had healthy and happy babies.  Thank God.  I will be so happy when this baby is born healthy and happy as well.  (I am believing God for it)
I share your frustration about the medical field.  Some women have doctors who work in teams and provide seriously adequate pain relief for them throughout the entire pregnancy, some women have doctors who act like they've never heard of it.  I have no idea why the entire field of pain management is not informed about the risks and benefits of pain and pain relievers in pregnancy.  I have also read that opiates and narcotics are safer than NSAIDS in pregnancy, and again, better than the stress on our bodies and our babies of dealing with high pain levels.  It's just so inconsisent from one doctor to another!  I, too, have turned down and turned in prescriptions (that I've paid for and recieved) in accordance with the rules, only to be treated like an addict for needing pain relief later.  It's such a disgusting double standard that it really pisses me off on a regular basis.  Most people in pain management have a list of rules to follow a mile long.  We follow those rules, then ask for what we need and are treated badly.  It's not fair and it's not right, in pregnancy and not.

I am glad that you and I are due around the same time!  We can share this together.  I knew we were both having complicated pregnancies, but I didn't realize you had to have surgeries already this time around.  I wish neither of us had to deal with the pain and stress of complications and could just sit back and enjoy the pregnancy.  Again, thanks for sharing.  I am hoping that this will help get the word out to other pregnant moms who may be concerned about taking medication that it is okay and the baby will be okay.  We're not alone!

1240706 tn?1331602111
by brigadiva, Aug 08, 2010
Thanks for your response.  I am sorry for all you have to go through,as well!  Pregnancy is truly hard enough on us without the additional stesses we have to endure with pain, and uncaring physicians, that is for certain!  I am glad to at least have a forum this time around, it helps you to not feel like you are going through everything all alone.

Fortunately, my husband found out he is not going to be deployed (well, at least until after the baby is born and a few months old), so at  least he will be here to help with the other kids when I have to go in for surgeries.  So, that was a huge relief!

Yeah, everything started up earlier this time around, I was hoping maybe that would be a blessing in disguise, that maybe if the stents were put in earlier that I could avoid so many blockages and surgeries, but the pain this past week is telling me otherwise, unfortunately.  I go in to my new urologist tomorrow.  Hope he is good :o)

It does amaze me the ignorance of many doctors when it come to pain management.  Especially since it is so easy these days to look up all the research and many findings right here on the internet, as both you and I have done (without a medical degree lol)!  In 2001 and 2006 when I was pg my urologist and Ob kept contact with each other about what was going on and what treatments were best and safest for the baby.  This time it seems I have to remind my Ob of who I even am every time I go in, and most of the time I don't even see her, I see this horrible nurse midwife who rushes me through and doesn't seem interested in anything I tell her.  My previous urologist this pg didn't even care to have my records tx from the other two pgs.  I am only lucky I convinced him to at least CALL my urologist from those pgs, otherwise he might not even have done the procedure right lol.  Scary.

Stay well! :o)

Avatar universal
by JadedSweetheart, Aug 08, 2010
Goodness, that IS scary!  It's so irritating when the doctors won't talk to eachother.  I tried to get my OB (I am seeing a teaching practice, so it's never the same one twice) office and PM to communicate and it was like speaking to a wall.  They handed me a post-it note with "Drug Free Living" and a phone number on it.  I tried to explain that it was okay with my PM that I was taking these meds, and the resident's just put a checkmark in my chark or something and nodded their heads.  
I didn't post in my original journal post that I originally had a PM doctor who would see me and everything was okay, then the price of my medication went through the roof so he prescribed a lesser medication, less frequently.  I recently found out that he's not going to be seeing his patients this month (for some reason) and that I need to find another doctor.  So now I've been calling everyone in the State of Florida to find out if someone will take a pregnant patient.  It appears to be a liability issue.  I called the high-risk OB/Maternal-Fetal medicine specialist that I go to and they told me that they tried to find a PM to see me and couldn't and that they would not provide PM.  I've been SO upset, but I am determined.  I have a list of 30 local PM doctors and am hoping just one of them says they will see me.  If worse comes to worst I will go to the OB armed to the teeth with information and hopefully the doctor will be able to help me.  I have experienced disconnect between the doctor who actually sees me and the nurse who I call on the phone at the same office before.
I was also thinking about how your doctor told you acetomenophen is worse for you than opiates, I'm sure it is much harder on your kidneys (and liver) and would be much worse for you to take than opiates which can relieve pain in smaller doses.  I really hope your new urologist is great and listens to you.  It is so important and seemingly rare to find a doctor that listens!

Avatar universal
by JadedSweetheart, Aug 10, 2010
I posted this in the Pain Management forum, but I wanted to post it here, too.  Sort of like an "update to the story".
I went to a new PM on Monday.  We picked the most reputable looking one from the ads we had and made an appt.  We didn't ask if they saw pregnant women, we just figured we'd go in, lay out the facts, and go from there.  It was a risk because we had to drive 2 hours (to Kissimee) to get there, and we didn't know what he would do, but it seemed like a good idea because they do more than PM, including an Urgent Care center and hormone replacement, stuff like that.  
I filled out the information honestly regarding being pregnant and I was going to wait until the doctor brought it up as I was just SO nervous.  I was afraid of what he might not do, but I noticed on the paperwork that they have a thing in the contract, basically a waver, that says while opiate therapy has not shown serious risks in pregnancy, it may pose some and the patient acknowledges the risks, etc.  
We got through most of the appt and I genuinely liked the doctor, he does a mix of homeopathic or natural vitamin supplements, etc, but he didn't say anything about the pregnancy so I was a little worried.  Then he asked me, since I'm childbearing age, what I'm doing for birth control.  I froze for a second but I knew I needed to tell the truth and honesty is ALWAYS the best policy.  I told him "Well, I don't need BC because I'm pregnant, I wrote it in the information."  (Now we know how much they actually read in the paperwork that took me 45 mins to fill out!)
He was like "Does  your OB know you take pain meds?"  I told him that she does.  He said "Oh, okay that changes some things, I have to go look up the meds and make sure they're safe" and left the office.  I was really worried and I told my husband "I made him run away!"  He came back about 10 loong minutes later and sat down and said "Well if you don't take any pain medication, your cortisol will get very high and could cause problems with the baby, so we're not going to take that away."  I was like "Praise God!  It's a doctor who actually understands!"  Then he asked me about the dilaudid.  I told him honestly how it was and how inadequate I felt it was at the current dose but that a higher dose more frequently would be better.  He said he wasn't very familiar with dilaudid and wasn't comfortable prescribing something he didn't know much about.  I told him I completely understood, I'm not really a fan of it either.  So he saw that I was taking oxycodone 30 before and asked how it worked.  I told him it was the most effective one I've been on, but that I couldn't afford $6 a pill.  He was shocked that any doctor would charge that for the medication and assured me they didn't price gouge.  Then he asked what my previous daily dose was and he said it would be okay!
He decided to stop the Soma or any muscle relaxer because the pain med was the primary one that I needed and instead he prescribed magnesium.  He said it's really good for muscles.  I am much more comfortable taking a natural supplement than the soma anyway.  He told me I need to stop the Klonopin as it's a benzodiazepine, but prescribed melatonin.
I mean, he seemed like he genuinely CARED about the baby and wanted to make sure if I had to take one med, that I didn't have to take any others that might not be safe.  Overall, I am overjoyed that I found a caring doctor!  This really did turn out to be a blessing in disguise.  The medication was less than half the price they tried to charge me at the last doctor, and I am really happy about the natural supplements.  I was a little worried about the Soma and Klonopin.  I am going to taper the Soma, and I wasn't taking much Klonopin anyway, so I will have a little on hand in case there are any withdrawls, but I doubt there will be any.
I just wanted to share with all of you who have been so good to me, thinking of me and praying for me.  God most definetly answered my prayers and performed a near miracle!
I am so grateful that things have finally worked out and that it's going to be okay.  I even feel more comfortable with this doctor.  His office is not sketchy.  It's definetly not a pill mill.  
Thank you for being there for me during the difficult times.  Your thoughts and prayers have been so helpful and encouraging.  

1240706 tn?1331602111
by brigadiva, Aug 10, 2010
That is awesome news!  So glad you found someone who listens and wants to help!   I pray that you will have a nappy and healthy pregnancy... and be relieved of your pain! :o)

Avatar universal
by JadedSweetheart, Aug 10, 2010
Thank you!  It's been such a relief to me and will help me relax a lot!  I hope that your new urologist will be able to help your kidneys so you can enjoy your pregnancy more and be relieved of your pain as well!


1240706 tn?1331602111
by brigadiva, Aug 11, 2010
Thank you!  He already seems more competent and personable than the last guy (but that isn't hard lol).  Time will tell if he lives up to his first impression!  Had a renal scan yesterday (of course, they don't tell you anything, but I could see the hydroneprhosis, just don't know if it is still severe, or not).  If he needs to replace the stents I will be going in on Tuesday... yayyyyy lol.  But it is like I told him, as much as I do not like the idea of frequent surgery, I dislike severe pain even more, so if it is necessary, then so be it.  

Hahaha, I just re-read what I wrote above... no I do not hope you have a "nappy" pregnancy hehehe... but I DO hope it is a HAPPY one :oD

Avatar universal
by JadedSweetheart, Aug 11, 2010
I figured you meant happy, lol.  :D
I know what you mean about frequent surgery vs. severe pain.  Neither is fun, but I'd take the frequent surgeries, too.  I'm glad he seems more competent and personable.  Those are good qualities in a doctor who's going to cut you open!
Keep us updated about what happens.  I'll be thinking of and praying for you!

1240706 tn?1331602111
by brigadiva, Aug 11, 2010
:oD Thank you!  And I, you, as well!

1264863 tn?1391118193
by luv2bmomjen, Sep 28, 2010
I found this post.  Hope you guys don't mind me asking some things if I need too.  Still don't know if I am pregnant but what is a safe ammount of oxy?  I am currently on 8 10/325's a day and one 30mg Roxi (without tylonol).  I am also taking 4 Soma a day.  I stopped the valium and tamadol as soon as I thought I might be pregnant.  

Avatar universal
by JadedSweetheart, Sep 29, 2010
I certainly don't mind you asking anything.  I don't usually journal, but wanted to put some information out there for any women in my situation and to give support.
I don't know what a safe amount is and I would guess it's different for everyone.  I take about 120mg a day and have throughout the pregnancy except when my previous doctor switched me to dilaudid.  Hopefully if you are pregnant your doctor will just keep you on the same meds, they don't usually like to prescribe anything in a class C like Soma unless it's absolutely neccessary but every doctor is different and I was taking soma up until a few months ago.  Flexeril is a class B, so a little safer.  I wanted to switch to flexeril in the beginning but the previous doctor didn't think I should and this one wanted me on no muscle relaxers but eventually prescribed one flexeril a day.  I'm trying to make it work.
I've been having a lot worse pain lately so I'm trying to figure out what I can do about it.


1264863 tn?1391118193
by luv2bmomjen, Sep 29, 2010
Thank you this makes me feel so much better about my situation.  I know that I could get off the valium and tradadol and hopefully the soma in time.  I would like to be at a minimum so when my pain goes up as it would with pregnancy I could have somewhere to go to make it through.
Thank you

Avatar universal
by SadLivingwPain, Nov 04, 2010
Thank you so much for your journaling!! This has been very helpful! I too am pregnant and due late January 2011.

Jaded, I wanted to let you know I have an amazing pain management doctor and they do so so many different things for their patients! When you said u travel two hours to Kissimmee I thought you might be closer to where I live.  Kissimmee is an hour away from Me'. Could be longer depending on what part of Kissimmee. Please let Me' know if you would like my PM Dr name and their office.  They have several locations and they are wonderful! Definately not a pill mill.  When is your due date? I have so much more I would like to say but I am heading to my ob now.  I will definately write back later. Good Luck to all and I wish everyone healthy and happy pregnancies!!

Avatar universal
by JadedSweetheart, Nov 04, 2010
I'm so glad this has been helpful to you!  I also saw my OB today along with the PM.  I will PM you with all the details!  It's so great to meet another person in this state dealing with the same situation!
Thank you for commenting!

Avatar universal
by hebbyv, Dec 12, 2011
Does anyone know anything about Fentanyl patches and pregnancy? I have been on a low dose(50 mcg) for over a year and a half, along with percocet(10/325) on occasion for break through pain. I have been in pain management for about 5 years.
I am not sure if I am preganant yet, but I am getting older (38) and my husband and I are ready to finally bring a baby into this world. I wish my circumstances were different, however until now I was unable to even think about a child, and now that is all I think about. I do not want 9 months of pain, but am willing to take it for a miracle baby. I am very brave as you can see while I am on my meds, I am sure if they were taken away completely I may sing another tune, lol.

Avatar universal
by nicole071981, Dec 19, 2011
thank u so much for your posts!  I am 6a weeks pregnant and have interstitial cystitis and live in a ton of pain every day.  my doctor that diagnosed me, has pretty much called me a drug seeker and wont give me any narcotics, not to mention I am off all the other meds for this disease.I will meet my new ob next week. any suggestions on how to approach her. I buy oxys from a friend and take about 60-80 mg/day. I have felt bad because they are not prescribed however I can't live w the pain.I am also happy to see that oxy does not cause birth defects.

Avatar universal
by Par2526, Apr 28, 2014
Nicole071981 I know this post was a few years back... Just wondering how you are making out? I suffer for Ic for the past 15 years! I'm now 32 w a 6 mnth old healthy baby girl! I would love to give u my email to xchange stories, talk, etc.....

Avatar universal
by lilangels1163, Oct 15, 2015
When I was pregnant with my first child I got kidney stones for my first time. I thought I was dying!! My OB doc prescribed me loratab. I was on that medication for about three months. My son was born perfect, no side effects whatsoever. True blessing from God. My second child I got extremely sick with a bacterial infection called camplyobacter (?spelling) I got three strains from the water on base at cherry point. I was on a morphine pump for weeks then oral Percocet, I was prescribed tramadol since I was 21 with spondylolisthesis. O couldn't take that med because they weren't sure what could happen so they switched it to Percocet but I didn't take out till the illness was so bad that I was in the hospital for weeks and lost so much weight and have never pooped so much in my life. Not long after that scenario of my pregnancy I got kidney stones AGAIN! Horrible just horrible. They have me a catheter and my urine was Brown. Immediately a pain pump was in my IV then she decided to put a stint from my kidney to my bladebladder because the kidney stone was massive. AinStint stayed in until 2 weeks after I had my daughter who had zero problems other than jaundice, which has nothing to do with side effects of meds. My third child oh my god Lord!! All I ask was why me why me??? Kidney stones UTI kidney infections the works. I was put on oxycodone 15mg with no Tylenol five times a day. When she was born which I was rushed to St Vincent hospital in Indianapolis Indiana because of the pain, I had kidney stones pushing out while in labor and a month early (kind of strange though because it was my first due date) TWO DAYS ACTIVE LABOR because I was early and not dialating. So there I sat screaming and crying and the doc took my epidural out twice! . Strange doc, but he was the doc so I didn't have any say really. When she was finally born, she seemed timid and crying if she want wrapped tight, so they tested her and she was addicted to the meds, I cried so hard, felt like dying for her to not have to feel this, they took her to the NICU and I got to start with her (btw I only saw maybe three parents there on a daily with 20 babies, so sad) I couldn't leave her it was killing my soul to see her on methadone. They expected her to be there for one month, 8 days later my baby girl came home, they were so shocked but thought somehow my breast milk (I breast Fed all my babies) helped ween her down better than the meds. She is a happy go lucky little girl about to turn 4!! :-) ladies when we are pregnant we have take care of ourselves as well, do what you feel is right and I'll pray for you all, everyone has a different story but all pray for the same thing, a healthy baby! Your strong and you got this! If you need meds then listen to yourself and find a very good doctor, you will get through this just fine! Good luck ladies!!!!

Avatar universal
by MrMjMomma, Nov 14, 2015
I know this is kind of an older thread but reading it has helped me alot. I'm 39 weeks pregnant with my little boy. I have severe chronic pain and have worked with my doc and ob closely to get as low on my meds as I can. I take 2.5 perc. 10s a day at the most and 400 MG of tramadol (not everyday but on bad days these are the highest amount) niether doc ever talked to me about stopping or going lower on doses before he was born to prevent withdrawal myou ob still haven't but my regular doc mentioned him having withdrawl athe my last appt yesterday and totally blindsided me  I guess I just thought I was on a low enough amount and the fact that my ob never said anything that it was a big concern. My regular doc made it sound like it was possible but not defient so now I'm terrified that he is gonna be born miserable he doesn't deserve that. I just want him here and healthy. And then I'm worried that the hospital will treat me crazy for being on meds I know they are all prescription but I get treated awful by the pharmacy here for picking up my meds pregnant so I'm just afraid of the nurses doing the same anyone have any advice or experience to help with my anxiety. Now I feel guilty everything I even take a third of a pill and don't know if I have time to stop or if I should keep taking it or what. I was so stunned at my appt I didn't get to ask all the questions I have now and won't see my doc till induction day next week. Any advice? Thank u ladies

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