It’s normal to experience some aches and pains while pregnant, but the Food and Drug Administration (FDA) warns that using some common medications like ibuprofen during pregnancy to manage those pains can increase the risk for health issues in the baby and complications during delivery.
Non-steroidal anti-inflammatory medications (NSAIDs) are a class of drugs used to relieve aches and pains and, sometimes, to reduce fevers. Some common NSAIDs include ibuprofen (Motrin, Advil), aspirin, and naproxen (Aleve). These types of drugs are available over-the-counter as well as by prescription, often in higher doses. Note that acetaminophen (Tylenol), another common over-the-counter pain medication, is not an NSAID.
Previously, experts recommended that people use caution with over-the-counter pain medications during pregnancy—and avoid NSAIDs entirely once they’re at 30 weeks unless specifically directed to use them by their doctor. That’s because these medications can cause heart issues in the baby and complications during delivery, the FDA says.
For most pregnant people, it’s safe to occasionally take acetaminophen instead to help manage pain. But doctors may recommend low-dose aspirin to pregnant people with certain medical conditions, such as clotting disorders, or risk factors for preeclampsia, the Mayo Clinic says. That’s because it is thought to help regulate blood flow and clotting, which helps prevent preeclampsia, according to the American College of Obstetricians and Gynecologists (ACOG).
The FDA’s new warning highlights the potential dangers of taking NSAIDs like ibuprofen later in pregnancy, and urges consumers to avoid it now starting at 20 weeks rather than 30 weeks. Taking NSAIDs “around 20 weeks or later in pregnancy may cause rare but serious kidney problems in an unborn baby,” the FDA says. Specifically, this can lead to low levels of amniotic fluid (which surrounds and protects the baby).
Now the FDA is changing the prescribing information and, for over-the-counter drugs, the drug facts label to include warnings that people who are 20 weeks later in pregnancy should avoid using these medications. If pregnant people need to use NSAIDs, the FDA recommends they stick with the lowest effective dose and consider having their amniotic fluid levels monitored if they need to take the medication for more than 48 hours.
The recommendation is based on a review of previous studies and 35 cases of low amniotic fluid levels and kidney problems in unborn babies associated with NSAID use reported to the FDA. In 11 of those cases, low amniotic fluid levels were detected in pregnant people, the levels returned to normal after they stopped taking the NSAID. The FDA also said that low levels of amniotic fluid were detected as early as 20 weeks. These numbers seemed to line up with what the FDA saw in previous research, the agency said.
Some pregnancy pains are, unfortunately, totally normal. For issues like leg pain, round ligament pain (felt in the lower abdomen), and low back pain, you can try using non-medication strategies to ease the discomfort, such as wearing a maternity support belt, using support pillows while you sleep at night, or applying heat or cold to the area. For vaginal pain, wearing compression stockings can help prevent blood from collecting in the lower extremities and causing discomfort.
But if you feel like you’ve tried everything to ease the pain and it’s not helping, check in with your doctor to get their guidance. They might recommend you try a specific type of over-the-counter pain medication, such as acetaminophen. Additionally, if you’re experiencing any sharp or intense pain, vaginal bleeding, or a fever, talk to your doctor. Those are signs that you may be dealing with something that requires more than home care to deal with.