I thought it was about time I put all these hospital visits to good use. I have now been prescribed pretty much everything you can be prescribed for pain during pregnancy (in the UK), and had numerous doctors explain to me what medications I can and cannot take.
I hope that this post will help you gain a little more information about medications during your pregnancy experience and reduce the amount of scrolling through the world-wide web.
This post covers Paracetamol, Ibuprofen, Codeine and Co-codamol.
Where This Post Began
For those of you who have been following my pregnancy journey, you will know that 3 weeks ago I was in the Out of Hours clinic at the hospital, and then the maternity unit in the next town. This resulted in a diagnosis of renal colic, likely resulting from a kidney stone.
I discussed how pregnant women can become more susceptible to kidney stones (although there is no increased risk associaed with pregnancy) because of the extra pressure all your organs undergo during gestation.
Kidney stones can take a while to pass by themselves and treatment, both of the stone and of the accompanying pain, are limited during pregnancy. X-rays are the most reliable screening test (although ultrasound can be used with mixed results), but of course radiation would never be used anywhere near a developing fetus.
Pain Relief: Paracetamol, Codeine and Co-codamol
Due to the extreme agony of renal colic and the limited options for pain relief in pregnancy (under usual circumstances Paracetamol is the maximum and then recommended to be used as little as possible), it is very common for women to be admitted to hospital if they develop stones during pregnancy.
Medications containing Codeine should only be used under prescription during pregnancy because it contains opiates, and should not be taken at all during the first and third trimesters as it is during these developmental stages that baby will be most effected by its use.
I was prescribed Co-codamol (which combines Codeine and Paracetamol) because if you have ever had renal colic you will be aware that regular painkillers just don’t touch it.
Unfortunately, I did not react well to these tablets (and to be perfectly honest was not keen on taking even prescribed medication with opiates in it). They made me dizzy, disoriented and extremely nauseous. They numbed the pain beautifully, but made me completely disfunctional.
When you react negatively to Co-codamol, you just plain react badly to it. Attempts to reduce the dosage and prescriptions of straight Codeine, are unlikely to have any different results.
What are Your Alternatives?
Whilst the tablets reduced the pain enough for me to deliver walking tours, the side effects would have made me a health and safety nightmare. With my additional reluctance over what the tablets contained, I stopped taking them and headed off to the doctor.
She prescribed just straight Paracetamol and told me that to make it effective, I would need to keep on taking it every 4 to 6 hour. As you will note from the link above, this is not ideal.
Ibuprofen should also always be taken with care, not for prolonged periods, and is ideally completely avoided during pregnancy.
So in answer to the initial question, there are very few alternative options.
When (as in this instance) screening tests make you certain that the pain is not related to baby (always a relief to any expecting parent) it is the case that the pain is not a complication of the pregnancy, but that treatment of the cause is complicated because of the pregnancy.
Personal Update and Notes on Buscopan
This was my final alternative for the pain I was experiencing. For two weeks following the initial hospital visit, the pain became gradually less severe and to my relief I was able to manage it without going near Codeine.
But last week, suddenly the pain spiked once again and rather than occurring centrally, moved around to my back, concerning me that it was kidney related. Once again, we ended up with a midnight trip to hospital, numerous blood tests and multiple medical opinions.
There seemed to be some surprise that I had received the diagnosis of kidney stones without any screening tests (as I mentioned above, you won’t be x-rayed during pregnancy due to radiation, but ultrasounds can be used, although they are less effective in this area). Currently, I have been re-diagnosed with constant, considerable abdominal pain of unknown cause.
After a lengthy but pleasant discussion with the doctor, there was one final painkiller we could try, Buscopan. This was because of the new conclusion that the pain wasn’t renal and the guess was that perhaps it could be bowel related.
Buscopan is usually used to treat conditions such as irritable bowel syndrome (IBS), menstrual cramping and other forms of cramps and internal spasms. For the majority, it has no side effects making it a suitable alternative for those who react negatively to Codeine. There is, however, a very long list of instances in which you should not take Buscopan, and like Ibuprofen it is not a solution for long term pain relief.
Where We Are at Present
Ultimately, it is feasible that 3 weeks ago when the first round of hospital trips and tests began, I did have something (the professional jury still seems to be out as to whether it was a stone or not) irritating my kidneys, but although I am still experiencing considerable abdominal discomfort, it is now unlikely to be kidney related.
I am relieved, kidneys are vital organs and no one wants there to be something wrong with them. Whilst it is daunting to be experiencing unexplained abdominal pain, it is reassuring to know that all the blood tests have come back clear, showing that the kidneys are functioning properly. These blood tests also indicate that there is not infection or inflammation, which suggests that if there was a kidney stone, it is not the cause of this current pain and that it isn’t a urinary tract infection (UTI) or anything else too be overly worried about.
This is good news because it is when these (otherwise unrelated conditions) result in infections or fevers that they can start to impact the developing fetus.
I can gain comfort from a referral to get an ultrasound scan on my kidneys next week.
As ever, if you are experiencing any medical concerns, always seek professional assistance.