A new study found that 91% of women given a C-section and 59% of women who give birth vaginally are prescribed opiates for pain.
The study looked at data regarding over 200,000 births in Tennessee. Experts said these numbers are surprisingly high, especially for vaginal deliveries. The pain of vaginal deliveries can usually be managed with over the counter painkillers such as ibuprofen.
The researchers found that this prescribing practice leads to the women who are prescribed opiates facing an increased risk of persistent opioid use or overdose in their first year postpartum. Almost 4,600 women in the study experienced a serious opioid-related event – dependence on opioids, overdose or persistent opioid use. 69% of these women filled more than a 90-day supply of the opiates. 18.5% of these women were diagnosed with a substance use disorder. 2% of these women overdosed on opiates and 0.2% died.
Lead researcher Dr. Sarah Osmundson said the study raises opioid overprescribing concerns, especially in terms of mothers who give birth vaginally.
“For those women, it’s probably not necessary,” she said.
Dr. Eleazar Soto of UT Physicians/UTHealth in Houston, Texas agreed with Osmundson.
“We typically don’t prescribe a narcotic after a vaginal delivery,” he said, calling the 59% rate in the study “very high.”
One quarter of women in the study who gave birth via C-section ended up getting a refill of their prescribed opiates. Over 10 percent of women in the study who gave birth vaginally ended up getting a refill of their prescribed opiates.
“We don’t know why second prescriptions were made,” Osmundson said. She said the pain typically improves with the first prescription, suggesting that doctors need to do a better job of monitoring the ongoing pain-relief needs of new mothers.
Soto said there is evidence that even the pain after a C-section can be effectively managed with non-opioid painkillers. He and his colleagues did a study where they gave some women opioids and some women ibuprofen/acetaminophen after getting a C-section. Women who were given ibuprofen/acetaminophen experienced better pain control and fewer side effects in that study.
“This work highlights serious risks associated with opioid prescribing after childbirth, especially among women who receive multiple prescriptions,” Osmundson said. “Routine prescribing after vaginal birth is still common, and it is alarming to know that this may put women at risk of long-term problems with opioids for a procedure (vaginal birth) where opioids have dubious benefit.”