It is important to discuss medication choices with your GP if you feel your pain is not well controlled. Pain relief is available to buy over the counter at your local pharmacy, but it is helpful to talk with your midwife or GP to make them aware that you have severe pain. It is often a case of trial and error to find the medication that suits you best, so do not be too downhearted if the first product you try does not help. Although PGP is a common condition, your GP may be relatively unfamiliar with its treatment and you may have to stress your need for pain relief if you have severe pain. Many women find that during pregnancy, GPs not used to managing PGP may be unwilling to prescribe anything stronger than paracetamol, in which case you can ask for a referral to a consultant (e.g. an obstetrician) who has more experience of pain management.
Be aware that taking painkillers regularly usually gives the best effect with chronic pain. However, if you take them regularly when you are not experiencing pain, your body may become accustomed to them, and they will become ineffective when you do experience pain.
More information about any of these drugs can be found in the British National Formulary (BNF). The side effects of all drugs can be found in the leaflets provided by the manufacturers, so do read them before starting to take any medication. It is usually best to take painkillers with food to reduce any potential irritant effects on the stomach.
A non-opioid analgesic. Effective for mild pain. Usually starts to work after 15-60 minutes and lasts for approximately six hours. Suitable for use during pregnancy. Suitable for use whilst breastfeeding. Does not cause drowsiness.
AspirinA non-opioid analgesic and anti-inflammatory. Effective for mild pain particularly joint and muscle pain. Not usually recommended in pregnancy, especially during the last few weeks, so discuss with your doctor. Aspirin passes into breast milk and may cause problems such as Reyes Syndrome, so should not be taken while breastfeeding.
Codeine including paracetamol or aspirin and codeine combinationsCodeine is a mild opioid analgesic and is effective for mild to moderate pain. It may cause constipation and/or drowsiness. Codeine should not be taken in the first trimester of pregnancy as there is a possible association with respiratory and cardiac conditions in the baby. It can also lead to drug dependence in the baby which may include withdrawal symptoms after birth. Codeine passes into breast milk and so is regarded as unsafe to take during breastfeeding.
Non-steroidal anti-inflammatory drug (NSAID). Effective for pain, inflammation, stiffness and soft tissue injury. Usually starts to work after 1-2 hours, with duration of action of 5-10 hours. Ibuprofen gives its best effects with PGP if taken regularly for at least two weeks.
Ibuprofen should not be used in pregnancy and is also not recommended when breastfeeding.
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