Safe management of chronic pain in pregnancy in an era of opioid misuse and abuse

J Obstet Gynecol Neonatal Nurs. Sep-Oct 2014;43(5):554-67. doi: 10.1111/1552-6909.12487. Epub 2014 Aug 14.


Safe and effective management of chronic pain in pregnancy is challenging. Use of over-the-counter analgesics, opioids, opioid substitution therapies, complementary and alternative therapies, antidepressants, and anxiolytics each have benefits and risks for the mother and neonate that must be considered. Because of their potency, opioids are often used despite associated risks for adverse effects, abuse, diversion, and addiction. Development of a pain management protocol for the counsel and care of pregnant women with pain is necessary.

Keywords: Opioids; chronic pain; opiates; pain management; preconception care; pregnancy.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Analgesics / administration & dosage
  • Analgesics / adverse effects
  • Analgesics, Opioid / administration & dosage*
  • Analgesics, Opioid / adverse effects
  • Chronic Pain / diagnosis
  • Chronic Pain / drug therapy*
  • Female
  • Humans
  • Incidence
  • Opioid-Related Disorders / epidemiology
  • Opioid-Related Disorders / prevention & control*
  • Patient Safety
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / drug therapy*
  • Pregnancy Trimesters
  • Prescription Drug Misuse / prevention & control*
  • Prescription Drug Misuse / statistics & numerical data
  • Risk Assessment


  • Analgesics
  • Analgesics, Opioid