Ibuprofen in pregnancy – is it safe?

Expert advice on the safety of ibuprofen to treat pregnancy headaches, back pain, sciatica and pelvic pain

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In a nutshell

It depends on the stage of pregnancy: it’s best avoided in your 1st and 3rd trimesters.

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The expert view

With the joys of pregnancy can come back pain, sciatica, pelvis pain, and even more frequent headaches, so it can be tempting to find something stronger than paracetamol. Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) which is used as a painkiller – but when you are pregnant, it can cause potential harm to your baby. 

There are many studies pointing to potential harm – the latest (Feb 2018) suggesting ibuprofen in early pregnancy can harm a baby girl’s future fertility – but experts agree that further research is needed. Until then, it’s wise to be cautious.

“It is best to avoid ibuprofen in pregnancy, if you can,” says MFM’s GP Dr Philippa Kaye. “If you are in pain, for example back pain, then you can use paracetamol and if this is not enough then speak to your doctor about an alternative.”

The Medicines and Healthcare Products Regulatory Agency (MHRA) advises that NSAIDs shouldn’t be used in the first two trimesters of pregnancy unless “the potential benefit to the patient outweighs the potential risk to the foetus”.

NSAIDs shouldn’t be used at all during the third trimester unless on the advice of a doctor.

And the NHS advises that although the safety of ibuprofen depends on what stage of pregnancy you’re at, if you’re unsure at all then it’s best not to take ibuprofen at all.

During weeks 1-13 (1st trimester), avoid taking ibuprofen because:

  • it may increase the risk of miscarriage
  • your baby could develop a heart defect or other abnormalities, such as defects in their abdominal wall or a cleft palate
  • if your baby turns out to be a girl, taking ibuprofen may, according to new research (Feb 2018), result in a “dramatic loss” of the germ cells that go into making the follicles from which your baby’s female eggs develop

During weeks 14-27 (2nd trimester), you can take ibuprofen occasionally if you need medicine to relieve pain and reduce inflammation, but opt for paracetamol if possible.

During weeks 28-40 (3rd trimester), avoid taking ibuprofen because it may:

  • increase the risk of heart problems that cause high blood pressure in your unborn baby’s lungs
  • delay your labour
  • reduce the amount of amniotic fluid in which your baby floats

It’s important only to take ibuprofen after week 28 on the advice of a doctor. Your pregnancy will be monitored regularly to check for any problems.

What if I’ve already taken ibuprofen?

If you’ve taken ibuprofen occasionally when you’re pregnant, it’s unlikely to cause harm to your baby, but paracetamol is the recommended painkiller if you really need something. If you have taken frequent doses of ibuprofen after week 28 of your pregnancy, seek advice from your GP.

Worth noting

Research into the use of NSAIDs is continuing, and a recent study of 65,000 women – published in the Canadian Medical Association Journal – has found there is no link between taking the drugs and miscarriage.

Mums on our forum say

“I am currently not well and not taking it too gracefully. I’m on antibiotics for a throat infection and I can’t sleep because I can’t breathe through my nose! I am so used to being able to take the maximum dose of ibuprofen and decongestant so I can keep going and not have to resort to going to bed, it hits me hard when I have a bump and can take nothing. I don’t do being ill!” Nicolette

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“I’m 4 weeks plus 3 days and I have had the same [cramping] – sometimes quite powerful cramping, but nothing beyond bad period pains (which is where I normally call on my good friend ibuprofen…..so this has been a little hard to get used to for me!). Mine are also worse standing up – with the lovely weather we’ve been having, I’ve found an ice pack is really helpful (rather than a hot water bottle).” Jg2012

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