Can You Take Ibuprofen While Pregnant? What Doctors Want You to Know

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Experts break down the risks of taking Advil or Motrin while pregnant, safer alternatives, and what to do if you’ve already taken it.

From headaches and backaches to tender breasts and sore feet, pregnancy pain is an all-too-common experience. Between 20 and 80 percent of women report experiencing some form of pain while they’re pregnant. Fluctuating hormones, weight gain, and changes to posture and sleeping positions can all contribute to the ache.

Popping a pain reliever is a quick fix under regular circumstances, but it might not be a good idea during pregnancy. While ibuprofen may be a staple in medicine cabinets and on pharmacy shelves, it’s not always safe to take while pregnant. Here’s evidence-based information to help you safely treat pain while you’re pregnant. Don’t forget to consult your doctor.

What is ibuprofen and how does it work?

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and reduce inflammation. Its well-known brand names are Motrin and Advil, and various strengths and dosages are available.

Ibuprofen works by blocking the production of an enzyme that makes prostaglandins—a group of chemicals that trigger inflammation and pain when we have an injury, strain or other ache. In response to an infection or illness, prostaglandins also produce fevers by increasing heat production in the hypothalamus, which controls body temperature. Reducing the amount of prostaglandins reduces pain, fever or swelling. This usually happens 20 to 30 minutes after taking ibuprofen.

Can you take Advil while pregnant? A trimester-by-trimester breakdown

Generally speaking, the experts recommend acetaminophen during pregnancy instead of Advil, Motrin or other medications containing ibuprofen.

First Trimester: A large 2023 study of 1.8 million pregnancies found a significant association between NSAID use in early pregnancy and negative outcomes in the pregnancy. Compared to pregnancies not exposed to NSAIDs, NSAID use accounted for a 14 percent higher risk for birth defects, 29 percent higher risk for low birth weight, and a 9 percent higher risk of oligohydramnios.

Second Trimester: While ibuprofen might be considered safer in the second trimester compared to the first and third trimesters, it’s still not recommended.

In 2020, the U.S. Food and Drug Administration recommended not taking NSAIDs, including ibuprofen, after 20 weeks of pregnancy. If ibuprofen is taken, the pregnancy should be closely monitored by a doctor.

Third Trimester: Taking ibuprofen in the third trimester poses serious risks to the baby. It can cause premature closure of the ductus arteriosus, a blood vessel in the baby’s heart. It may also cause oligohydramnios (low amniotic fluid), which can result in premature delivery of the baby or, in the most severe cases, death.

“We think the greatest risk of ibuprofen exposure is around the 28-week mark, so the end of the second trimester and into the third trimester,” says Jamie Stanhiser, M.D., M.S.C.R., a reproductive endocrinologist and fertility specialist at Reproductive Partners Fertility Center- San Diego.

If there is NSAID use during this time, Stanhiser recommends an anatomy ultrasound and possibly a referral to a maternal-fetal medicine doctor, who specializes in higher-risk pregnancies, for an evaluation.

  • Here are the risks of taking ibuprofen.
    Premature Closure of Ductus Arteriosus (DA): “The ductus arteriosus is a temporary blood vessel in a fetus that connects the aorta—the main blood vessel from the heart—to the pulmonary artery, the vessel going to the lungs,” explains Faith Ohuoba, M.D., an OB-GYN at Memorial Hermann Health System in Houston, Texas, and a clinical associate professor at the University of Houston. It lets blood bypass the baby’s lungs since the fetus gets oxygen from the mother through the placenta instead of breathing air.
  • The DA is supposed to close after birth to allow the baby to breathe oxygen with the lungs. If it closes while in utero, it can cause significant damage. “What can happen from there is that the baby can get pulmonary hypertension, which is a terrible neonatal disease that has long-lasting impact and even risks death,” Stanhiser says.
  • Oligohydramnios: Oligohydramnios is a condition in which amniotic fluid levels are too low. In cases with ibuprofen, it’s likely that the interference with prostaglandin production causes kidney dysfunction and reduced urine production by the baby.
  • “Ibuprofen can also affect the kidneys, causing low amniotic fluid, which can result in early delivery or the need to be induced,” Ohuoba says.
  • Increased Risk of Miscarriage: Some research suggests ibuprofen may increase the risk of miscarriage, especially if it’s taken right around conception or over a long period. It’s not totally clear, though, if that increased risk can be fully attributed to the ibuprofen or to the reason the person is taking the medication, such as a chronic health condition or an infection.
  • Other Potential Risks: While the research has mixed findings, ibuprofen may cause dysfunction of the platelets and increase the risk of birth defects, heart defects, and a fetal intestinal malformation called gastroschisis.

What are the alternatives to ibuprofen for pain relief during pregnancy?

Acetaminophen, more commonly known by its brand name, Tylenol, is recommended during pregnancy. Acetaminophen is generally considered safer than ibuprofen during pregnancy, especially in the first and second trimesters. While safe, it should still be used at the lowest dose possible and for the shortest duration necessary.

Other medications may be prescribed by your physician, depending on the condition. Always consult with your OB-GYN before taking any medication.

There are also ways to manage pain that don’t involve a pill. Non-pharmaceutical remediesfor pain that are safe during pregnancy include ice, heating pads (on the lowest setting and only for 10 to 15 minutes at a time), warm baths or showers, stretching, prenatal yoga, walking or other gentle exercise. Lumbar pillows or pregnancy support belts can help with lower-back pain.

Specialty pregnancy massages or acupuncture sessions may also alleviate pain. If muscle or joint aches and pains aren’t going away, seeing a physical therapist or chiropractor may be able to help.

When is it absolutely necessary to take ibuprofen during pregnancy?

Hormonal fluctuations and changes to the body in pregnancy can cause existing chronic conditions to worsen. A prescription NSAID, indomethacin, can be given for certain inflammatory diseases between 18 and 20 weeks, such as rheumatoid arthritis. These medications can only be used for a short period, says Pamela Berens, M.D., a professor and OB-GYN with UTHealth Houston. You should be closely monitored by your doctor.

A corticosteroid may also be given to suppress the immune system and reduce inflammation in chronic inflammatory conditions, such as inflammatory bowel diseases like Crohn’s disease or ulcerative colitis.

Be sure to discuss medication with your doctor. They can accurately assess whether the benefit of taking the drug may outweigh its risks. Self-medicating is not recommended.

What to do if you’ve already taken ibuprofen while pregnant

While ibuprofen use may increase the risk of miscarriage, it’s important to note that miscarriage is a common experience. It’s estimated that up to 20 percent of known pregnancies end in miscarriage.

Berens says if you happened to have taken ibuprofen and then found out you’re pregnant, everything is likely OK. “Provided she has a pregnancy with a heartbeat, it really didn’t hurt the baby.”

Even so, you should discontinue taking ibuprofen and let your healthcare provider know so they can assess the potential risks to the pregnancy based on the gestational age and dosage.

At your first prenatal appointment — or, better yet, at a preconception consultation — let your doctor know all of the medications (both OTC and prescription) and supplements you take, even in powder, liquid or shake form. Your doctor can tell you which ones are safe and which ones need to be stopped or require an alternative.

Talking to your doctor about pain management during pregnancy

Unfortunately, pain can come with the territory in many pregnancies. “It is important to have ongoing conversations with your doctor regarding pain control, especially before you take any type of pain reliever,” Ohuoba says. “Your doctor should typically offer a list of commonly pre-prescribed over the counter medications that you can take during your pregnancy.”

Ibuprofen is not recommended during any stage of pregnancy. Taking ibuprofen can increase the risk of serious pregnancy complications, including the closure of the ductus arteriosus and oligohydramnios. Acetaminophen is considered to be the safer alternative to relieve pain and fever. Drug-free remedies like ice, heat, massage, or stretching may also be effective. Before taking acetaminophen or any other medication while pregnant or trying to become pregnant, consult your doctor.

Experts

Pamela Berens, M.D., a professor and OB-GYN with UTHealth Houston

Faith Ohuoba, M.D., an OB-GYN at Memorial Hermann Health System in Houston, Texas, and a clinical associate professor at the University of Houston

Jamie Stanhiser, M.D., M.S.C.R., a reproductive endocrinologist and fertility specialist at Reproductive Partners Fertility Center in San Diego