Researchers found that 27% of women who had vaginal deliveries filled an opioid prescription.
About 1 in 50 women who are given an opioid prescription right before or after giving birth will go on to use opioids persistently in the first year postpartum, according to recent research.
The study, published in JAMA Network Open, looked at opioid use around the time of childbirth. Using data from more than 308,000 births that took place between 2008 and 2016, researchers found that 27% of women who had vaginal deliveries filled an opioid prescription, as did 75.7% of women who had a cesarean. Of those women, 1.7% of those with vaginal deliveries and 2.2% of those who had cesareans went on to fill prescriptions for opioids at least two more times during the year after birth.
The researchers said that the similarities in rates of persistent use indicated that the opioids themselves—not the pain from childbirth—put people at risk of persistent use.
The data “makes us think that there’s something inherent to the prescription rather than what women are going through that’s driving persistent use,” lead researcher and OB-GYN from the University of Michigan, Alex Peahl, told STAT News.
The rates are also similar to the rates of persistent opioid use among other populations that receive a first-time opioid prescriptions, including people getting their wisdom teeth removed.
The researchers said that doctors could help reduce the frequency of persistent use by avoiding prescribing unnecessary opioids to people who have recently delivered.
“These results suggest that maternity care clinicians can potentially decrease new persistent opioid use among women after either vaginal or cesarean delivery through judicious opioid prescribing,” the study authors wrote.
Marian Jarlenski, assistant professor of health policy and management at the University of Pittsburgh Graduate School of Public Health, said that providers need to be aware that they can change a patients’ long-term health by not offering opioids that aren’t needed.
“This study shows that there continues to be a chance to really intervene on the prevention side,” she said.
Although 2% may seem small, given how many women give birth each year, it’s a rather significant figure.
“It’s of course a topic that is on many people’s minds because pregnancy is one of the most common reasons why a lot of young women without any sort of health conditions come into contact with the health care system,” said Brigham and Women’s Hospital epidemiologist Rishi Desai, who was not involved with the study.
The American College of Obstetricians and Gynecologists estimates that one in 300 women who give birth by cesarian will develop persistent opioid use. Their guidelines for post-birth care include using opioids and alternative pain management techniques.