Do Women Receive Too Many Opioids After C-Sections?

By Kelly Burch 07/28/17

A new study examined the amount of opioids women actually used after having caesarean sections.

pregnant woman lying in a hospital bed

Women who give birth by cesarean section are given double the amount of opioid pills that they actually need, and are unlikely to dispose of unused pills properly, leaving them and their family members at risk of misusing the prescription drugs. 

According to a study published in Obstetrics & Gynecology in July, women receive, on average, 40 opioid pills after a C-section, but most only take around 20 pills. Study authors found that the number of pills a patient was given could affect how many pills she took. 

“Some of our work has shown that the greater the number of pills people have at home, the greater the number of pills they take,” Lisa Rae Leffert, study co-author and chief of the obstetric anesthesia division at Massachusetts General Hospital, told The Huffington Post. “There’s no basis that they have more pain.”

Alarmingly, 95.3% of patients hadn’t disposed of their leftover pills. With more than 1.2 million women getting C-sections in the U.S. each year, this leaves many powerful opioids unaccounted for. 

“Right now, many people don’t understand the risks of having unused opioids at home, and many people don’t have a locked cabinet,” said Chad Brummett, director of the pain research division at the University of Michigan. “By keeping them unlocked, it makes them available to use by kids, family members and friends.”

Theresa Edwards, of Austin, Texas, did not finish her Vicodin prescription after her 2006 C-section and was later surprised to see that she could have had a refill. She kept the pills in her home, despite the fact that a person living with her was addicted to heroin. 

“I didn’t know anything about disposing of pills,” Edwards said. “I kept them because I do that with medication sometimes, which is dumb. Now as an [older] adult, I know you’re never supposed to do this. You’re supposed to turn them back in.”

Researchers say that the study highlights the fact that doctors need to have conversations with C-section patients about pain management and properly disposing of unused opioids. 

“There needs to be more of a conversation with the patients,” said Malavika Prabhu, study co-author and obstetrician-gynecologist at Massachusetts General Hospital. “For many patients, having a C-section is the first major surgery they [have] ever experienced.”

In fact, some women may not want or need opioids to deal with the pain of a C-section. The study found that 85.4% of women filled an opioid prescription after a birth by cesarean. Others, including study co-author and anesthesiology professor at Columbia University Medical Center, Ruth Landau, relied on over-the-counter medication. Landau took only Tylenol and ibuprofen when she had her C-section, and hopes that other mothers are made aware of this option. 

“It will empower women to choose to be responsible to take ownership on what they feel and how they want to feel,” Landau said. “I’m not saying everyone should take nothing, but we’re each different...I really think the conversation needs to be between the provider and the woman.”

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.