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While many new parents rely on pain medication to recover from birth, there are risks to consider before filling a prescription. “After a vaginal delivery, opioids are usually not needed unless there has been major damage to the perineum or rectum. Despite this, some physicians routinely prescribe opioids for vaginal births, too,” explained Andrew Combs, M.D., PhD, a maternal-fetal medicine (MFM) specialist and senior adviser for MFM clinical quality at Pediatrix® Medical Group. “This became commonplace during the early 2000s when [doctors] were inundated with the dogma that encouraged us to overprescribe opioids and to be aggressive in our attempts to eradicate all pain. Some of that teaching is still ingrained, and it has taken substantial reeducation for [providers] to learn that opioids are not usually needed in these cases.” Opioids are not always necessary even with cesarean births. “Two recent studies showed that about 1 in 3 cesarean patients who received a time-scheduled intravenous NSAID needed no opioids postoperatively. This [approach] is far better than waiting for the pain to occur and then trying to reduce it with opioids,” said Dr. Combs.
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