Draft Opioid-Prescribing Guidelines for Uncomplicated Normal Spontaneous Vaginal Birth

Area of Science:

• Obstetrics and Gynecology
• Pain Management
• Public Health

Background:

• Acute pain is common during and after uncomplicated vaginal delivery.
• Current clinical practice guidelines for opioid prescribing in this specific obstetric population are lacking.
• The Centers for Disease Control and Prevention (CDC) recommends improved opioid-prescribing practices.

Purpose of the Study:

• To determine the prevalence of opioid administration for uncomplicated vaginal delivery.
• To develop consensus-based guidelines for pain management in this patient group.

Main Methods:

• Analysis of a national healthcare database (2014-2016) for opioid use in 49,133 women.
• Electronic Delphi survey with 14 obstetric expert participants.
• Adaptation of CDC opioid guidelines for the inpatient obstetric population.

Main Results:

• 78.2% of women received opioids during hospitalization; 29.8% received them at discharge.
• Descriptive statistics characterized patient and hospital factors associated with opioid administration.
• Seven of eight adapted guidelines were endorsed by expert panelists after three survey rounds.

Conclusions:

• Significant opioid administration occurs during and at discharge for uncomplicated vaginal births.
• Draft consensus guidelines were developed to address the lack of specific clinical practice guidelines.
• These guidelines provide a foundation for future research and broader clinical adoption.