Opioid Use in the Postpartum Period: Are We Prescribing Too Much?

Area of Science:

• Obstetrics and Gynecology
• Pain Management
• Public Health

Background:

• Opioid exposure for women of reproductive age frequently begins postpartum.
• Increasing maternal opioid dependency is linked to adverse neonatal and maternal outcomes.
• Lack of clear postpartum opioid prescribing guidelines contributes to the problem.

Purpose of the Study:

• To compare the quantity of opioid pills prescribed with the actual quantity used by patients in the postpartum period.
• To assess the extent of opioid overprescribing following childbirth.

Main Methods:

• A pilot study involving patients admitted to a labor and delivery unit.
• Review of medical records for prescribed opioid quantities.
• Post-discharge phone surveys to determine patient opioid usage.
• Statistical analysis using Welch t-test to compare prescribed vs. used amounts.

Main Results:

• Significant overprescribing of opioids was observed for both vaginal and cesarean deliveries.
• An average of 10 unused opioid pills per patient after vaginal delivery (P<.001).
• An average of 7.5 unused opioid pills per patient after cesarean section (P<.05).
• Low rates of unused opioid pill disposal among participants.

Conclusions:

• The study demonstrates clear overprescribing of opioids in the postpartum period.
• Excess opioid pills prescribed after delivery increase community availability and potential for misuse.
• Highlights the need for revised opioid prescribing practices in postpartum care.