(Date: August 2022. Version: 4)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

What is it?

Codeine is used to relieve pain and to prevent coughing. It can be prescribed or bought over the counter in combination with other painkillers.

What are the benefits of taking codeine in pregnancy?

Codeine can provide effective pain relief and sometimes works where other painkillers have not. If codeine is prescribed in pregnancy, this is because a doctor thinks that its use is important for a pregnant woman’s quality of life. Please do not use codeine in pregnancy unless it has been prescribed.

Are there any risks of taking codeine during pregnancy?

While it is clear that the majority of babies born to women taking codeine do not experience any long-term effects, some studies have shown that, very occasionally, codeine use in early pregnancy may be linked to heart defects and spina bifida in the baby. Further research is required to confirm these links.

Codeine used around the time of delivery can affect the baby for a while after birth, meaning that they may need to be looked after in a neonatal unit. The baby may be ‘jittery’, have feeding problems, and initially need some help with breathing. These problems usually settle within the first few days.

Are there any alternatives to taking codeine?

Yes; other painkillers can be safely used in pregnancy but may not provide the same level of pain relief as codeine. Chronic pain can sometimes be improved with talking therapies; however, this does not work for everyone and some people may need or prefer to take a medicine.

Women using codeine who become pregnant or who are planning a pregnancy should consult their doctor or specialist so that their medication and dosage can be reviewed, and the risks and benefits of changing to something else can be weighed up. If you are using codeine long-term, please do not stop taking it or change the dose without speaking to a healthcare professional.

What if I prefer not to take codeine during pregnancy?

Severe and/or chronic pain can greatly affect quality of life. If your doctor suggests that you consider taking codeine in pregnancy they will help you to weigh up whether any possible risks are outweighed by the benefits of your pain being well-controlled.

Will my baby need extra monitoring?

You will be offered a very detailed scan at around 20 weeks of pregnancy as part of your routine antenatal care. Taking codeine in pregnancy is not expected to cause problems that would require any extra monitoring of your baby prior to birth.

Babies who have been exposed to codeine in the womb around the time of delivery may be more closely monitored for a while after birth to ensure that they are breathing and feeding as normal.

Are there any risks to my baby if the father has taken codeine?

We would not expect any increased risk to your baby if the father takes codeine. 

Who can I talk to if I have questions?

If you have any questions about the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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