Destructive Detective

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I don't know where you get your information, but opioids are commonly used to treat chronic or severe pain during pregnancy and have been for a very long time. Oxycodone is category B :
Quote:
Either animal reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women, or animal reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the first trimester (and there is no evidence of risk in later trimesters
Tylenol is the safest analgesic available for pregnancy. Percocet contains both, but a rather small amount of the oxycodone even in the highest strength (10mg). Oxycontin does not contain Tylenol and is available in strengths up to 80 mg, although those are generally prescribed for people who have increased tolerance due to ongoing treatment for chronic pain. So, to answer your question as to who would prescribe this to a pregnant woman: anyone who sees her and is licensed to prescribe - assuming they are compassionate and want to alleviate her pain.

http://www.cfp.ca/content/56/1/25.full

http://www.aafp.org/afp/2003/0615/p2517.html

Funny, I googled "percocet pregnancy" and within the first page I got stuff saying that certain painkillers such as percocet that were taken in the first trimester of pregnancy were linked to certain birth defects. Also, it's a category C drug (meaning risks have not been ruled out, so you're taking risks, sometimes unknowingly since the good doctor doesn't always explain the risks of certain meds and acts like they don't know you're in too much pain to bother reading the handout the pharmacy gives you before popping the pills or taking whatever the doc hands you, trusting they know best). And the problems with using it later on in pregnancy is that it can cause withdrawal in the babies, which ain't surprising with narcotics, and not really something she had to worry about, seeing as she was only 12 weeks. I will admit that I do think that there haven't been enough studies on the use of opioids in pregnant humans, and that the risks in conjunction with the bigger picture are small (though they likely increase with age since if yer an older lady being preggers, you already are at risk for birth defects and complications from age alone. And one would assume that with an 18 year old kid in her passel of seven she's likely in that 'risky to be pregnant because of age' stage). But also percocet has a risk of causing bleeding or making bleeding worse, and causing a drop in blood pressure (and that's one of the common side effects). All things I wouldn't really want to exacerbate in a patient that is already bleeding and pregnant. You know, if I were a health professional intent on my patient's well being, instead of just wanting to shove them out the door with a prescription to shut them up.
http://consumer.healthday.com/disabilities-information-11/misc-birth-defect-news-63/oxycontin-vicodin-type-painkillers-tied-to-birth-defects-study-says-680013.html
http://www.webmd.com/drugs/2/drug-7277/percocet-oral/details/list-sideeffects
Funny, I googled 'opioid use during pregnancy' and got far more reliable sources saying they are commonly prescribed when needed for pain during pregnancy and have few adverse effects. Your source says 'common' but fails to give any figures as to rate of occurrence. Oddly enough the rate of severe birth defects in babies whose mothers took oxycodone during pregnancy was lower than that of the national average by 0.3 %. Maternal stress can harm a fetus. I see you are one of those types who thinks people should just grit their teeth and bear pain rather than dare give them relief thru drugs. Sad. stare

I have to take vicodin for my back, and it took me 7 years of tests and 'gritting my teeth and bearing it' to get that small measure of relief from pain so severe that I can't walk or stand for more than five minutes unaided. So no I don't think they should have to grit their teeth and bear the pain. Pregnant or no, they deserve pain medication that is safe for them to take, or have the risks explained so they can make and informed decision about how they wish to deal with their pain management. I know what it's like to live with chronic pain, I know what it's like when it gets so bad you can't even walk. So no, I'm not a grin and bear it type. I say get relief, even if it means risk to the fetus, because their 'life' does not trump the mothers and it doesn't trump her quality of life unless she so wishes it. What I am saying, is that she should not have been prescribed that particular drug in her particular situation because it would exacerbate issues with her current and possibly long term condition (the bleeding and small risk of birth defects...).

I have had to take percocet before I got my vicodin prescription, and I have experienced that drop in blood pressure and respirations when taking it while suffering through my monthlies (which always made the back issue worse, so I was more likely to have to take a percocet at the time). It doesn't feel good, and honestly the pain was almost preferable to the few hours where I felt like I was about to drop dead because it felt like a heinous chore to breathe and the world wouldn't stop spinning and being fuzzy cuz my blood pressure was down. I thought I had low blood sugar. Even took a blood test. Nope. Just the fun common side effects of percocet coupled with heavy bleeding. Certainly taught me to check up on side-effects after that experience. Scared the crap out of me.

The birth defect risk may not have been much of an issue, but the bleeding was. I did not convey it properly in the original post, but my real concern was for the blood pressure drop and possible depression of breathing that tend to accompany opioids like percocet, enough so that they are listed as common side effects. When a doctor prescribes things, they have to take in the current health of the patient too, and she came in already bleeding (which can cause a drop in blood pressure), so why would you give her a drug where one of the COMMON side effects is a drop in blood pressure and the 'call your doctor' side effects which include widening of the veins, which would lead to more bleeding, but like a quicktime event of impending messy death. They didn't prescribe her just any opioid, they prescribed her specifically PERCOCET, which is the one associated with low blood pressure and vein widening. Considering she was bleeding profusely enough to go to the ER, I honestly don't think you'd prescribe something for pain that would exacerbate the bleeding issue (widening of the veins), or issues caused by the bleeding (low blood pressure), without at the very least keeping the patient for monitoring for an hour or two after administering the first dose of the drug (which if you've been to the ER and they had to prescribe you something for pain, they tend to give you your first dose there to help you with the pain and then send you off to the pharmacy to pick up your prescription. So it would make sense that she probably got a dose of it while she was there, but it doesn't seem like she was monitored for her reaction to it).

They never even addressed if they got the bleeding under control in the article, so who knows if that was still a known issue (we do know she was still bleeding internally, hence the drop in blood pressure that led to her passing out and going into a coma). I mean, if they had to give her that cuz it was the strongest thing they could give her, they should have kept her for monitoring, considering her situation, or warned her of the side effects so she could say 'hey hun I'm feeling faint we need to go back to the ER stat' when her husband was driving to pick up her meds. They were negligent in that big time, not just in the ultrasound department. Be it the doctor didn't know better or her situation was not clearly communicated to them by the nurses and ultrasound tech, the hospital ******** up.
Sorry it took so long to find a doctor who believes in pain management. I might come back tomorrow and discuss opioids more, but right now I'm tired and Percocet is a moot point as I see no indication in this article that she actually took any.

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She was rushed to hospital, where she underwent an ultrasound, her family said. After carrying out further tests, doctors reportedly gave her a prescription for a painkiller and told her to go home.


But just minutes later, while her husband, Robert, was collecting the Percocet prescription at a nearby Walgreens drugstore, Mrs Avila apparently stopped breathing in the parking lot.