Discharge Analgesics after Vaginal or Cesarean Section Delivery [32D]

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The first exposure to opioids for many women is after delivery. We seek to evaluate the rates of opioid prescriptions written at the time of discharge after delivery at Kapi’olani Medical Center for Women and Children (KMCWC) for the year 2016, and how these rates changed after new opioid prescribing guidelines were distributed by the CDC in March 2016


We conducted a review of all deliveries at KMCWC during the months of January and September for the year 2016. Deliveries in which the baby was admitted to the NICU were excluded. Both cesarean and vaginal deliveries were assessed and the quantity of prescribed opioids at the time of discharge.


There were a total of 907 deliveries that met inclusion criteria, 456 during January and 451 during September. There were 104 (22.8%) cesarean sections during the month of January and 352 (77.2%) vaginal deliveries. In September, there were 90 (20.0%) cesarean sections and 361 (80%) vaginal deliveries. The percentage of vaginal deliveries which received opioids at the time of discharge decreased from January to September (29% vs. 22%, p=<0.05). The mean number of prescribed pills was significantly lower for cesarean sections (30.5 vs. 28.6, p=0.0049) and a decrease for vaginal deliveries (26.5 vs. 25.5, p=0.35).


The numbers of opioids prescribed decreased from January compared to September 2016, showing that behavioral change can occur in the teaching hospital setting. Even though this data is reassuring, more work needs to be done to help alleviate the opioid epidemic.

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