Well, that depends on your individual attitude to the relative risks of each drug. I realise that answer sounds unhelpful, but the alternatives all have risks.

Well, that depends on your individual attitude to the relative risks of each drug. I realise that answer sounds unhelpful, but the alternatives all have risks. Opioids (and tramadol, a opioid that also has other effects) have been variably associated with birth defects, but the evidence is not conclusive[1]. [1] http://www.ajog.org/article/S0002-9378(10)02524-X/abstract http://www.ajog.org/article/S0002-9378(10)02524-X/abstract