Medications in Pregnancy

Most women know that pregnancy brings many changes to their lives. It’s common knowledge that abstaining from alcohol, cigarettes, and illicit drugs is crucial during pregnancy. Fetal development, particularly in the 1st trimester, is very susceptible to the adverse affects of these chemicals. However, fewer women are aware of the vulnerability of the fetus to common medications including over-the-counter medicines to treat everything from minor pain and common illnesses like colds and flus. Herbal supplements, certain vitamins, and prescribed medications can also cause harm to a developing fetus.

The Center for Disease Control estimates that around two thirds of women in the United States takes one or more prescription medications during pregnancy. Another important statistic is that around 50 percent of pregnancies are unplanned. Therefore, it is important for women of childbearing age to discuss with her healthcare provider any medications, including herbals and over the counters, when she thinks she may be pregnant. Medications in pregnancy are a complicated matter, and many times providers will work to balance the medical needs of the mother with the known and sometimes unknown risk to the fetus.

Historically, the Food and Drug Administration has been reluctant to study the safety of drugs on pregnant subjects for fear of harm to fetuses, which means that most medications have not been empirically evaluated for safety during pregnancy. Often times, longitudinal metadata studies will show trends of complications of certain medications during pregnancy, and those compounds will be designated as unsafe to take during pregnancy.

Since the data on safety of most medications during pregnancy is scant, it is always imperative to consult with your healthcare professional when taking any medication, including prescription, over the counter, and herbal supplements. That stated, often times medications are necessary and critical for the management of many health conditions in pregnant women. Stopping a necessary medication during pregnancy can have significant adverse affects on a woman’s health, and it is never recommended to simply stop a medication without professional consultation.

Many women are treated with prescription medication for chronic conditions such as diabetes, hypertension, anxiety, and depression, just to name a few, and it is paramount that they continue to treat these conditions medically during pregnancy. Sometimes, medications can be adjusted or substituted during pregnancy and during lactation to ensure the best results for both mother and baby.

The best policy is to try to take as little medications as possible while pregnant and lactating, but there are several long enduring medications that have been shown to be safe to take during pregnancy. Prime among these are prenatal vitamins including folic acid and iron, which are essential for a healthy pregnancy. While certainly not exhaustive, these include familiar names that have been used for many decades without any remarkable adverse effects during pregnancy. Many of these are household names, and most are presently available over the counter and treat myriad of common conditions and symptoms.

The CDC offers a detailed listing of safe and available medications on their patient education website at www.webmd.com/women/pregnancy-medicine#1. The list is conveniently broken down by condition and the accompanying medication by both generic and some brand names. 

Timothy J. Hardy, M.D.

Dr. Timothy Hardy, M.D. has been practicing medicine in the community for many years. He received his medical degree from Eastern Virginia Medical School and founded his own practice, Atlantic OB-GYN, in 1990, where he has been providing women with exceptional care ever since. Website: www.atlanticobgyn.com
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