Medications and Pregnancy

Be Proactive and Ask Questions

When possible, think ahead. It’s best to address questions about medications and vitamins before you are pregnant. Ask your healthcare provider about the over-the-counter medications you currently use. These include drugs for everyday conditions, such as heartburn, allergies , or headaches . In addition, check with your healthcare provider about any prescription medications you currently take. Both types of medications may need to be either discontinued or changed before you get pregnant.

Women With Chronic Conditions Have Special Needs

Not long ago, many women with chronic conditions, such as lupus or diabetes , considered pregnancy to be too risky. However, because of advances in the fields of high risk obstetrics and internal medicine, many of these women now deliver healthy babies. Sandra Gangell, of the Pregnancy Risk Network of People, Inc., encourages women with chronic health problems to assemble a healthcare team to help them manage their disease processes and medications during this important time. Ideally, the team should be formed before conception. She also states that enlisting a teratology specialist is particularly important, as these doctors specialize in the understanding of how medications and other substances effect a developing fetus. Ronald J. Ruggiero, PharmD, of the University of California San Francisco, agrees with Gangell. He notes that obstetricians can't be expected to know the effects of all medications used for chronic conditions.

In some cases, such as with women have asthma , depression , diabetes, high blood pressure , or HIV , stopping medication can be significantly more harmful to the fetus than taking the drugs during pregnancy. In these types of cases, OTIS can provide information about a specific drug and the risk to the fetus, based on timing during the pregnancy. Some drugs are potentially harmful early in the pregnancy, but not later on. Conversely, others present a greater risk around the time of delivery. OTIS can also inform you about the risk/benefit profile of medications that can help manage your condition during your pregnancy.

Dr. Ruggiero warns pregnant women not to take herbal remedies or supplements, because there are no reliable studies about their effects during pregnancy. Since they are not regulated the way conventional medications are, there is no way to gauge the purity or actual dose of the substance you're taking. There may be many alternative and complementary therapies that are safe and/or helpful in pregnancy. But you need to do your research to find out if there is safety in pregnancy information, and physicians recommend that you discuss these modalities with them as well.

An excellent resource about both drugs and complementary modalities is the Motherrisk Program hosted by the Hospital for Sick Children in Toronto, Canada.