Are you pregnant or thinking of getting pregnant? Taking control and choosing healthy habits can help you live well, be healthy, and feel good about your life. Preconception health care focuses on taking steps now to protect the health of a baby you might have sometime in the future while prenatal care aims at ensuring you have a healthy pregnancy, safe childbirth, and postnatal recovery.

When you’re pregnant, getting sick can be scary especially with the common fear that ingesting some medicines can negatively impact your baby’s development. Still, there are conditions you may need to treat while you’re expecting.

Things to discuss with your doctor

Your doctor will want to discuss your health history and any medical conditions you currently have that could affect a pregnancy, including any previous pregnancy problems. It’s very crucial to talk to your healthcare providers before starting or stopping any medicines.

Be sure to discuss the following with your healthcare providers:

• Best ways to keep any health conditions you have under control.
• All medicines you take, including prescriptions, over-the-counter (OTC) medicines, herbal and dietary supplements, and vitamins.
• Your personal goals and preferences for the health of you and your baby.

Are medicines harmful during pregnancy?

Almost every pregnant woman will face a decision about taking medicines before and during pregnancy. However, there’s very little data about the effects of taking most medicines in pregnancy because pregnant women are often not included in studies that determine the safety of new medicines.

Here are some facts:

• 9 in 10 women report taking some type of medicine during pregnancy, and 7 in 10 report taking at least one prescription medicine. Over the last 30 years, the use of prescription medicines during the first trimester (first 3 months) of pregnancy increased by more than 60%.
• You need to take medicines during pregnancy to control your health conditions. In some cases, avoiding or stopping a medicine during pregnancy may be more harmful than taking that medicine.
• At the same time, taking certain medicines during pregnancy can increase the risk for birth defects, pregnancy loss, prematurity, infant death, or developmental disabilities.
• The effects of medicine on you and your baby may depend on many factors, such as
  • How much medicine you take
  • When during the pregnancy you take the medicine
  • Other health conditions you have
  • Other medicines you take

Have a healthy pregnancy: FAQs

1. Is it safe for me to take medicines before I get pregnant?

If you are trying to have a baby or are just thinking about it, it is not too early to start getting ready for pregnancy. Many women need to take medicine to stay healthy during pregnancy. If you are planning to become pregnant, you should discuss your current medicines with a healthcare provider, such as your doctor or pharmacist.

Some medicines can cause birth defects very early in pregnancy, often before you even know you are pregnant. Creating a treatment plan for your health condition before you are pregnant can help keep you and your developing baby healthy.

2. I need to take a medicine while pregnant. What do I do?

If you are pregnant, talk with a healthcare professional about any medicines you have taken or are thinking of taking. You should go over all prescriptions, over-the-counter medicines, herbal and dietary supplements, and vitamins.

Although no medicine is completely risk-free, a healthcare professional, such as a doctor or pharmacist, can help you pick a treatment plan that works for you. You should not start any new medicines or stop a current medicine without talking to a healthcare professional.

You might need to take medicines to treat a health condition. For example, if you have asthma, epilepsy, high blood pressure, or depression, you may need to take medicines to stay healthy during pregnancy. Some untreated health conditions may actually be more harmful than the medicines used to control them.

However, as you’re aware, some medicines can increase the risk of birth defects, pregnancy loss, prematurity, infant death, or developmental disabilities. A healthcare professional can help you weigh the risks and benefits of each medicine and determine the safest treatment for you and your developing baby. The risk-to-benefit ratio should justify the use of a particular drug, and the minimum effective dose should be used.

3. I took a medicine before I knew I was pregnant. What do I do?

If you took medicines before you learned you were pregnant, you may want to talk with a healthcare professional about any concerns you may have.

Some medicines can be harmful when taken during pregnancy, but others are unlikely to cause harm. A dietary supplement like folic acid is especially important before and in the first few weeks of pregnancy because it prevents some birth defects.

4. Why are certain drugs contraindicated in the first and third trimesters especially, but less in the second?

The potential for harm to the pregnancy and your unborn baby also depends on the gestational age. The safety and efficacy profile of some medications may change during the course of a normal pregnancy according to the gestational age of the fetus.

Doctors usually tell women to avoid taking medicines during pregnancy, if possible, especially during the first 3 months when the baby’s organs begin to form. They may interfere with normal fetal development and cause birth defects. Such medicines are said to be teratogenic hence designated as contraindicated. Teratogens are thought most harmful early in pregnancy—about 10-14 days after conception to about 8 weeks into pregnancy.

Non-steroidal anti-inflammatory drugs are also contraindicated especially in the last few weeks of pregnancy because they can lead to fetal kidney problems, low amniotic fluid levels, interfere with labor, or cause congenital heart problems.

The Food and Drug Administration (FDA) assigned pregnancy risk letter categories (A, B, C, D, or X ) to all drugs used in the United States based on their level of risk, where the risk increases from category A to X. However, the FDA has since 2015 started to implement a new labeling system for drugs.

5. Should I trust online information about medicine safety in pregnancy?

Use caution when consulting online sources about medicine safety in pregnancy—instead, use this information to start a conversation with a healthcare professional. Many websites post lists of medicines that are “safe” to take during pregnancy. However, for many medicines listed, there is not enough scientific evidence of their safety during pregnancy.

Take caution when watching online videos as well. A 2015 study found that content in current YouTube videos does not accurately describe the safety of specific medicines used during pregnancy. This is an important reason for you to talk with a healthcare professional about potential risks of using medicines during pregnancy.

6. Can I take medicine once I’m no longer pregnant?

After pregnancy, keep you and your baby healthy by talking with a healthcare professional, such as a doctor or pharmacist, about the medicines you are thinking of taking. It is important to talk to a healthcare professional about managing your health condition while breastfeeding.

Conclusion

With limited information about the safety of most medicines in pregnancy, especially newer medicines, you can still help improve the evidence on medicines and pregnancy. Always tell your healthcare provider about any problems you have with your medicine. You may enroll in pregnancy registries which track the outcome of you taking a particular medicine or you can help researchers find answers to medicine safety during pregnancy by signing up for a research study.

In sum, try not to worry if you are pregnant and taking any prescription medication. Just try to talk to your doctor so you can make the best decision for you and your baby about your treatment during the pregnancy.

Part of this article originally appeared as “Pregnant or thinking of getting pregnant?”