Many women who are pregnant have many questions concerning the use of a number of drugs or medications during pregnancy. Not all medicines are safe to take during pregnancy. Some medicines may cause birth defects, pregnancy loss, prematurity, infant death, or developmental disabilities.
Pregnancy and medications
Although some medicines are considered safe during pregnancy, the effects of other medicines on developing fetus are unknown. Most medicines taken during pregnancy cross the placenta and reach the developing fetus, therefore it is wise to be extremely cautious when prescribing any medication during pregnancy. Women are advised that before taking any medicine when they are pregnant – including painkillers – they should check with their obstetrician, pharmacist, or healthcare provider.
Certain medicines can be most harmful to a developing baby when taken during the first three months of pregnancy – often before a woman even knows she is pregnant.
If you were taking prescription medicines before you became pregnant, please ask your obstetrician or healthcare provider about the safety of continuing these medicines as soon as you find out that you are pregnant. Do not just stop taking a medication on your own as this can also lead to problems as well.
Your qualified healthcare provider will weigh the benefit to you, and the risk to your baby, when making his or her recommendation about a particular medicine. With some medicines, the risk of not taking them might be more serious than the potential risk associated with taking them.
If you are prescribed any new medicine, please inform your healthcare provider that you are pregnant.
Teratogenic Medications
During the last decades, it has been clearly shown that drugs administered to the mothers during pregnancy might have detrimental effects on the physical development of the fetus. Thalidomide is a well-described example of how an innocent, over-the-counter, medication for morning sickness could exert such a deleterious effect on the fetus, such as miscarriages, and physical deformities. A teratogen is an agent that can disturb the development of the embryo or fetus. Teratogens halt the pregnancy or produce malformation deformities. There are a number of drugs that are capable of acting as teratogens – including many antibiotics, anti-hypertensive drugs and acne medications. Talk to your obstetrician if you think you might be pregnant and are presently using a medication that might be teratogenic.
Prenatal vitamins and supplements
Most prenatal vitamins are safe to take during pregnancy. It should be noted that the time when they should be taken might depend on the medical history of the women. A number of vitamins are not safe to use during pregnancy especially in high doses. Please talk to your medical doctor before taking any over-the-counter medications and supplements. When in doubt about any medication or supplement, ask your healthcare provider before taking or using it.
Alcohol and pregnancy
Drinking alcohol during pregnancy increases the risk of miscarriage, premature birth and your baby having a low birthweight. It can also affect your baby after he/she is born. Drinking during pregnancy can cause your baby to develop a serious condition called fetal alcohol spectrum disorder. There is no known safe amount of alcohol use during pregnancy. There is also no safe time for alcohol use during pregnancy. All types of alcohol are equally harmful, including all wines and beer. It is never too late to stop alcohol use during pregnancy. Stopping alcohol use will improve the baby’s health and well-being. If you are using alcohol during pregnancy, please let your obstetrician or healthcare provider know. He/she can provide the necessary information and care for you.
Illegal drugs and pregnancy
Using illegal or street drugs during pregnancy, including cannabis, ecstasy, cocaine, and heroin, can have a potentially serious effect on the developing fetus. Women using these drugs should discuss this with their healthcare provider.
It is best not to stop abruptly without first seeking medical advice as there may be withdrawal problems or other side effects. If you use drugs, it is important to seek help straight away so you can get the right advice and support. If illegal drugs are part of your life, getting help can really improve the outlook for you and your baby.
Use of herbs during pregnancy
The use of herbal medicine during pregnancy is a common occurrence. Different studies revealed that using herbal medicine during the first 12 weeks and the last 12 weeks of gestation is dangerous for the fetus. The common untoward effects of using herbal medicine in pregnancy are heartburn, premature labour, miscarriage, increase blood flow, abortion, and allergic reactions. Pregnant women should consult their doctors before using any herbal medicines. Not all “natural” remedies or complementary therapies are safe in pregnancy.
Some products used may not be of a high quality and may contain other substances, such as lead, which could be harmful.
What medicines can you take during pregnancy?
It can be hard to know if a particular medicine is safe for the developing fetus. Most medicines are not studied in pregnant women because researchers worry about how the medicines might affect the baby. Some medicines have been taken for so long, by so many women, that obstetricians have a good idea of how safe they are. If you are pregnant always talk to your obstetrician or midwife before you take any medicines.
Women with medical conditions
Women with pre-existing medical conditions (such as asthma, epilepsy, or diabetes) must continue treatment with the appropriate medications during pregnancy – under supervision of an experienced and qualified medical doctor.
Planning a pregnancy
If you are planning a pregnancy, talk to your obstetrician or midwife about any medicines you are taking, including over-the-counter ones. Some of them may be safe during pregnancy, but others may not be safe. Your doctor or midwife may have you stop taking a medicine or may switch you to another one. Some medicines that are not safe in the first trimester may be safe to use later in the pregnancy.
Folic acid is especially important before, and in the first few weeks of pregnancy, because it prevents some birth defects. Take at least 400 mcg of folic acid every day for at least 2 to 3 months before trying to get pregnant – and while you are pregnant. Some women need higher doses. Talk with your health professional about how much folic acid you need.
What else can you do
The use of various medications and drugs during pregnancy can pose many challenges. Most women take a drug of some kind during pregnancy – often without realising the potential for harm. All pregnant women are advised to inform their doctor or midwife of all medications and drugs they take or have recently taken, including prescription and over-the-counter medicines, nutrition supplements, complementary therapies (such as herbal medicine), social drugs (such as alcohol) and illegal drugs. This will prove extremely helpful.
Conclusion
Many individuals are aware of the dangers of using various medications and drugs during pregnancy, yet we know that many women do use them during pregnancy. It is estimated that drugs are used in over half of all pregnancies, and prevalence of use is increasing. The most used drugs include antiemetics, antacids, antihistamines, analgesics, antimicrobials, diuretics, hypnotics, tranquilizers, and social and illicit drugs. Healthcare providers must continue to educate communities about the dangers of using various medications and drugs during pregnancy.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented. Always talk to your doctor for professional medical advice.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
