A Guide to Medication in Pregnancy

Can I take medication during pregnancy?

At some point, almost every pregnant person deals with the question of medication. Maybe a cold is making you miserable or a headache won’t quit, or you might have a health condition that needs treatment. But while the pregnancy rules about alcohol, smoking, and sushi are pretty clear, medication is more confusing. The problem is research. Meaning – we don’t have much. Most medications are not studied in pregnant people because of the potential risks. So, there isn’t a lot of medical evidence to judge how safe they are, especially the newer ones. However, some medicines have been around for so many years, and so many people have taken them that doctors have a pretty good idea they are safe during pregnancy. Others have been shown to be so dangerous that there’s no doubt you should stay clear of them. And some are in a grey area where you and your provider need to look at the risks and benefits, and decide what is best for you and your baby. Make sure you feel comfortable discussing any medication issues with your OB-GYN or midwife and that your questions and concerns are taken seriously. Your doula can provide backup at prenatal visits as an advocate and to help talk through your options.

When should I take medication?

There are moments during pregnancy when taking medicine is optional. You might decide to just live with that cold or headache instead of reaching for a pill. It’s up to you. But there are also times when you really don’t have a choice. Leaving an infection like a UTI untreated is much more dangerous for your pregnancy than taking an antibiotic for a week or two. You might have a pregnancy-related issue like severe morning sickness, miscarriages, or preterm labor that needs treatment for a limited time. Or, you might have an ongoing condition like asthma, depression, or diabetes, which means you have to take medicine daily to stay healthy. Talk to your provider about the safest medicines for your situation and your pregnancy, as some drugs are considered safe during the second or third trimester. Make sure to get advice from your OB-GYN or midwife before taking any over-the-counter or prescription drugs, and even herbal remedies.

Which medications can I take?

While your provider should be your first resource, you may also want to check out certain medicines on your own. Unfortunately, a lot of pregnancy information on websites or in videos can be out of date or inaccurate. So, the most reliable source is the FDA. They use a system of letter categories to help clarify what is known about each drug so far. All prescription medicines and many over-the-counter drugs have a category listed on their information sheet or the FDA’s online database. The categories are:

CategoryDefinitionDetailsExamples
ANo known riskIn human studies, pregnant people and their babies had no problems using this medicine.Folic acid Levothyroxine
BNo clear evidence of riskThere are no human studies, but animal studies showed no problems. OR Some animal studies showed problems, but human studies did not.Amoxicillin Tylenol Benadryl  
CRisk can’t be ruled outThere are no human studies, but animal studies showed some problems. OR There are no good studies at all.Zoloft Ibupofen Diflucan
DEvidence of some riskHuman studies have shown some problems. But in serious situations, the medicine may still be necessary.Dilantin Lithium Losartan
XDangerousHuman or animal studies show this medicine is dangerous and should never be taken by pregnant people.Accutane Lipitor Ativan

Can I take medication after giving birth?

Once your baby is born, the medication situation certainly changes. But if you are breastfeeding, you will need to know whether any drug you take can enter your breast milk and how it might affect your baby. Talk to your OB-GYN, midwife, or lactation consultant beforehand to go over the risks and benefits. In some cases, medicines might pass into your breast milk in small amounts, but they are so important to your physical or mental health, that not taking them is much more risky. The best online resource for breastfeeding and medication is the LactMed database, which has the latest medical evidence and is checked often for accuracy. You can search for specific drugs to learn about their levels in breast milk, any research about the effects on babies, and other options to consider.

Remember

Deciding whether or not to use a medicine during pregnancy is between you and a trusted health care provider. There are different views on what is safe or necessary even within the medical field, so don’t feel pressure to follow anyone else’s advice or experience. Of course, your growing baby’s safety is always on your mind, but don’t forget that your health and wellbeing also matter.

Interested in how a doula can help you navigate medication questions? Learn more at meetmae.com.