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Taking Medication While Pregnant

Safe or Sorry?

WebMD Feature
Reviewed by Gary D. Vogin, MD

Feb. 11, 2002 -- When I was four months pregnant, I developed severe stomach pains and was rushed to the hospital. Suspecting appendicitis, the emergency room doctors advised X-rays -- the only way to find out if their suspicions were correct. I panicked. After all, X-rays were on that ominous list of "don'ts" I had so fastidiously been avoiding throughout my pregnancy.

The doctors agreed to monitor me carefully and to hold off for an hour or so. In the meantime, they grew less convinced that my discomfort was appendicitis and more sure I merely had a case of the flu and dehydration. But what I hadn't fully understood was that a burst appendix was far more dangerous to me and my baby than any X-ray.

My misguided fears aren't uncommon. Experts say many women -- and even some doctors -- think some medications and exposures are more harmful to a pregnancy than they actually are. It's a good idea to avoid substances you don't need, they say, but you shouldn't feel compelled to be a martyr, either.

"I think there are great misperceptions out there," says Karen Filkins, MD, director of reproductive genetics at the UCLA School of Medicine, who ran a pregnancy hotline in Pittsburgh for 12 years and fielded thousands of calls from pregnant women who were unduly worried about exposing their babies to everything from mouthwash to Ex-Lax.

Citing a variety of conditions from asthma to the common cold, Filkins says medications can often ensure safer pregnancies than if illnesses are left untreated. "In fact, the worst thing you can do is go cold turkey and stay sick. Fever, for instance, has more potentially damaging effects early in pregnancy than taking something like Tylenol."

Teratogens: The Tests of Time

Women have traditionally been cautioned against taking medications during pregnancy, because there are no guarantees that any drug is safe. The only way to do that would be to put the drugs through controlled trials with pregnant women, and no one wants to assume the ethical or legal liabilities of exposing a pregnant woman and her fetus to potential harm.

The U.S. Food and Drug Administration requires manufacturers to test drugs that might be used by reproductive-age women in pregnant animals, but the reactions in animals aren't always the same. Thalidomide, a sedative and antinausea drug used by pregnant women in Europe, produced limb deformities in nearly 6,000 babies born between 1956 and 1963, but did not affect pregnant rats. Fortunately, the drug was not approved in the United States.

Yet over the years, experts have accumulated data on the effects of an array of medications used by women during pregnancy. One of the largest such studies, published in the late 1970s, tracked 50,282 pregnant women who took a variety of drugs from 1958 to 1965. Drugmakers also must report any problems they find out about to the Food and Drug Administration, and doctors voluntarily do the same.

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