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Taking Medication While Pregnant

Safe or Sorry?

Choices continued...

In other cases, the severity of the illness needs to be assessed. For example, the latest generation of antidepressant drugs, called selective serotonin reuptake inhibitors (like Prozac), don't appear to harm the fetus, according to one recent study. But for those who only use it to ease PMS, it may be worth eliminating while pregnant.

For others, stopping the medication could pose grave consequences. One patient was told by a doctor to give up her antidepressants, and halfway through the pregnancy she tried to commit suicide by jumping off a bridge and lost the baby, Niebyl says. "The issue boils down to whether the woman really needs to take it or not."

However, even less severe conditions like persistent headaches or allergies may warrant taking some medicine. No one has to grin and bear it if they're feeling lousy, experts say. "If it's of sufficient severity that it's interfering with their life, I would advise them to take something that I have reasonable confidence in being safe," says Pitkin.

In some cases, the choice of drug is critical, but in most others, something is available. "If a patient is taking a drug that should not be used during pregnancy, there usually are alternatives that are safe," Niebyl says.

ACE inhibitors used to treat high blood pressure, for example, can damage a baby's kidneys, but other blood pressure drugs don't. The same goes for antibiotics: tetracyclines cause tooth discoloration and delayed bone growth in babies, but other antibiotics, including penicillin, amoxicillin, and erythromycin, are safe to treat a range of conditions.

Timing may also make a difference. Acetaminophen is typically recommended instead of aspirin for pain relief, especially in the last trimester, because aspirin carries a greater risk of bleeding. Ibuprofen should be limited to no more than a day or two because prolonged use can affect fetal circulation.

In fact, one recent study of 22 women by researchers from the University of Texas M.D. Anderson Cancer Center in Houston even found that chemotherapy treatment for breast cancer in the second and third trimesters doesn't put babies at significant risk, despite widespread fears to the contrary. The study also showed that radical and partial mastectomies are safe treatments.

Sometimes the medications that are necessary still carry a risk of birth defects, such as the use of anti-convulsants to treat epilepsy. Doctors should counsel women that they have twice the risk of birth defects on these drugs, but in some cases it may be possible, at least in the first trimester, to withhold treatment, reduce the dosage or switch to a different anticonvulsant that reduces the risks.

But with any drug, even over-the-counter medications such as Tylenol, use caution and get an OK first from your doctor or midwife, particularly since you can't diagnose your own illness, Filkins says.

"I think there are medications that can be extremely helpful and can allow women to have a safer pregnancy, but there are many issues involved in terms of what can be taken safely and when, so it's very important to seek medical care."


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