Taking Medication While Pregnant
Safe or Sorry?
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
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
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."