Can You Take Medicines While Pregnant? What to Know
People who are pregnant do many amazing feats — growing and birthing a baby is tops, of course. But going 9 months without taking a medication to ease pain, relieve heartburn, or manage a chronic condition shouldn’t be one of them.
“We prefer for patients to manage illnesses with medications deemed safe during pregnancy rather than go without them and potentially harm their health,” says Jeffrey Ecker, MD, a Mass General Brigham obstetrician-gynecologist and chair emeritus of the Department of Obstetrics and Gynecology at Massachusetts General Hospital.
That’s a relief, because an estimated 9 in 10 people take some type of medicine during pregnancy – and 7 in 10 pregnant people take at least one prescription medication, according to the Centers for Disease Control and Prevention (CDC).
“Taking care of your own health during pregnancy is one of the most important factors to having a healthy pregnancy outcome, and medications can play an important role,” says Dr. Ecker. Still, it’s normal to have concerns about the effect of medications on your pregnancy and unborn child. Here’s what you should know.
Medications and pregnancy: What’s safe?
The general consensus is that it’s OK to take most medications when you’re expecting, although there are always exceptions. A lot of what we know about medications and pregnancy is based on animal studies, and findings may not always match what is true for pregnant people.
“Much of the information we have is based on observations when medication is taken to treat a specific condition, making it difficult to know if any observed concerns are the result of the medication or the condition itself,” says Dr. Ecker.
What we know is that many medicines are considered safe during pregnancy. Some medications like the acne drug isotretinoin (more commonly known as Accutane® or Claravis®) aren’t safe because they increase the risk of birth defects, miscarriage, or preterm birth. And some medication effects on pregnancy and fetal development remain unknown.
Because a lot of fetal development happens during the first trimester, your doctor may recommend not taking a medication during this time. But you may be able to take the drug during the later trimesters.
As with many pregnancy concerns, it’s always best to check with your OB/GYN or primary care provider (PCP). But if heartburn has you wide-eyed at 2 a.m. and it’s not a medical emergency, you can also turn to these reliable sources to learn more about medications and pregnancy:
Should I take medications for a chronic condition while pregnant?
Taking medications to manage a chronic condition, such as diabetes, epilepsy, Crohn’s disease, or heart disease, can be important during pregnancy.
“It’s never a good idea to decide on your own to stop taking a prescribed medication without talking to your doctor first,” says Dr. Ecker. “For many chronic conditions, taking medications is the best way to keep you and your unborn baby healthy.”
Ideally, you should talk to your provider about your medications before you try to conceive. “Your doctor may prescribe a different medication that’s known to be safer during pregnancy or change the dosage,” says Dr. Ecker. “For the best outcome, you want to make sure any chronic condition is well managed before you get pregnant. In many instances optimizing pregnancy health goes beyond medications. It includes taking a prenatal vitamin with folate, maintaining a healthy weight, and eating nutritious foods.”
Managing mental health conditions like depression and anxiety before, during, and after pregnancy is also important. The American College of Obstetricians and Gynecologists (ACOG) estimates that mental health conditions affect as many as 1 in 5 pregnant people. Untreated or poorly treated depression and other mental health conditions during pregnancy can jeopardize your well-being. They may also increase the risk for postpartum depression or worsening of mental health symptoms after childbirth, which can affect how well you bond with and care for your newborn.
Medications are often an integral part of mental health treatment plans, especially when combined with counseling. While most antidepressant and antianxiety medications are safe during pregnancy, certain ones may cause problems. Your doctor will know the safest, best medication for you.
Can I take over-the-counter (OTC) medications while pregnant?
Antacids for heartburn are fine to use as indicated on their labels. In contrast, the FDA warns that taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, after the 20th week of pregnancy may affect an unborn baby’s developing kidneys. This kidney damage may decrease the amniotic fluid that helps protect a baby while they’re in the womb.
Checking with your provider, or using one of the reliable resources noted above, is the best way to make sure an OTC medication is safe. “Dr. Google is not the best source,” says Dr. Ecker. “Most of the information you find online for over-the-counter and prescription drugs and pregnancy cites animal studies and uses medical jargon that can be difficult to understand.”
Is it safe to take medications while breastfeeding (chestfeeding)?
More than half of people who chestfeed take one or more medications in the months after childbirth, according to a New England Journal of Medicine study. In fact, most people receive pain relievers, even opioids, while recovering in the hospital. “In this instance, the benefit to the patient greatly outweighs any small risks to the infant,” says Dr. Ecker. “The amount of drug that passes to a newborn is small and their exposure is brief.”
Most medications that are safe to take during pregnancy are also OK to take when chestfeeding. But again, it’s always best to check with your provider. There are some medicines to avoid while chestfeeding because of the effect the medicine may have on your baby. Aspirin in chestmilk, for example, may affect the way a child’s blood clots. Aspirin can also put your baby at risk for Reye’s syndrome, a rare condition that causes brain swelling and liver damage.
Pseudoephedrine, a medication in some decongestants, is another OTC remedy that is generally considered safe. Still, you should talk to your pediatrician before taking it. This medication may make your baby cranky or cause other side effects, which isn’t ideal if you’re congested, tired, and cranky yourself. Your doctor may recommend a different OTC decongestant or other ways to relieve sinus pressure like nasal saline sprays or nasal irrigation (neti pot).
If you took weight-loss medications, such as GLP-1 agonists, before pregnancy or are considering them now, you should first talk to your primary care provider and your baby’s pediatrician. There’s limited data on the safety of newer weight-loss drugs while chestfeeding.
These trusty sources also provide information about medications while chestfeeding:
- LactMed®, a National Library of Medicine Drugs and Lactation Database
- MotherToBaby LactRx smartphone app
Talk to your provider about medication safety
Whether or not you’re expecting a baby, Dr. Ecker stresses that everyone should only take medications they need to maintain good health and always at the lowest effective dose. “I see patients who have been on a medicine for years for a problem they no longer have,” he says. “Pregnancy — and the time when you’re just thinking about getting pregnant — is a perfect opportunity to reassess your medication use.”
