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It is difficult to make general statements about the use of drugs (whether prescription or over-the-counter) during a pregnancy because the potential effects depend on the specific type of medication taken, when in the pregnancy it is taken, for how long, and at what dosage. Medication is most likely to be harmful in the early critical weeks of the pregnancy, but some medications, such as thalidomide, can result in severe birth defects regardless of when they are used. If a woman wants to use over-the-counter medications to relieve the discomfort of colds, headaches, or nausea, she should discuss this decision with her physician who will be able to weigh the potential benefits from using the drugs against the possible risks for the fetus. Because most herbal remedies and food supplements have not been tested by the U.S. Food and Drug Administration for safety, it is best to avoid these completely during a pregnancy. To see how safe your own medications would be for a pregnant woman, try Active Learning: Safety of Medications During Pregnancy.

Active Learning: Safety of Medications During Pregnancy

Do you know whether your medications are safe for use during pregnancy? You can find out by making a list of all your medications (both prescription and over-the-counter), vitamins, and herbal supplements, and checking their safety.

The Physicians’ Desk Reference (PDR) (PDR Staff, 2016) contains the information that comes in the insert you receive with your prescriptions, including any warnings or contraindications for a drug’s use. A separate volume of the PDR deals specifically with nonprescription drugs, dietary supplements, and herbal medicines. This information is available through the PDR Network website at www.PDR.net or as a book in your campus library.

Medications and pregnancy. A woman should be very careful about what medications she uses during her pregnancy. The labeling on the medication itself may provide a warning about use during pregnancy, but the Physicians’ Desk Reference also contains information about safety. Of course, pregnant women should check with their doctor if they are uncertain about the safety of any medication.

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You also can search the Internet by typing the name of a specific drug and the word pregnancy to see whether there are any advisories against its use. Remember to check the credentials of any sites you use. Sites maintained by the Centers for Disease Control and Prevention, the National Institutes of Health, or the American Congress of Obstetricians and Gynecologists will give you information you can trust.

When a woman has a chronic condition such as asthma, diabetes, or high blood pressure, continuing her medication during pregnancy may be necessary to protect her well-being. For example, women who are diabetic have an increased risk of miscarriage, stillbirths, preterm births, and some birth defects if they do not effectively control their glucose level while pregnant (National Institute of Diabetes and Digestive and Kidney Diseases, 2017). A pregnant woman needs to consult with her doctor and carefully weigh the benefits of any medications and supplements against the potential risk to her pregnancy and developing fetus.

In recent years, the number of prescriptions written for a variety of opiate painkillers, including codeine, fentanyl, morphine, and oxycodone, has increased dramatically. As their medical use has increased, so has the illegal use of these drugs. Whether opioids are prescribed or illegal, their use during a pregnancy is associated with a wide range of complications and numerous harmful effects for the fetus, including an increased risk of stillbirth, premature birth or low birth weight, and birth defects that include neural tube defects and heart problems (March of Dimes, 2016). Following birth, the newborn will go through drug withdrawal, which can include tremors, excessive crying, sleep problems, vomiting, and diarrhea (March of Dimes, 2015a). If a woman becomes pregnant while using an opiate drug, she needs to talk with her health care provider. She should not suddenly discontinue her use because this could be more harmful to her baby than continuing. The best advice for a woman who is using an opioid medication, whether legally or illegally, is to use contraception so that she does not become pregnant.