Medications and drugs before and during pregnancy
Always speak with a health-care professional before taking any prescription or non-prescription medication, herbal remedy or drug.
As pregnant women, we all want to do what is best for our growing babies. This often means making careful choices about what we put into our bodies. Prescription and over-the-counter medications, herbal products, topical creams, inhalers, mega doses of vitamins, alcohol, nicotine and street drugs can cross the placenta into a baby’s bloodstream.
Because your unborn baby is going through critical stages of development, these products can affect him or her differently than they affect you — sometimes causing birth defects or other significant problems. The safe use of medication is essential to optimize the health of both a pregnant woman and her unborn child.
Is it safe to take medicine while I am pregnant?
Ideally, you should not take any medication during pregnancy unless you and your health-care provider determine that it is necessary. A small number of medications have been shown through clinical studies to be safe for use in pregnancy. The effects of many other medications on your baby are not known. While few medications have been proven to be harmful to a growing baby, there has not been much research in this area and we do not really know what effect some drugs might have.
However, many women are commonly treated for medical conditions during pregnancy. Sometimes, the risk of not taking medication may be more serious than the potential risk associated with taking the medication. It is important to understand the options available to you and the risks they may carry.
Before you start taking any type of prescription or non-prescription medication or herbal remedy, it is very important that you speak with a health-care professional. This is important throughout your entire pregnancy, and particularily during the first three months, when your baby’s major body systems are forming.
I am pregnant. Should I stop taking my medication?
If you were taking a prescription medication for a diagnosed medical condition before you became pregnant, you should speak with your health-care provider as soon as possible about the safety of continuing this medication. Do not stop taking your medication or change its administration schedule on your own. Depending on your health problem, not taking your medication may be more harmful to you and your baby than continuing to take the medication.
If you are using hormonal birth control, such as the pill, the patch, the shot or the ring and become pregnant, you should stop using them — but don’t worry, there are no known negative effects to the baby.
I am trying to get pregnant.
Medications that are known to cause harm usually do so within the first few weeks of pregnancy, when the baby’s major body systems are forming — and often before you know you are pregnant. If you are taking medicine of any kind, it is best to review it with your health-care provider before you become pregnant.
If you are taking a medication that is known to be harmful for babies, you may need to change to a drug that will still give you the treatment you need and is also deemed safe to use during pregnancy. If the prescription cannot be changed, your health-care provider may advise you to reduce your dosage or to have additional tests done to monitor the effects of medication throughout your pregnancy. Or, you may be advised to stop using the drug, if it is safe to do so.
What about natural or herbal remedies?
Many people use natural or herbal products with the assumption that they are safer than other options. Many of these natural or herbal products have not been clinically tested to evaluate their safety and effectiveness. Even fewer products have been properly tested during pregnancy. Although a product may be considered natural, it still may contain ingredients that could harm you or your baby when used during pregnancy. Always ask your health-care professional first.
What’s safe, what’s harmful?
Only your health-care provider will be able to tell you what medications are safe for you to use before and during your pregnancy. Speak with your doctor, midwife, nurse or pharmacist before taking any prescription or non-prescription medication or herbal remedy, including the ones listed below:
- Morning sickness medications
- Cold and flu remedies
- Pain relievers: ASA(Aspirin), NSAIDS (Ibuprofen), Acetaminophen
- Sleeping pills
- Acne medications
- Natural or herbal remedies
- Anticonvulsants to control epilepsy
- ACE inhibitors or angiotensin receptor antagonists to treat high blood pressure
- Blood thinners
- Mood stabilisers such as lithium
- Hormonal contraceptives
Can I take something for nausea and vomiting?
Do not take over-the-counter medicines or herbal remedies without consulting your health-care provider. There are several medications that can be taken to treat nausea and vomiting. Diclectin® is the only prescription medication approved by Health Canada for the treatment of nausea and vomiting in pregnancy. It has been proven to have no harmful effects on babies. Your health-care provider can also suggest some non-pharmaceutical ways to manage and prevent nausea and vomiting.
What about caffeine, alcohol, nicotine and street drugs?
Moderate amounts of caffeine (one to two cups of coffee per day) are safe for consumption during pregnancy.
If you are pregnant or may become pregnant, avoiding alcohol is the safest choice. Evidence shows that high levels of alcohol consumption and binge drinking can have serious effects on your baby, including early in pregnancy. There is no known safe amount of alcohol during pregnancy. Speak with your health-care provider if you need help controlling your alcohol consumption.
There is a proven link between smoking during pregnancy, low birth weight or preterm babies, and other negative effects. This is also true for exposure to second-hand smoke. Research has shown that there is still benefit when smoking is stopped as late as 32 weeks in pregnancy, although it is best to quit before you become pregnant. Speak with your health-care provider about managing your cravings during pregnancy.
Street drugs are never safe for use, particularly during pregnancy; speak with your health-care provider if you need help.
For your baby’s sake, it is never too late to reduce or eliminate consumption of alcohol, nicotine or street drugs.
For more information
The Motherisk program of the Hospital for Sick Children in Toronto is a recognized leader for information about medications in pregnancy and breastfeeding. You may talk to the team at Motherisk by calling the toll-free number
1-877-439-2744 or visiting www.motherisk.org.
Other resources from the Society of Obstetricians and Gynaecologists of Canada
– Brochures available online at www.sogc.org:
- “Alcohol use in pregnancy”
- “Folic acid: Before and during pregnancy”
- “Healthy eating, exercise and weight gain: Before and during pregnancy”
- “Immunization: Before and during pregnancy”
- “Nausea and vomiting of pregnancy”
- “Medications and drugs while breastfeeding”