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DESCRIPTION
Medications (this includes drugs as well as homeopathic treatments and herbal preparations) taken by pregnant women can cross the placenta and reach the fetus and possibly cause birth defects, particularly in the first 3 months when fetal organs are being formed. Therefore, it is important that a pregnant woman take only medications considered essential and that she understand their risks and benefits. Sometimes, the risk of the illness has to be weighed against the known or unknown risk of the medication as illnesses and infections may also cause fetal problems.
There are many drugs that have been used relatively safely in pregnancy. Once you have made certain a medication is relatively safe (however, no drug has been proven to be absolutely safe!), you have researched and become informed of the side effects and contraindications using a Physician's Desk Reference (PDR) (for drugs) and have your midwife's or health care provider's approval, don't hold off taking it. The earlier treatment begins for most infections or disorders, the better the chances are for a faster, uncomplicated recovery. Be sure to report any side effects, adverse reactions or concerns to your midwife before and after treatment has begun.
Frequently, a woman has taken a prescription or non-prescription medication ever before she realizes she has missed a menstrual period and may be pregnant. Always discuss this with your midwife or health care provider at your first prenatal visit. Be sure you know the name of the medication, the dosage amount, length of time you took it, and if you had any side effects. This also includes any herbal products or homeopathic treatments you have used.
With some chronic conditions, prescribed medications that carry some risks may need to be taken to control the disorder despite the pregnancy. In these situations, your midwife or health care provider will attempt to prescribe the lowest dose possible for effective treatment and reduce risks to the fetus. It is important to adhere to the dosage schedule and to advise your midwife or health care provider if symptoms are not being controlled.
There are many herbal remedies available that are used to treat a variety of medical problems and are used to prevent others. It is important to recognize that these remedies contain chemicals (usually in much less concentrated dosages) just like drugs do and can present risks to the fetus. Don't use any remedy or preparation without approval of your midwife or health care provider.
TERATOGENESIS
Teratology is the science dealing with the structural, functional, and behavioral abnormalities of offspring. A teratogen is an agent that causes abnormalities (birth defects) in a developing embryo or fetus. Examples are rubella virus (German measles) and the drug thalidomide. If a drug is classified as a teratogen, there must be evidence that taking the drug during pregnancy causes congenital abnormalities that cannot be explained by other factors.
MoonDragon's Health Information: Teratogens List
HOW DRUGS ARE RATED FOR RISK IN PREGNANCY
A pregnancy risk category is assigned to individual medications and identifies the potential risk for that particular drug to cause birth defects or death to the unborn child (fetus). These categories are assigned by applying the definitions of the FDA to the available clinical information about the drug. Most drugs are tested only on animals and not on humans for safety during pregnancy because such testing would subject unborn children to unnecessary risks.
All drugs are best avoided during pregnancy, but this rating system can help your midwife or health care provider begin to assess the risk-to-benefit ratio should drug treatment become necessary. You and your midwife or health care provider should discuss these benefits and risks carefully before any drug treatment is initiated.
PREGNANCY RISK CATEGORY
Definition of the drug categories (A, B, C, D, AND X):
A: Adequate studies in pregnant women have failed to show a risk to the fetus in the first trimester of pregnancy and there is no evidence of risk in later trimesters.
B: Animal studies have not shown an adverse effect on the fetus, but there are not adequate studies in pregnant women; or animal studies have shown an adverse effect on the fetus, but adequate studies in pregnant women have not shown a risk to the fetus.
C: Animal studies have shown an adverse effect on the fetus but there are no adequate studies in humans; or there are no studies in animals or women. The drug may be used for pregnant women because of the benefits and despite its potential risk.
D: There is evidence of risk to the human fetus, but the potential benefits of use in pregnant women may be acceptable despite potential risks (e.g., life-threatening situation for a serious disease for which safer drugs cannot be used or are effective).
X: Studies in animals and humans show fetal abnormalities, or reports of adverse reactions indicate evidence of fetal risk. The risks involved clearly outweigh potential benefits and the drug is contraindicated for pregnant women.
NA: None Assigned.
RECOMMENDED BOOKS
Drugs in Pregnancy & Lactation: A Reference Guide to Fetal & Neonatal Risk
Physicians Desk Reference Prescription Drugs 2003
Physicians Desk Reference Non-prescription Drugs & Dietary Supplements 2003
Physicians Desk Reference Herbal Medicines, 2nd Edition
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or a family member are pregnant or trying to conceive and want to know more about taking a prescription, non-prescription, homeopathic therapy, or herbal preparation that has not been previously discussed with your midwife or health care provider. This includes cold medications, headache or pain remedies, laxatives, antihistamines, anti-nausea drugs and any herbal remedies. Do not treat yourself!
You experience side effects from a prescription or non-prescription medication.
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