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Managing Your Medications During Pregnancy
an article from the Fall 2007 issue of…
When you’re pregnant, you may wonder what part of your routine can stay the same and what needs to change. For example, is it safe to take medication while pregnant? The simplest answer is: It depends.
“All medications have certain risks and benefits, and each woman’s situation is different,” said Adela Navarro, M.D., a board-certified OB/GYN with Harbor Hospital. “Before you start — or stop — taking any over-the-counter, herbal or prescription medication, it’s important to consider the risks and benefits.”
Sometimes, the benefits outweigh the risks. “A doctor may prescribe an antibiotic if a pregnant woman has a urinary tract infection,” Dr. Navarro explained, “since without an antibiotic, the woman risks developing a kidney infection, which could cause preterm labor.”
Or a woman may need medication to manage a long-term health condition, such as diabetes. “Not using the medication you need could be more harmful than taking it,” Dr. Navarro said. “A woman with asthma needs medication to avoid reduced lung function; otherwise, her baby won’t have enough oxygen.”
On the flip side, some medications may pose too great a risk. Doctors agree that pregnant women should never take the oral acne medicine isotretinoin because it can lead to birth defects and miscarriage.
Before and During Your First Trimester
Take a multivitamin with 400 micrograms of folic acid. “Folic acid can help prevent a type of birth defect that affects the brain and spine,” Dr. Navarro said. “Studies show that 50 to 70 percent of these birth defects can be prevented if a woman gets the recommended amount of folic acid before she becomes pregnant and during her first trimester.”
When you become pregnant, ask your doctor if you need to take a special multivitamin just for pregnant women.
Also, make sure you get 30 milligrams of iron each day during the first trimester. That’s twice the amount other women need. “Iron helps keep the blood healthy, and pregnant women have more blood in their bodies, requiring this increased intake” Dr. Navarro explained.
In Your Second Trimester
About 6 to 8 percent of pregnant women develop high blood pressure — many during their second trimesters. However, Dr. Navarro warned that some types of medication to treat blood pressure are not safe for pregnant women. You should explore treatment options with your doctor.
It’s wise to avoid using prescription and over-the-counter pain medications during the second trimester. “These can affect the development of the baby’s nervous system,” Dr. Navarro said. “There also is evidence that using certain pain medicines may be linked to a child’s risk of developing schizophrenia.”
During Your Third Trimester
During the last trimester, common pain relievers can still be harmful, causing blood-flow problems for the baby.
“Pregnant women should stay away from aspirin, as well as nonsteroidal antiinflammatory drugs such as ibuprofen and naproxen,” Dr. Navarro said. Antidepressants and Pregnancy The American College of Obstetricians and Gynecologists recently advised women who are pregnant, or want to become pregnant, to avoid a type of antidepressant called paroxetine, as research has shown the potential for heart defects and other risks to the baby.
The data is less clear on other antidepressants. “Some studies have shown that antidepressants called SSRIs may be linked to low birth weight and other risks. Yet, other studies have found no risks,” Dr. Navarro said.
It’s important to discuss your medications with your obstetrician or nurse-midwife. These experts will only prescribe medications that are safe for you and your baby, and can offer advice on over-the-counter medications. Working with your team of caregivers will help ensure your pregnancy and delivery are safe and healthy.
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