One of the most important pieces of advice during pregnancy is to be extremely careful about any medications you use. By "medications," I mean prescriptions your doctor may write for you and over-the-counter preparations, vitamins, minerals and herbs. Any of these substances may affect a developing baby. What may seem like only a little to you could pass through the placenta to your developing fetus.
If possible, discuss the medications you must take for medical conditions before you get pregnant. If you were unable to do this, discuss all medications (prescription and over-the-counter) you take on a regular basis at your first visit. Dosages may need to be adjusted, or you may have to stop taking a particular substance. However, never stop taking any medication you need for a chronic problem without consulting your doctor first! Some medication cannot and should not be stopped during pregnancy. Talk to your doctor before making any decisions about medication use.
Various medications you take affect the developing baby.
Be extremely careful about any medications you use—not only prescriptions your doctor may write for you, but also over-the-counter preparations, vitamins, minerals and herbs. Any of these substances may affect a developing baby.
Vitamin Usage during Pregnancy
Prenatal Vitamins
It's very important to take your prenatal vitamins for your entire pregnancy. Sometimes late in pregnancy a woman stops taking them—she gets tired of taking them or she decides they aren't necessary. The vitamins and iron in prenatal vitamins are essential to your baby's well-being, so take them until your baby is born.
Folic Acid
Most women don't need to take extra folic acid during pregnancy if they follow a good diet and take prenatal vitamins as directed. Folic acid is found naturally in green leafy vegetables. Prenatal vitamins have 0.8 to 1 mg of folic acid in each pill, which should be sufficient for a normal pregnancy.
Studies indicate a woman who has had a baby with a neural-tube defect, such as spina bifida, may be able to reduce her chances of having another baby with the same problem if she takes extra folic acid before pregnancy and throughout early pregnancy.
As of 1998, many products have been enhanced with folic acid. These foods include staples, such as some bread products, rice, cereals, noodles, farina and commeal. Read labels.
Prescription and Nonprescription Medications during PregnancyPrescription MedicationsDiscuss all medications (prescription and over-the-counter) you take on a regular basis at your first prenatal visit. This is an extremely important part of your prenatal care. You may need to have your dosage adjusted, you may have to stop taking a particular substance, or certain conditions may require additional medication
Thyroid medication. It's important to continue taking your thyroid medication throughout your pregnancy. Be sure your doctor knows what you take. Thyroid hormone is made in the thyroid gland. This hormone affects your entire body and is important in your metabolism. Thyroid hormone is also important in your ability to get pregnant. Don't stop taking or change your dose of thyroid hormone without talking with your doctor. Thyroxin (medication for low thyroid or hypothyroid) is safe to take during pregnancy.
Propylthiouracil (high-thyroid or hyperthyroid medication) passes to the baby; you will probably be given the lowest amount possible during your pregnancy.
Lupus medication. The medication used to treat lupus is steroids; the primary steroid given is prednisone. Many studies have been done on the safety of prednisone during pregnancy, and it has been found to be safe.
Prozac™. Studies indicate Prozac is safe for use during pregnancy.
Skin medication. Accutane® (retinoic acid isotretinoin) is a common treatment for acne. However, pregnant women must nor take it! There is a higher frequency of miscarriage and malformation of the fetus if a woman takes Accutane during the first trimester of pregnancy.
Tetracycline, also commonly used to treat acne, should not be taken during pregnancy because it can cause discoloration of your baby's permanent teeth later in life. (For that reason, tetracycline must not be prescribed for any child under age 8.)
Any type of medication you use can get into your bloodstream and could be passed to your baby. Retin-A, which some women use on their skin, should be avoided during pregnancy because we do not know its effects on the fetus at this time.
Nonprescription or Over-the-Counter Medications
Although they do not require a prescription, over-the-counter (OTC) medications should be taken with care during pregnancy. Many OTCs contain aspirin, caffeine or phenacetin—all should be avoided during pregnancy. Limit your use of cough syrups, which may contain as much as 25% alcohol.
Be careful with medications containing ibuprofen, such as Advil®, Motrin® and Rufen®. Avoid newer medicines, such as Aleve® and Orudis®, until we know more about them and their safety in pregnancy. Read package labels and ask your doctor or pharmacist before taking anything.
Any type of medication you use can get into your bloodstream and could be passed to your baby.
Safe nonprescription preparations. OTC medications that are safe include acetaminophen (Tylenol), some antacids (Amphojel, Gelusil, Maalox, milk of magnesia), throat lozenges (Sucrets®), some decongestants (Sudafed®) and some cough medicines (Robitussin®).
Aspirin. Almost any medication you take when you are pregnant passes to your baby or has some effect on your pregnancy. Discuss aspirin use with your doctor.
Can Birth-control Methods Affect Pregnancy?
Some women who discover they are pregnant have been practicing birth control. They worry about the effect birth-control pills, lUDs and spermicide may have on their pregnancy.
Birth-Control Pills
If you get pregnant while taking birth-control pills, stop taking the pills, and notify your doctor. Any method of contraception can fail; the chance of failure with birth-control pills is between 1 and 3%. There is a small increase in problems for the fetus if you take birth-control pills while you're pregnant. It is not cause for great alarm, but discuss it with your doctor.
IUDs
If you become pregnant while using an lUD, notify your doctor immediately. You will need to discuss whether the lUD should be removed. Most doctors usually attempt to remove the lUD, if possible. The risk for miscarriage is higher if your lUD is left in place. The risk for ectopic pregnancy is also higher if you get pregnant with an lUD.
Spermicides
Spermicides have not been shown to be harmful to a developing fetus. Some women who discover they are pregnant have been practicing birth control.
Immunizations and Vaccinations in Pregnancy
Be careful about immunizations and vaccinations during pregnancy. Some immunizations may harm the developing fetus and should not be received by a pregnant woman. The risk of exposure to various diseases is an important consideration. Not all vaccines harm the fetus. That's why it is so important to discuss this concern with your doctor.
Sometimes immunization is needed. Once your doctor determines you have been exposed to a disease, or exposure is possible, he or she will weigh the risk of the disease against the potential harmful effects of the immunization. There are vaccines you should never receive if you are pregnant. Avoid vaccinations for measles, mumps and rubella (MMR), poliomyelitis and yellow fever. You should receive primary vaccine against polio only if your risk of exposure is high; for example, if you are traveling to a high-risk area.
Few vaccines are considered safe for a pregnant woman. The only vaccines generally regarded as safe during pregnancy are tetanus, diphtheria and rabies. Others may be safe, but we are unsure about them at this time, so avoid them.
If you are unsure if you might need a vaccine and are pregnant, talk to your healthcare provider. If you don't think you are pregnant, it would still be wise to have a pregnancy test and to be using reliable contraception before receiving a vaccine.