At some point, you’ve probably heard of the foods pregnant women should avoid (soft cheeses, sushi, cold cuts, etc.), but when it comes to medications, it’s not so cut and dried. And while going drug free for nine months sounds ideal, the reality is nine out of 10 women in the U.S. take medication at some point during their pregnancy.
Choosing which drugs are safe for you and your baby isn’t always easy—especially if you regularly take medication for your mental health or pre-existing health conditions. It’s an important, must-have conversation with your doctor as soon as you find out you’re pregnant, but we spoke with a couple experts about what you could expect.
“Everything in life is about the risk-benefit ratio,” said Dr. Felice Gersh, founder and director of the Integrative Medical Group of Irvine and author of PCOS SOS: A Gynecologist’s Lifeline to Naturally Restore Your Rhythms, Hormones, and Happiness. “If the woman has a certain infection or a life-threatening disease, there may be a pharmaceutical she absolutely needs. You have to make compromises sometimes.”
In other words, the ability for a certain drug (such as blood pressure medication) to keep a mom-to-be healthy throughout her pregnancy may outweigh the small risk it poses to the developing fetus. This evaluation is done by you and your doctor on a case-by-case basis, and it’s important to understand all potential risks involved.
When it comes to how a drug may affect a fetus, timing is a huge component. “In general, the first trimester is the highest risk because that’s the time when the fetus is most vulnerable,” said Dr. Ceppie Merry, who has a PhD in clinical pharmacology and writes for Healthy But Smart. “The growing fetus has an immature kidney and liver system, and it can’t handle drugs the same way adults can. You need to be careful throughout every trimester, though, and even in what’s called the ‘fourth trimester,’ as some drugs can be passed through breast milk.”
The types of drugs you take also make a huge difference in the protection of the fetus. Some prescriptions—and specific brands of prescriptions—pose bigger risks than others. For example, valproic acid (Depakote) has shown a high risk of causing physical birth defects and cognitive/behavioral health issues in babies in the womb compared with other anti-seizure medication. While selective serotonin reuptake inhibitors (SSRIs), which are used to treat depression, may increase the baby’s risk of neonatal adaptation syndrome, the impact of stopping the medication during pregnancy on the mental health of the mother may make it difficult for her to get good prenatal care. Again, it goes back to the risk-benefit analysis between you and your doctor.
Ultimately, everything you put into your body can have an impact on your fetus; even over-the-counter medications and natural supplements can potentially cause birth defects or other health problems for the child later in life. For example, high doses of aspirin during the first trimester could cause congenital defects and miscarriage. Bismuth subsalicylate (Pepto Bismol) should also be avoided during pregnancy because chronic exposure to one of the active ingredients (salicylate) may be toxic to your baby.
Now, does that mean you have to endure common discomforts like a headache or an upset stomach when you’re carrying a baby? Not necessarily.
“The field of complementary and alternative medicine can really help you while you’re pregnant,” Dr. Merry explained. “Certain forms of healing, like relaxation, hypnosis and acupuncture, will have no impact on your baby.”
Dr. Gersh suggests a few natural remedies for common pregnancy ailments: Heartburn may be relieved by avoiding triggering foods such as citrus fruit, tomato, and onion. A cup of ginger tea can settle certain digestive issues. A head and neck massage can relieve physical and emotional tension. And when you have anxiety, taking magnesium and listening to a guided meditation can help you relax.
All that being said, every pregnancy is unique. If you’re feeling less than your best—for any reason—it’s best to talk to your doctor to explore which medicine is right for your pregnancy.