
Image: iStock. By Treasure McGuire, The University of Queensland.
In a recent survey, one-third of Australian women who were pregnant or had a child 11 years or younger said they had taken either a prescription or over-the-counter medicine during pregnancy.
Women take prescribed, over-the-counter, complementary and lifestyle medications for various reasons when planning or during their pregnancy.
Many women take micronutrient supplements before, during and after pregnancy to ensure they and their baby are receiving adequate vitamins and minerals. A common one is folic acid, which helps prevent birth defects in the baby’s brain and spinal cord. (These are the five common pregnancy symptoms no one ever warns you about. Post continues after video.)
Many women also take medications for pregnancy-related conditions such as morning sickness.
Medication during pregnancy may also be necessary due to incidental illnesses such as coughs and colds, or to manage a pre-existing condition.
For women to be able to assess the risks and benefits of a medicine in pregnancy, they need to understand three key concepts.
First, all couples have a 3-5% risk of having a baby with a major birth defect. This is known as a “background risk” because it exists for everyone. Untreated maternal disease, such as epilepsy or depression, can increase this background risk.
If a medicine is potentially implicated as contributing to an adverse event, the risk from the medicine needs to be increased above the background risk. Unlike our grandmothers, women today expect a happy and healthy pregnancy outcome. This can lead to couples looking for something else to blame, including medication, when things go wrong. (Post continues after gallery.)
Miscarriage grief cards
Second, there are critical time points during a pregnancy when medicines are likely or unlikely to impact on pregnancy outcome.
A common time to seek help is when medication exposure occurs prior to the woman realising she is pregnant. The following table highlights that in the first four weeks from the last menstrual period, medication does not change the woman’s baseline pregnancy risk of a birth defect. This reassurance can reduce unnecessary anxiety for the rest of the pregnancy.