Drug Use in Pregnancy
In general, drugs should not be used during pregnancy unless absolutely necessary because many can harm the mother and/or fetus.
Sometimes drugs are essential for the health of the pregnant woman and the fetus. In such cases, a woman should talk with Dr Petrina or her chosen doctor or other health care practitioner about the risks and benefits of taking the drug.
Before taking any drug (including over-the-counter drugs) or dietary supplement (including medicinal herbs), as a pregnant woman you should consult your health care practitioner. Petrina welcomes any discussion about such concerns. You may be recommend to take certain vitamins and minerals during pregnancy and this should be discussed and explained as a matter of course with your health provider.
Of course this is all very different from the Illicit drugs that people take. It is essential that you trust your health provider with any information you have about any drugs or substances you know you are abusing or taking with a suspicion that it wouldn't be recommended in pregnancy. This should be done knowing it will be received free from judgement but followed with a genuine commitment to support you in ceasing any such use and facilitating optimum care. Please consider disclosing any use of drugs to Petrina or your respected health professional. Please also see the page None prescribed Drugs.
In general, drugs should not be used during pregnancy unless absolutely necessary because many can harm the mother and/or fetus.
Sometimes drugs are essential for the health of the pregnant woman and the fetus. In such cases, a woman should talk with Dr Petrina or her chosen doctor or other health care practitioner about the risks and benefits of taking the drug.
Before taking any drug (including over-the-counter drugs) or dietary supplement (including medicinal herbs), as a pregnant woman you should consult your health care practitioner. Petrina welcomes any discussion about such concerns. You may be recommend to take certain vitamins and minerals during pregnancy and this should be discussed and explained as a matter of course with your health provider.
Of course this is all very different from the Illicit drugs that people take. It is essential that you trust your health provider with any information you have about any drugs or substances you know you are abusing or taking with a suspicion that it wouldn't be recommended in pregnancy. This should be done knowing it will be received free from judgement but followed with a genuine commitment to support you in ceasing any such use and facilitating optimum care. Please consider disclosing any use of drugs to Petrina or your respected health professional. Please also see the page None prescribed Drugs.
Before we consider certain types of drugs it's useful to know just how they get through the placenta.
Drugs taken by a pregnant woman reach the fetus primarily by crossing the placenta, the same route taken by oxygen and nutrients, which are needed for the fetus's growth and development. Drugs that a pregnant woman takes during pregnancy can affect the fetus in several ways:
Drugs taken by a pregnant woman reach the fetus primarily by crossing the placenta, the same route taken by oxygen and nutrients, which are needed for the fetus's growth and development. Drugs that a pregnant woman takes during pregnancy can affect the fetus in several ways:
- They can act directly on the fetus, causing damage, abnormal development (leading to birth defects), or death.
- They can alter the function of the placenta, usually by causing blood vessels to narrow (constrict) and thus reducing the supply of oxygen and nutrients to the fetus from the mother. Sometimes the result is a baby that is underweight and underdeveloped.
- They can cause the muscles of the uterus to contract forcefully, indirectly injuring the fetus by reducing its blood supply or triggering preterm labor and delivery.
- They can also affect the fetus indirectly. For example, drugs that lower the mother's blood pressure may reduce blood flow to the placenta and thus reduce the supply of oxygen and nutrients to the fetus.
Vaccines
Vaccines made with a live virus (such as the rubella and varicella vaccines) are not given to women who are or might be pregnant. They may be offered to you Post Partum (after the baby is born.
Other vaccines (such as those for cholera, hepatitis A and B, measles, mumps, plague, rabies, tetanus, diphtheria, and typhoid) are given to pregnant women ONLY if they are at substantial risk of developing that particular infection.
However, all pregnant women are recommended to have the Whooping Cough (Pertussis) vaccine between 28-32 weeks of pregnancy ideally. The flu vaccine is also identified as being recommended in the latest research to all pregnant women also. Please discuss these issues to your satisfaction with Petrina or your chosen health care provider.
Drugs Used to Treat Heart and Blood Vessel Disorders
Drugs to lower high blood pressure (antihypertensives) may be needed by pregnant women who have had high blood pressure before pregnancy or who develop it during pregnancy. Either type of high blood pressure increases the risk of problems for the woman and the fetus ( High Blood Pressure During Pregnancy and Preeclampsia and Eclampsia).
However, antihypertensives can markedly reduce blood flow to the placenta if they lower blood pressure too rapidly in pregnant women. So pregnant women who have to take these drugs are closely monitored. Two types of antihypertensives—angiotensin-converting enzyme (ACE) inhibitors and thiazide diuretics—are usually not given to pregnant women because these drugs can cause serious problems in the fetus, such as kidney damage, inadequate growth before birth (growth restriction), and birth defects.
Digoxin, used to treat heart failure and some abnormal heart rhythms, readily crosses the placenta. But at the usual doses, it typically has little effect on the baby before or after birth.
Psychoactive Drugs
Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) such as paroxetine, are commonly used during pregnancy. Use is common because about 7 to 23% of pregnant women have depression. For pregnant women, the benefits of treating depression usually outweigh the risks but must be considered carefully. Discuss with Petrina or your chosen health care professional
Sometimes a drug requires extra monitoring of its effect such as increased number of ultrasound scans, growth analysis, cardiac and placental flow studies.
If a pregnant woman takes antidepressants, the newborn may have withdrawal symptoms after delivery. To prevent these symptoms, doctors may gradually reduce the dose of the antidepressant during the 3rd trimester and stop the drug before the baby is born.
However, if the woman has significant signs of depression or if symptoms worsen as the dose is reduced, antidepressants should be continued. Depression during pregnancy can lead to postpartum depression, which involves a serious change in mood and requires treatment.
Legal Recreational Drugs
Cigarette (tobacco) smoking
Cigarette smoking harms both pregnant women and their baby. The most consistent effect of smoking on the fetus during pregnancy is a reduction in birth weight: The more a woman smokes during pregnancy, the less the baby is likely to weigh. This is sometimes seen in a light hearted light but it has potentially serious consequences and can reflect fetal compromise.
Birth defects of the heart, brain, and face are more common among babies of smokers than among those of nonsmokers. Also, the risk of sudden infant death syndrome (SIDS) is increased.
A mislocated placenta (placenta previa), premature detachment of the placenta (abruptio placentae), premature rupture of the membranes (containing the fetus), preterm labor, uterine infections, miscarriages, stillbirths, and premature births are also more likely.
In addition, children of women who smoke have slight but measurable deficiencies in physical growth and in intellectual and behavioral development. These effects are thought to be caused by carbon monoxide and nicotine. Carbon monoxide may reduce the oxygen supply to the body's tissues. Nicotine stimulates the release of hormones that constrict the vessels supplying blood to the uterus and placenta, so that less oxygen and fewer nutrients reach the fetus.
Because of the possible harmful effects of smoking during pregnancy, as a pregnant women you will be encouraged to make every effort to not smoke during pregnancy, Please discuss options for support in doing this with Petrina or your chosen Health professional.
It is also recommended that pregnant women should avoid exposure to secondhand smoke because it may similarly harm the fetus.
Alcohol
Drinking alcohol during pregnancy is the leading known cause of birth defects. Because the amount of alcohol required to cause fetal alcohol syndrome is unknown, pregnant women are advised to abstain from drinking any alcohol.
The risk of miscarriage almost doubles for women who drink alcohol in any form during pregnancy, especially if they drink heavily. Often, the birth weight, of babies born to women who drink regularly during pregnancy is substantially below normal.
Fetal alcohol syndrome is one of the most serious consequences of drinking during pregnancy. Binge drinking as few as three drinks a day can cause this syndrome. It occurs in about 2 of 1,000 live births. This syndrome includes inadequate growth before or after birth, facial defects, a small head (probably caused by inadequate growth of the brain), intellectual disability, and abnormal behavioral development. Less commonly, the position and function of the joints are abnormal and heart defects are present.
Caffeine
Whether consuming caffeine during pregnancy harms the fetus is unclear. Evidence seems to suggest that consuming caffeine in small amounts (for example, one cup of coffee a day) during pregnancy poses little or no risk to the fetus.
Caffeine, which is contained in coffee, tea, some soft drinks, chocolate, and some drugs, is a stimulant that readily crosses the placenta to the fetus. Thus, it may stimulate the fetus, increasing the heart rate. Caffeine also may decrease blood flow across the placenta and decreases the absorption of iron (possibly increasing the risk of anemia).
Aspartame
Aspartame, an artificial sweetener, appears to be safe during pregnancy when it is consumed in small amounts, such as in amounts used in normal portions of artificially sweetened foods and beverages. Pregnant women with phenylketonuria, an unusual disorder, should not consume any aspartame.
Vaccines made with a live virus (such as the rubella and varicella vaccines) are not given to women who are or might be pregnant. They may be offered to you Post Partum (after the baby is born.
Other vaccines (such as those for cholera, hepatitis A and B, measles, mumps, plague, rabies, tetanus, diphtheria, and typhoid) are given to pregnant women ONLY if they are at substantial risk of developing that particular infection.
However, all pregnant women are recommended to have the Whooping Cough (Pertussis) vaccine between 28-32 weeks of pregnancy ideally. The flu vaccine is also identified as being recommended in the latest research to all pregnant women also. Please discuss these issues to your satisfaction with Petrina or your chosen health care provider.
Drugs Used to Treat Heart and Blood Vessel Disorders
Drugs to lower high blood pressure (antihypertensives) may be needed by pregnant women who have had high blood pressure before pregnancy or who develop it during pregnancy. Either type of high blood pressure increases the risk of problems for the woman and the fetus ( High Blood Pressure During Pregnancy and Preeclampsia and Eclampsia).
However, antihypertensives can markedly reduce blood flow to the placenta if they lower blood pressure too rapidly in pregnant women. So pregnant women who have to take these drugs are closely monitored. Two types of antihypertensives—angiotensin-converting enzyme (ACE) inhibitors and thiazide diuretics—are usually not given to pregnant women because these drugs can cause serious problems in the fetus, such as kidney damage, inadequate growth before birth (growth restriction), and birth defects.
Digoxin, used to treat heart failure and some abnormal heart rhythms, readily crosses the placenta. But at the usual doses, it typically has little effect on the baby before or after birth.
Psychoactive Drugs
Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) such as paroxetine, are commonly used during pregnancy. Use is common because about 7 to 23% of pregnant women have depression. For pregnant women, the benefits of treating depression usually outweigh the risks but must be considered carefully. Discuss with Petrina or your chosen health care professional
Sometimes a drug requires extra monitoring of its effect such as increased number of ultrasound scans, growth analysis, cardiac and placental flow studies.
If a pregnant woman takes antidepressants, the newborn may have withdrawal symptoms after delivery. To prevent these symptoms, doctors may gradually reduce the dose of the antidepressant during the 3rd trimester and stop the drug before the baby is born.
However, if the woman has significant signs of depression or if symptoms worsen as the dose is reduced, antidepressants should be continued. Depression during pregnancy can lead to postpartum depression, which involves a serious change in mood and requires treatment.
Legal Recreational Drugs
Cigarette (tobacco) smoking
Cigarette smoking harms both pregnant women and their baby. The most consistent effect of smoking on the fetus during pregnancy is a reduction in birth weight: The more a woman smokes during pregnancy, the less the baby is likely to weigh. This is sometimes seen in a light hearted light but it has potentially serious consequences and can reflect fetal compromise.
Birth defects of the heart, brain, and face are more common among babies of smokers than among those of nonsmokers. Also, the risk of sudden infant death syndrome (SIDS) is increased.
A mislocated placenta (placenta previa), premature detachment of the placenta (abruptio placentae), premature rupture of the membranes (containing the fetus), preterm labor, uterine infections, miscarriages, stillbirths, and premature births are also more likely.
In addition, children of women who smoke have slight but measurable deficiencies in physical growth and in intellectual and behavioral development. These effects are thought to be caused by carbon monoxide and nicotine. Carbon monoxide may reduce the oxygen supply to the body's tissues. Nicotine stimulates the release of hormones that constrict the vessels supplying blood to the uterus and placenta, so that less oxygen and fewer nutrients reach the fetus.
Because of the possible harmful effects of smoking during pregnancy, as a pregnant women you will be encouraged to make every effort to not smoke during pregnancy, Please discuss options for support in doing this with Petrina or your chosen Health professional.
It is also recommended that pregnant women should avoid exposure to secondhand smoke because it may similarly harm the fetus.
Alcohol
Drinking alcohol during pregnancy is the leading known cause of birth defects. Because the amount of alcohol required to cause fetal alcohol syndrome is unknown, pregnant women are advised to abstain from drinking any alcohol.
The risk of miscarriage almost doubles for women who drink alcohol in any form during pregnancy, especially if they drink heavily. Often, the birth weight, of babies born to women who drink regularly during pregnancy is substantially below normal.
Fetal alcohol syndrome is one of the most serious consequences of drinking during pregnancy. Binge drinking as few as three drinks a day can cause this syndrome. It occurs in about 2 of 1,000 live births. This syndrome includes inadequate growth before or after birth, facial defects, a small head (probably caused by inadequate growth of the brain), intellectual disability, and abnormal behavioral development. Less commonly, the position and function of the joints are abnormal and heart defects are present.
Caffeine
Whether consuming caffeine during pregnancy harms the fetus is unclear. Evidence seems to suggest that consuming caffeine in small amounts (for example, one cup of coffee a day) during pregnancy poses little or no risk to the fetus.
Caffeine, which is contained in coffee, tea, some soft drinks, chocolate, and some drugs, is a stimulant that readily crosses the placenta to the fetus. Thus, it may stimulate the fetus, increasing the heart rate. Caffeine also may decrease blood flow across the placenta and decreases the absorption of iron (possibly increasing the risk of anemia).
Aspartame
Aspartame, an artificial sweetener, appears to be safe during pregnancy when it is consumed in small amounts, such as in amounts used in normal portions of artificially sweetened foods and beverages. Pregnant women with phenylketonuria, an unusual disorder, should not consume any aspartame.
