Knowing how to manage illness and what medications are safe to take is important to protect your own and your baby’s health.
Whether you have a
preexisting medical condition, or acquire an illness or infection during
pregnancy, always consult your doctor before taking medication or
before stopping any prescribed medication.
Preexisting conditions
If you have a condition
such as high blood pressure or diabetes prior to pregnancy, your
pregnancy will be classified as high risk and you’ll need to be
monitored carefully. If you become pregnant while taking medication for a
condition, don’t stop taking the medication, but consult your doctor as
soon as possible. You may find that your existing medication is safe,
or you may need to change to another type of medication. The most
important thing is to control your condition during pregnancy to
minimize the risks to you and your baby, which will usually mean
continuing with medication.
Diabetes
If you have diabetes and
are planning to conceive, you need to get advice on how to manage your
condition. Meet with your doctor while you’re thinking about conceiving
to discuss the best way to control your blood sugar levels and talk
about how diabetes will be managed in pregnancy. Women with diabetes are
advised to take a prenatal vitamin with folic acid before trying to
conceive and for the first three months of pregnancy. Diabetic women who
are overweight may be advised to lose weight before getting pregnant,
and they’ll likely be told to monitor their blood sugar more frequently
and take their medications on time during their pregnancy. Babies born
to diabetic women also have a greater risk of other problems, such as
having a large birth weight, respiratory problems at birth, jaundice,
and low blood sugar at birth.
As soon as you’re
pregnant, you should be referred to an obstetrician who specializes in
pregnancy and diabetes where you’ll receive extra care. You will have
more frequent prenatal visits, additional scans, and extra blood tests
to monitor your blood sugars. You may need diabetes medication and/or
insulin injections each day; the dose usually changes throughout
pregnancy and needs to be monitored. The better your blood sugar
control, the less likely you or your baby is to experience problems
during pregnancy.
Since diabetic women have an increased risk of late pregnancy problems such as preeclampsia and premature labor, you may be advised to have an induction of labor a week or so before your due date .
Once in labor, your
blood sugar levels will be closely monitored, and you will probably be
given an insulin IV. After the birth, your baby’s blood sugar levels
will be closely monitored too for around 24 hours. If you’re planning to
breast-feed, which is recommended, your insulin dose may need to be
changed after the birth.
Diabetes is controlled
with daily insulin injections in pregnancy. As the skin on your abdomen
becomes taut, you may find it easier to inject into the fatty tissue of
the thigh.
Epilepsy
If you have
epilepsy, it’s very important to discuss pregnancy with your doctor
before you become pregnant, since certain drugs carry a small risk of
causing harm to the developing baby. Nonetheless, it’s also important
that your epilepsy is controlled, so your doctor will try to ensure that
you’re on the lowest possible dose of medication before you get
pregnant. When you are pregnant, the anomaly scan at around 20 weeks
will check for problems such as cleft palate, which are slightly more
common with certain medications. If your condition worsens in pregnancy,
contact your doctor.
Continuing with asthma medication is important to keep symptoms under control in pregnancy.
Systemic lupus erythematosus
This is an
autoimmune disorder that can affect many parts of the body, including
the kidneys, joints, skin, nervous system, heart, and lungs. The
condition is more common in women, and particularly in those of
childbearing age. Some women find that the symptoms for this condition
ease during pregnancy, however for some they can worsen. It’s important
to control the condition during pregnancy since it can affect the
developing baby, with an increased risk of miscarriage, poor growth,
premature labor, and stillbirth. Most medications for lupus are safe to
use during pregnancy, but some aren’t, so you need to check with your
doctor about whether you need to change your current medication. From
around 32 weeks, your baby will be closely monitored and his growth and
well-being will be checked. If there are concerns about you or your
baby, labor may be induced early, or you may have a planned cesarean.
High blood pressure
If you have high
blood pressure that requires medication, check with your doctor that the
medication you are on is safe to use during pregnancy. It’s important
to continue your medication so that your blood pressure is controlled,
because high blood pressure can be dangerous both for you and your baby.
Your doctor will frequently check your blood pressure, and will test
your urine to check for the presence of protein, because high blood
pressure and protein in the urine are symptoms of the condition preeclampsia. Your doctor may also recommend additional scans to check that your baby is growing well.
Thyroid problems
If you have an
underactive thyroid gland for which you are taking thyroxine, you’ll
need to have a blood test to ensure that your thyroid is functioning
well and that you’re taking the correct dose, since sometimes the
thyroxine requirement increases in pregnancy. It’s important that you
are not lacking in thyroxine, because this may affect the baby. If you
are being treated for an overactive thyroid gland, check with your
doctor that you’re taking a thyroid medication that is safe in
pregnancy. Your thyroid function will be monitored to check that your
medication doesn’t need to change.
Bowel disease
Women with
inflammatory bowel conditions, such as ulcerative colitis or Crohn’s
disease, usually find that their condition improves during pregnancy,
although you may relapse after the baby is born. Although it’s unusual
for bowel conditions to cause major problems during pregnancy, it is
important to check that you are not anemic, which can be a side effect
of some bowel conditions, and your doctor may recommend extra scans to
check that the baby is growing well.
Infections during pregnancy
When you’re pregnant,
your immune system is slightly suppressed. This is necessary to stop you
from rejecting the baby, who is genetically half the father’s! This
means that you may be slightly more susceptible to common problems such
as colds, coughs, a sore throat, or food poisoning, and that the illness
may last longer.
If you’re laid low with an illness during pregnancy, take time to rest and recuperate since pregnancy can exacerbate everyday symptoms.
Colds and coughs
Most women get a cough
or cold at some stage during their pregnancy. However, you should avoid
taking cold medications since these can contain ingredients that are not
safe in pregnancy, especially during the first three months (see Cold remedies).
Steam inhalations can ease congestion and hot honey drinks help to
soothe a sore throat. Saline nasal sprays can also help relieve
congestion.
Flu
If you get the flu during
pregnancy, call your doctor to get advice or make an appointment. Drink
plenty of liquids and get plenty of rest. Don’t take any flu or cold
medications without talking to your doctor first. Flu complications can
include dehydration and pneumonia, and complications are more common in
pregnant women. The US Centers for Disease Control and Prevention
recommend that all pregnant women should get flu vaccinations. However,
the CDC says they should not get the nasal-spray flu vaccine, which is
not approved for pregnant women.
Food poisoning and stomach upsets
A severe episode of
food poisoning can cause problems for you and your baby and could
trigger an early miscarriage, so it’s vital to practice good kitchen
hygiene.
If you do develop food poisoning or a stomach upset, try to drink
plenty of fluids, and if it continues for more than 24 hours, see your
doctor.
Yeast
If you have an
abnormal discharge, talk to your doctor since this may be yeast
(candidiasis), which is common in pregnancy. A swab may be taken to
confirm the diagnosis, and an appropriate local antifungal
treatment prescribed. Eating natural yogurt may help restore the
bacterial balance in your vagina. Wearing cotton underwear and avoiding
tight clothing is also recommended.
Urinary infections
Many pregnant women
get urinary infections because the hormone progesterone relaxes all of
the smooth muscle, allowing the bacteria that normally live in your
vagina to travel up the urethra (the tube that leads to the bladder)
where they may cause an infection. The symptoms of an urinary infection
may be slightly different in pregnancy. You may have the classic
symptoms of burning when urinating and frequent passing of urine, or you
may have different symptoms such as back pain, lower abdominal pain,
nausea, or vomiting. These are usually easily treated with antibiotics,
most of which are safe in pregnancy.
| Q: |
I’m asthmatic. Can I use my inhalers during pregnancy?
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| A: |
It’s essential that you keep asthma under control in pregnancy,
which means continuing to use your inhalers, since the risks from
uncontrolled asthma are greater than any risk from taking asthma
medication. If asthma is uncontrolled, it can mean that not enough
oxygen gets to the baby, leading to a low birth weight or other
problems. One of the best ways to control asthma, in addition to taking
medication, is to avoid asthma triggers such as pet fur and dust mites.
Use air filters, vacuum often, and damp dust, and use duvet, mattress,
and pillow protectors. Sometimes, pregnancy reduces the severity of
asthma, but if you feel wheezier than usual, talk to your doctor about
reviewing your medication.
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| Q: |
Homeopathy seems to be a popular form of therapy. How effective is it and is it safe?
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| A: |
Homeopathy works on the principle of treating like with like to
stimulate the body’s natural healing mechanisms. There has been debate
about the efficacy of homeopathy and the scientific opinion is that
there is insufficient evidence to show that homeopathy has any effect
beyond that of a placebo. But talk to your doctor before using any
homeopathic products or remedies during pregnancy, since homeopathy is
an area of complementary and alternative medicine that’s associated with
much debate and scientific controversy. If your doctor gives you the
okay, a certified homeopath may be able to provide treatment.
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| Q: |
What’s the verdict on taking herbal remedies and teas during pregnancy?
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| A: |
The US Food and Drug Administration does not regulate herbs and
other dietary supplements, and there’s not much research about the
health effects of many herbs on pregnant women, so it’s best to avoid
them while you’re pregnant, including herbal teas. Decaffeinated black
teas are your best bet, but if you want a fruit or ginger tea, read the
ingredient label on the package carefully to be sure that no herbs are
present. If you want to use an herbal remedy, talk to your doctor first.
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What to do
Exposure to chickenpox or rubella
Chickenpox in
pregnancy can cause problems for the baby and can be severe in a
pregnant woman, possibly leading to pneumonia. If you contract rubella
for the first time in early pregnancy, it can cause miscarriage or
severe problems in the fetus.
If you encounter chickenpox,
contact your doctor who can check your immunity. If you aren’t immune,
your doctor may advise an injection to protect you from severe
chickenpox.
Your rubella status is checked at the start of pregnancy. If you aren’t immune, you can be vaccinated after the birth. Meanwhile you need to be extra careful.
If you develop chickenpox or suspect rubella
because of a rash, contact your doctor immediately, but don’t go to the
doctor’s office, where you may spread the infection to other pregnant
women.
What’s safe and what’s not
Taking medications during pregnancy
During the first three months of pregnancy,
it’s best to avoid all over-the-counter medications. Once you are past
the first trimester, some other medications are considered safe, but
always consult your doctor if you are in any doubt. The following
provides guidance on medications used for treating common pregnancy
complaints and minor illnesses.
Antacids
Heartburn and
indigestion are common problems in pregnancy, particularly during the
third trimester when the increased size of the baby puts pressure on
your stomach. Some antacids are safe to use during pregnancy, although
you should avoid sodium bicarbonate because it may increase fluid
retention. Consult your doctor or pharmacist about which ones are
recommended.
Antibiotics
Many antibiotics used to
treat infection are safe for use during pregnancy. This includes
antibiotics containing penicillin, although there are safe alternatives
if you’re allergic to penicillin. The following antibiotics should be
avoided during pregnancy:
Streptomycin. This can damage the ears of the fetus as it develops and may result in hearing loss in the baby.
Sulphonamides. These can cause jaundice in the newborn baby.
Tetracyclines.
These drugs shouldn’t be taken because they can affect the development
of the baby’s bone and teeth and can cause discoloration in the teeth.
Antiemetics
If you have
severe nausea and vomiting and natural remedies such as gingersnaps or
ginger tea don’t relieve the problem, your doctor may recommend an
antiemetic medication that is safe to use during pregnancy.
Antifungal remedies
You should avoid
over-the-counter antifungal remedies, including oral and local remedies,
for treating yeast. Consult your doctor, who can recommend an
antifungal medication that is appropriate for use in pregnancy.
Cold remedies
Remedies for coughs and
colds often contain a range of ingredients, such as caffeine,
antihistamines, and other decongestants, many of which aren’t safe in
pregnancy. Ideally, avoid all cold remedies and instead have steam
inhalations and hot caffeine-free drinks. If you need relief, talk to
your doctor before using any over-the-counter treatments.
Diuretics
It’s normal to
experience some swelling in the hands and feet during pregnancy, and you
shouldn’t attempt to deal with this by taking diuretics, including
herbal diuretics. If you have sudden swelling in the face, hands, or
feet, you should consult your doctor immediately because this can be a
sign of preeclampsia
Laxatives
The first step in dealing
with constipation is to take dietary measures by increasing your intake
of fiber and drinking plenty of fluids. If this isn’t enough to ease
constipation, then some over-the-counter laxatives may be safe to take
during pregnancy, including laxatives that contain bulking agents. Those
containing castor oil may cause uterine contractions. Check with your
doctor before taking any laxatives.
Analgesics
The general advice is
to avoid all analgesics during pregnancy, especially during the first
trimester. Before using pain medication for a common problem, such as a
headache or backache, first try natural remedies; massage or a warm bath
are often effective in relieving aches and pains. If these aren’t
sufficient, call your doctor for advice. Aspirin and anti-inflammatories
such as ibuprofen should be avoided throughout pregnancy. The pain
medicine codeine can sometimes be used for a short period to treat
specific pain, but should only be taken on the advice of a doctor.
Rehydration solutions
If you have a stomach
upset resulting in a severe bout of diarrhea that lasts for an extended
period, your doctor may recommend a rehydration solution that is safe to
use in pregnancy.
Steroids
If you have eczema, or
find that this condition develops or worsens during pregnancy, talk to
your doctor about appropriate medications. Corticosteroids, which are
used to treat eczema, aren’t associated with birth defects, but they are
known to cross the placenta, so both topical and oral corticosteroids
aren’t recommended during pregnancy.
Steroid inhalers used to treat asthma are safe in pregnancy, and it’s important to control your asthma while you’re pregnant.
Oral steroids may
also be prescribed for certain other conditions, and these may be safe
to continue with under the guidance of your doctor. Anabolic steroids
should not be taken during pregnancy.
