Mamas on Bedrest: Use Medications in Pregnancy with Caution and Supervision

March 16th, 2011

Asthma Flare During Pregnancy

When I was pregnant with my son my asthma flared up. I hadn’t had an attack in years but there I was, about 5 1/2 months pregnant and suddenly I couldn’t breathe. I had a Proventil (albuterol) inhaler, but I was reluctant to take it. I called my OB service (of course this happened on the weekend) and her nurse called me back and instructed me to use the inhaler. They also referred me to a pulmonologist to make sure that my asthma was controlled throughout the remainder of my pregnancy.

The pulmonologist was a really wonderful man and took a long time with me assessing my medical history and my current asthma situation. He prescribed Pulmicort, an inhaled steroid, to be taken twice daily for the remainder of my pregnancy. Evidently I had developed some sort of inflammatory response in my respiratory system. It wasn’t clear if it was due to the pregnancy hormones or some sort of viral illness, but I was inflammed none the less. I was very hesitant to take the steroid inhaler. But the pulmonologist reassured me that it was safe during pregnancy and would not cause any adverse complications with my baby. Furthermore, he reminded me that if I wasn’t breathing well, I would not be getting enough oxygen. If I wasn’t getting enough oxygen for my body, then I certainly couldn’t give adequate oxygen to my baby. I was sold.

A pregnant woman’s body undergoes so many changes that often she develops illnesses and ailments that she’s never had before-and may well never have again-but which can be quite problematic during pregnancy. Treating illness during pregnancy can be a real challenge because many medications have not been adequately tested in pregnant women and their exact effects on the pregnant woman and her baby are unknown. However there are many situations, my asthma being one such case, where treating the ailment outweighs the potential harm of the medication. At the very least, the untreated condition is as hazardous to the mother and baby as the treatment. So what should a pregnant woman do if she becomes ill or if she is on regular medication for a chronic condition? Let’s address the chronic condition first.

Chronic Conditions and Pregnancy

Many women with chronic medical conditions such as asthma, epilepsy, colitis, depression and others may take medication regularly to manage symptoms and keep flares or attacks at bay. However, many of the medications used to treat these conditions may be harmful to a developing fetus. Very little pharmaceutical testing is done on pregnant women due to the potential harm to both mother and baby. So if a woman has a chronic medical condition and is contemplating pregnancy-or has already become pregnant, her is what she should do:

  • Notify her obstetrician or midwife immediately that she is on medication for a chronic condition
  • If she has a specialist who is monitoring her chronic condition, notify them immediately of her pregnancy
  • DO NOT STOP YOUR MEDICATION! This could have serious medical effects for you and your baby. Consult with the provider who prescribed your medication and discuss whether or not to continue the medication, to change medications, or to taper off the medication entirely. Medication changes should always be supervised.
  • Notify your providers of any and all medications that you are taking, especially if you have to change medications due to your pregnancy, so that you can avoid potential interactions and side effects.

Transient illnesses and Pregnancy

Pregnancy depresses a woman’s immune system, leaving her susceptible to many viruses and illnesses she would otherwise be able to easily fend off. So many women contract colds, allergies and other maladies and can’t seem to shake them. When this occurs, check with your OB or midwife to determine which over the counter (OTC) medications are safe for you to take.

A word of caution: Don’t assume that “natural” or “herbal” preparations are safe to take during pregnancy. So many people assume that if something is “natural” it is not harmful. Nothing could be further from the truth! Many pharmaceuticals are actually derived from herbs or plants. Penicillin for example, was originally derived from mold yet is a potent antibiotic. Herbs and “natural” preparations work because plants have bioactivity, i.e. they are able to change your biology.  This is how all medications work-they act on your body to either suppress a symptom or to enhance your body so that it can fight whatever is ailing it. However, because a woman’s body changes so much during pregnancy, what is normally harmless (at least to her) may in fact be harmful (if not to her, potentially to her baby). Always check with your OB or midwife before taking any medication while you are pregnant.

There is no doubt about it, pregnancy is wonderful and yet hard on a woman’s body. But with proper daily care and professional expertise as needed, most pregnant women cruise peacefully through pregnancy and have healthy babies.

Photo:  I was about 6 months pregnant with my son in this photo. My then 3 yo daughter is trying to move me.

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