If you have a health condition and are pregnant, it can be overwhelming to figure out which medications you can take without harming the baby. Special guest Kate Rope talks about her new book The Complete Guide to Medications During Pregnancy and Breastfeeding.
As soon as you realize you are expecting, your to-do list all of sudden seems to triple in size. There’s so much to do and so little time – from scheduling your prenatal visits, to setting up the nursery, and an almost endless list of shopping in order to get ready for the arrival of your new bundle of joy. What happens if you get sick in this process? By that I mean anything from catching the flu to being diagnosed with rheumatoid arthritis? It can be very scary, to think that any medications you must take could harm your baby. You already have enough to do and worry about.
One of the most common pregnancy questions I’ve received during my patients’ prenatal visits have been in regards to medication safety. There doesn’t seem to be much information for patients out there in terms of a self-help resource guide to determine what medications you can take safely, and the potential risks involved. Even over-the-counter medications can be harmful to the baby in pregnancy. I was pleased to see that there now is a great patient resource – the Complete Guide to Medications During Pregnancy and Breastfeeding. So I thought it would be a great idea to interview one of the authors and introduce the book to my audience in order to make sure they realize that such a resource does exist in case they need it.
See also: Top 10 Questions Pregnant Women Ask
So with that, let’s welcome Kate Rope, one of the authors of this helpful guide:
House Call Doctor: What led you to write a book about medications during pregnancy and breastfeeding?
Kate Rope: When I was pregnant with my first daughter, I developed a serious, but completely mysterious, pain in my chest. For the first 5 months of my pregnancy, it was misdiagnosed as various things, including heartburn, and I took a number of medications to alleviate it. Nothing worked. The pain became so bad that I ended up in the ER twice and was finally hospitalized. Along the way, I was subjected to X-rays, CT scans and nuclear radiation—all the things the pregnancy books tell you to stay away from in pregnancy.
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Finally, an ultrasound showed fluid and swelling around my heart. It's actually a fairly benign, but extremely painful, condition called pericarditis. And it’s unrelated to being pregnant. I had to manage it with ibuprofen and steroids for the remainder of my pregnancy. I felt incredibly scared and guilty doing so. I was worried the radiation I had been exposed to had harmed my developing baby, and that the steroids I was taking would damage her immune system.
I found it very difficult to be taking medication during this era of natural pregnancy. None of the books on my bedside table talked about the medications I was taking. Instead they all warned of all the ways I could damage my baby—eating deli meat, changing cat litter, even highlighting my hair. So prescription medication seemed extremely scary to me. I realized there was no good information out there for moms who have to take medication—prescription or otherwise—for their own health during pregnancy.
House Call Doctor: How did you handle all of that anxiety?
Kate Rope: Lucky for me, I had an excellent maternal fetal medicine expert as my obstetrician, and he talked me through all of the medications he was giving me and why. At one point, when I was really scared, he said to me, "Kate, we are in the shallow end of the pool. We can get a lot deeper." When my husband and I would start to worry about the medications, we would repeat to each other, "We are in the shallow end of the pool."
That helped, but after my daughter was born, I developed terrible postpartum anxiety that I’m certain was related to the fear I felt during pregnancy. So I wanted to write a book for women who need to treat medical conditions during pregnancy– whether they are complications, mood disorders, or even a cold. I want to help women understand that they can make good choices to take care of themselves at the same time that they are protecting the health of their growing babies.
House Call Doctor: Why is there so little information about medications and pregnancy?
Kate Rope: Even for commonly prescribed and frequently taken drugs—such as Advil, Sudafed, Amoxicillin, Zoloft, Prozac—there is very little information about their effects on pregnancy. Because of concern for liability issues, very few researchers (and almost no pharmaceutical companies) will use pregnant women in the controlled scientific studies that doctors depend on when they make prescribing decisions. So, doctors have to rely on animal studies and on scattered information from case reports of women who have taken particular medications during pregnancy and what their outcomes were.
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Unfortunately, there are very few comprehensive resources for doctors who are treating pregnant women. But my co-author, Dr. Carl Weiner—who is a perinatologist and professor of pharmaceutical sciences at the University of Kansas School of Medicine—literally wrote the book on it. His academic textbook for doctors brings together research on nearly 1,000 medications taken during pregnancy and breastfeeding. We worked together to translate his comprehensive book into easy-to-understand language and it became a book for moms— The Complete Guide to Medications During Pregnancy and Breastfeeding.
House Call Doctor: How does the book work?
Kate Rope: The Complete Guide to Medications During Pregnancy and Breastfeeding is an A to Z directory of more than 600 drugs and what we know about their effects and side effects if taken during pregnancy and while breastfeeding. It covers any animal research that has been done on the medication, how often and how long the medication has been used in pregnancy, whether it is effective for pregnant women, whether there appear to be any safety concerns for a developing fetus or embryo or a breastfeeding child, and whether another medication might be a better choice.
It's a great resource for a pregnant woman to grab off her shelf, read, and bring to her doctor so that together they can make good choices she's comfortable with. The book also includes chapters on how to find good medical care during pregnancy and how to get to a doctor who will have the best information on medications.
House Call Doctor: If you are taking medication for a chronic condition such as asthma or depression, what should you do before becoming pregnant?
Kate Rope: You should meet with your specialist, whether it's a cardiologist, a psychiatrist, or a rheumatologist and ask if he or she has experience treating pregnant women. You should also ask if he or she is comfortable working closely with your OB to manage your condition during pregnancy. If the answer is no to either one of these questions, ask if they can recommend a colleague who does.
You should have the same conversation with your prospective OB or certified nurse midwife. Ask if he or she has had patients with your condition before and how (or if) medication was used to control it.
Once you are working with doctors you trust, ask them about the medications you are taking and whether you need to (and can) continue them during pregnancy and what is known about their safety and effectiveness. Find out if there is a safer medication you should switch to.
Of course, since 50% of pregnancies are unplanned, many women don't have the luxury of making a choice before discovering they are pregnant. If you become pregnant while taking a medication that is critical to your health—mental or physical—do not discontinue it on your own. Meet with your doctors right away and make a choice together.
House Call Doctor: After your own difficult pregnancy and the anxiety you faced, what would you like other pregnant and breastfeeding women to know?
Kate Rope: That you can and should prioritize your own health alongside the health of your developing or breastfeeding baby. It is important that you are healthy, happy, and high-functioning both for yourself and for your family. With the right medical care and the right information, you will be able to make choices that are good for you and that you can feel optimistic about. And once you've made those decisions, do your best to feel calm and confident in them and have faith in the future health of your children. When I look at my healthy, happy daughter (who happens to have an incredibly strong immune system) now, all of those worries I had seem so far away.
Kate Rope is an award-winning freelance journalist with expertise in health, pregnancy, and parenting. She is the coauthor of The Complete Guide to Medications During Pregnancy and Breastfeeding. Kate's writing has appeared in many publications including National Geographic Adventure, Fitness, Real Simple, Shape, Parade, Parents, and Parenting. She also serves as editorial director of the Seleni Institute, a nonprofit organization dedicated to women's reproductive and maternal mental health. She lives in Brooklyn, NY with her husband and two daughters.
Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
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