December 3rd, 2018
Pregnancy and Drugs
The moment a women becomes pregnant, her body's physiology changes to support the growth of the fetus. These changes have profound impacts on how she will metabolize drugs. Physiologically, her body increases fat volume, increases blood flow to the kidneys, decreases proteins like albumin in the blood, increases total body water, changes to hepatic detoxification enzymes and delayed gastric emptying. (Costantine et. al. 2014)
According to the CDC, 90% of pregnant women take a medicine while pregnant. When it comes to choosing to use a medicine during any stage of pregnancy, a mother must decide on the cost benefit ratio of the drug's benefit to her versus the side effect to the developing fetus. For example, if a mother to be has asthma or diabetes and is suffering an attack or significant elevation in blood sugar, the treatment is absolutely necessary regardless of the fetus because of the life threatening risk to mom. On the other hand, antacid medications and non steroidal medicines being used for headache or heartburn are not obligatory needs and here is the point at which one must know the safety profile of a medicine that is to be considered.
Some basic principles to consider before choosing to use a medicine. First, is there a non pharmacological treatment available? For example, headaches can be painful, but a cranial massage, meditation and sleep may suffice where a medicine would be used. In the case of a diabetic patient, maximizing dietary efforts to reign in blood sugar by shunning all refined carbohydrates can significantly reduce drug needs. Clearly, this avenue gets my highest recommendation where possible.
Second, if you must use a drug, use the lowest dose possible of a drug that has been available for a long time which allows us to know safety kinetics and risk. Try to avoid the first trimester of pregnancy as this is the period of rapid cellular growth and carries the highest risk of DNA damage to the fetus. Try to stick to only one type of medicine at a time. Mixing medicines increases the risk of cross reaction and is dangerous to the fetus. (Schaefer et. al. 2015)
Third, spend time looking at the risk of the drug on the fetus by going to websites like www.motherbaby.org, the FDA site, perinatology site, CDC site, March of Dimes site and many others.
I firmly believe that a mother to be that follows an Anti-inflammatory diet, avoids stress or at least mitigates it with prayer and meditation, drinks adequate volumes of water, has a village of support, follows the sun and the moon for sleep and avoids toxin exposures will have the lowest risk of needing a medicine for all causes.
Drugs, mom and baby are best kept separate,
Dr. M
Constantine Frontiers in Pharmacology Article
Schaefer Drugs During Pregnancy and Lactation Book
Mother Baby Drug Website
FDA Pregnancy Website
Perinatology Website
CDC Website
Podcast on Good Medicine Can Be Bad for Baby
March of Dimes Website
