Why pregnancy changes the rules
During pregnancy, many medicines pass through the placenta to the baby. The first three months are when the baby's organs are forming, so this is the period of greatest concern for some medicines. Later in pregnancy, certain medicines can affect the baby's growth, kidneys or the timing of labour. The mother's body also changes, which can alter how medicines are absorbed and cleared. This is why advice that suits other adults does not always apply.
Tell every doctor and pharmacist
Always say that you are pregnant, planning a pregnancy, or breastfeeding whenever you see a doctor, dentist or pharmacist, and whenever you get anything over the counter. Many women in India first learn they are pregnant several weeks in, so women who could become pregnant should mention this possibility too. This includes creams, cough syrups, herbal and traditional products, weight-loss products and supplements, not just tablets.
Do not stop regular medicines suddenly
If you take medicine for epilepsy, thyroid disease, diabetes, high blood pressure, asthma, depression or another long-term condition, do not stop it on your own when you discover you are pregnant. Uncontrolled illness can be more dangerous to the baby than the medicine. See your doctor quickly; they may continue, adjust or switch the medicine to one with a better safety record in pregnancy.
Ideally, women with long-term conditions should see their doctor before trying to conceive, so treatment can be planned in advance. This visit is also a good time to check blood sugar, blood pressure, thyroid levels and haemoglobin, update vaccinations, and start any supplement the doctor recommends for a healthy pregnancy.
Medicines that need special caution
Some medicines are known to be harmful in pregnancy or at certain stages. Your doctor will avoid or replace them if possible, and will weigh the risks and benefits when there is no safer choice. This list is only for awareness, not for self-management, so do not stop any of these without talking to your doctor.
- Some BP medicines, such as ACE inhibitors and ARBs
- Certain seizure medicines, such as valproate
- Isotretinoin and some other acne and skin medicines
- Some antibiotics, such as tetracyclines
- Warfarin and some other blood thinners
- NSAID painkillers such as ibuprofen, especially in later pregnancy
Common complaints and simple care
Nausea, heartburn, constipation, headaches, colds and mild fever are common in pregnancy. Simple measures often help: small, frequent meals for nausea and acidity, plenty of water, fruits and fibre for constipation, and rest for colds. For fever and pain, paracetamol is generally considered the preferred choice in pregnancy, but check with your doctor or pharmacist and follow their advice or the label.
Avoid cold and cough combination products unless a doctor approves them, as some contain decongestants or other ingredients not suitable in pregnancy. The same caution applies to painkiller gels, strong laxatives, and remedies for acidity taken without advice. When in doubt, ask the pharmacist to check whether a product is suitable before you use it.
Supplements in pregnancy
Folic acid before conception and in early pregnancy helps prevent certain birth defects of the brain and spine. Iron and calcium are routinely given in Indian antenatal care because anaemia and low calcium intake are common. Your doctor will advise which supplements you need and for how long. Do not take high-dose vitamin A or unverified herbal pregnancy tonics without advice, since excess vitamin A can harm the baby.
Vaccines and infections
Some vaccines are recommended during pregnancy to protect both mother and baby, such as tetanus-diphtheria vaccination as per the national schedule, and your doctor may advise others. Live vaccines are generally avoided in pregnancy. Infections such as urine infections, malaria, dengue and typhoid need prompt treatment, as they can affect the pregnancy. Antibiotics and other treatments should be taken only on a doctor's prescription, who will choose options suitable for pregnancy.
Breastfeeding
Many medicines are compatible with breastfeeding, and stopping breastfeeding is often not necessary. Small amounts of some medicines pass into breast milk, so check each new medicine with your doctor or pharmacist. Watch the baby for unusual sleepiness, poor feeding or rashes after you start a new medicine. For any doubt about a medicine in pregnancy or while breastfeeding, consult a doctor or pharmacist before taking it.
Medicines doctors commonly use
Only your doctor can decide which medicine, dose and combination is right for you.
- Paracetamol (fever and pain reliever)Generally preferred for fever and pain in pregnancy.Check with your doctor and follow the label or your pharmacist's advice.
- Folic acidHelps prevent neural tube defects in the baby.Best started before conception as advised by your doctor.
- Iron and calcium supplementsPrevent anaemia and support the mother's bones and the baby's growth.Take them at different times, as calcium reduces iron absorption.
- AntacidsRelieve heartburn, which is common in pregnancy.Ask your pharmacist which type suits pregnancy and keep them apart from iron.
See a doctor urgently if
- Vaginal bleeding or fluid leaking at any stage of pregnancy
- Severe headache, blurred vision or swelling of the face and hands
- Reduced or no baby movements after they have become regular
- High fever, severe abdominal pain or persistent vomiting
- Rash, breathing difficulty or swelling after taking a medicine
Tests that may help
This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.