Medication use in pregnancy; treating the mother: Protecting the unborn

Each year, numerous new medications enter the market. The formal labeling for most of these drugs does not contain safety data related to exposure during gestation. However, millions of pregnant women have conditions that need to be treated such as diabetes, urinary tract infections and nausea and vomiting. The paucity of knowledge in regard to fetal safety of medications introduces significant challenges for practitioners, and situates the mother at risk of insufficient therapy for her disease, and her unborn baby at a potential risk of toxicity (McBride 1978; Koren 2013). For the vast majority of drugs which have been evaluated in pregnancy, large amount of data have failed to show fetal risks in humans (Koren et al. 1998). Most women are exposed to medications in pregnancy and although quite few medications have been shown to be teratogenic in humans, high levels of anxiety, coupled with misinformation and misperception, lead women and their prescribers to commonly avoid drug therapy even in life threatening conditions. It is critical for clinicians to always consider the risks of the untreated conditions in pregnancy and as needed, to empower women to use medications during gestation. Presently, we must change the climate whereby pregnant women and their unborn babies become therapeutic orphans.