What Over-the-Counter Medication is Not Safe in Pregnancy?

Pregnancy is a delicate time in a woman’s life, with the health and wellbeing of both mother and baby requiring extra care and attention. One of the essential aspects of antenatal health is understanding what over-the-counter (OTC) medications are safe to use and which ones can pose risks during pregnancy. While many OTC medications are generally safe, there are certain medications that should be avoided or used with caution to prevent potential harm to the baby. In this article, we’ll explore common over-the-counter medications that are not safe during pregnancy, provide insight into safe alternatives, and emphasise the importance of consulting healthcare providers as part of your antenatal care.

Understanding Antenatal Care and Medications

Antenatal care is vital for ensuring the health of both mother and baby. Regular antenatal appointments allow healthcare providers to monitor the progress of the pregnancy and provide guidance on issues such as nutrition, lifestyle, and medication use. It is important to note that even seemingly harmless over-the-counter medications can have unintended effects during pregnancy. Certain medications can interfere with the baby’s development, cause complications during birth, or increase the risk of miscarriage. When considering any medication, including over-the-counter drugs, expectant mothers should always consult their healthcare providers to ensure they are making safe choices. This forms a crucial part of your overall antenatal support plan.

Over-the-Counter Medications to Avoid During Pregnancy

1. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs, such as ibuprofen, aspirin, and naproxen, are common pain relievers used to treat headaches, muscle pain, and inflammation. However, these medications are not recommended during pregnancy, especially during the third trimester. NSAIDs have been linked to an increased risk of miscarriage and can cause problems with the baby’s heart, lungs, and kidneys if taken late in pregnancy. NSAIDs can also lead to complications with labour, such as prolonged bleeding.

Safe Alternatives:

For pain relief, paracetamol (acetaminophen) is generally considered a safer option during pregnancy. However, always check with your healthcare provider before taking any medication, including paracetamol, to confirm its safety based on your individual circumstances.

2. Cold and Flu Medications Containing Decongestants

Many over-the-counter cold and flu medications contain decongestants, such as pseudoephedrine and phenylephrine, which work by constricting blood vessels to reduce nasal congestion. While these medications may provide relief from cold symptoms, they are generally not recommended during pregnancy, particularly in the first trimester. Decongestants have been linked to an increased risk of birth defects, particularly in the development of the baby’s abdominal wall.

Safe Alternatives:

For congestion, it’s better to use saline nasal sprays or steam inhalation, which are safe and drug-free alternatives. These methods can help relieve nasal congestion without posing a risk to the baby.

3. Antihistamines

Certain antihistamines, used to treat allergies, can be unsafe during pregnancy. Medications such as diphenhydramine and chlorpheniramine, which are common ingredients in allergy medications, can cause drowsiness and may impact foetal development, especially if taken in high doses or frequently.

Safe Alternatives:

Non-drowsy antihistamines like loratadine and cetirizine are often considered safer options during pregnancy. However, you should still consult your healthcare provider before using any antihistamine.

4. Herbal Supplements and Natural Remedies

While herbal supplements and natural remedies are often perceived as safer alternatives to prescription and OTC medications, many have not been thoroughly studied for safety during pregnancy. Some herbal remedies, such as ginseng and goldenseal, can cause uterine contractions, increasing the risk of preterm labour or miscarriage. Others, like St John’s Wort, used for depression, can interfere with pregnancy hormones and medications.

Safe Alternatives:

Always talk to your healthcare provider before using any herbal supplements during pregnancy. In most cases, maintaining a healthy lifestyle, balanced diet, and regular antenatal yoga or light exercise can help alleviate common pregnancy symptoms without the need for supplements.

5. Acne Medications

Certain acne treatments, such as salicylic acid and benzoyl peroxide, are common in over-the-counter skincare products. However, strong acne treatments, especially those containing retinoids like isotretinoin (found in prescription acne medications), can cause serious birth defects and are strictly contraindicated during pregnancy.

Safe Alternatives:

For acne during pregnancy, consider using milder products such as those containing azelaic acid or glycolic acid. Always consult your healthcare provider or dermatologist for safe skincare options during pregnancy.

6. Antacids Containing Aluminium or Magnesium

Heartburn and indigestion are common during pregnancy, but some over-the-counter antacids, particularly those containing high levels of aluminium or magnesium, should be avoided. High doses of these elements can affect foetal development and cause complications, particularly if taken regularly over long periods.

Safe Alternatives:

Antacids containing calcium carbonate, such as Tums, are generally considered safe during pregnancy. In addition, lifestyle changes, such as eating smaller meals and avoiding foods that trigger heartburn, can help manage symptoms without the need for medication.

Importance of Antenatal Appointments and Support

It’s important to discuss any medications or supplements you are taking during antenatal appointments. This ensures that your healthcare provider can assess the safety of the medications in the context of your specific pregnancy. Antenatal support plays a key role in providing guidance on safe medications, nutrition, and overall wellbeing during pregnancy. Additionally, attending antenatal classes and seeking education on pregnancy health can help you make informed decisions about your medication and treatment options. Understanding the risks associated with over-the-counter medications and being proactive in managing your health is essential for maintaining a safe and healthy pregnancy.

The Role of Antenatal Fitness and Massage in Pregnancy Health

Beyond medication, engaging in activities such as antenatal yoga or receiving antenatal massage can help alleviate common pregnancy discomforts and reduce stress without the need for medication. Antenatal yoga focuses on gentle stretches, breathing techniques, and relaxation, which can help manage physical discomforts and emotional stress during pregnancy. Similarly, prenatal massage can provide relief from muscle tension, improve circulation, and promote relaxation. These alternatives can be especially helpful for managing symptoms like back pain, headaches, and anxiety during pregnancy, reducing the need for over-the-counter medications.

Consulting Your Antenatal Clinic for Guidance

Your antenatal clinic is an excellent resource for advice on medication safety during pregnancy. The healthcare professionals at these clinics can offer personalised guidance based on your medical history, current health status, and stage of pregnancy. If you’re unsure about any medications, whether prescription or over-the-counter, your antenatal clinic is the best place to seek answers. In addition to medication advice, antenatal clinics provide important services such as antenatal checkups, antenatal scans, and access to antenatal education classes that help expectant mothers navigate the complexities of pregnancy health, including safe medication use.

Conclusion: Making Safe Medication Choices During Pregnancy

When it comes to over-the-counter medications during pregnancy, it’s essential to prioritise safety for both mother and baby. While many OTC medications are generally considered safe, others pose significant risks and should be avoided. Always consult with your healthcare provider during antenatal appointments before taking any medications, including those available without a prescription. By staying informed, attending antenatal classes, and engaging in healthy activities such as antenatal yoga, you can manage many of the common discomforts of pregnancy without the need for risky medications. Your antenatal care team is there to support you in making the best decisions for your health and the health of your baby. Sources:

• NHS: Medicines to Avoid in Pregnancy: https://www.nhs.uk/pregnancy/keeping-well/medicines-in-pregnancy/
• Mayo Clinic: Safe Medications During Pregnancy: https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/pregnancy-and-medications/faq-20058542
• American Pregnancy Association: Antenatal Medication Safety: https://americanpregnancy.org/medications