Obviously I’m a guy that’s simply curious, but when a woman is pregnant and comes down with a cold for example, is it really taboo to take decongestants and the like?
I remember a couple of ladies that I know, had to use a bowl like contraption, vicks vaporizer and a towel to get some sort of relief from the usual cold symptoms.
Haven’t we moved along far enough to have some sort of meds that balance both the mom and unborn, or is the no meds thing old thinking that’s still being propogated.
Here is a good web site for looking up safety of over-the-counter and prescription meds. Sudafed is associated with an increased risk of gastroschisis, so a lot of pregnant women avoid it.
There are only like 14 drugs/substances that are absolutely known to be dangerous during pregnancy. There are only a few more that are known to be safe. What remains is a vast number of drugs where the safety is unknown. There’s no ethical way to test the safety of drugs during pregnancy–you’d have to give drugs to pregnant women and see what happens. What you have instead are degrees of risk: some drugs are classified as “probably safe” because animal studies show no problems. Some are “may be safe”, which means that there may have been negative effects animal studies, or there may be no studies available. Some are “safe only in rare incidences”, which means there is evidence of risk.
In each case, you evaluate the need for the drug against the potential side effects. For a cold, the symptoms don’t seem worth even a slight risk: if you are controlling epilepsy or diabetes or schizophrenia, more risk is acceptable.
I’m pregnant. I was also so sick last week with a nasty cold I felt like I could barely breath. My doctor told me benadryl, a vaporizer and if it got worse the emergency room. He’s told me since then that antibiotics should be prescribed if I my cough turned from clear to uglier colors. I would not take anything without consulting with an OB. He also told me that pregnant women are unfortunately more prone to colds because their immune system is compromised during the pregnancy.
Aspirin, and possibly ibuprofen, are about the only OTCs that are *known *to be dangerous to the fetus. They may cause a duct in the fetal heart to close prematurely, especially if taken in the last 3 months of pregnancy. This is A Bad Thing. Aspirin is generally off limits for pregnant women, while it’s often suggested that ibuprofen be avoided in the final trimester but is okay for use earlier (this is because we *know *aspirin causes the closure, we just *think *ibuprofen might, based on how it works.)
Sudafed, as already mentioned, is suspected but not proven to case birth defects, and probably best avoided for that reason.
Other OTC meds, vitamin supplements and herbals, may or may not be safe during pregnancy. Really, no one knows. These are the Category B and C drugs, and they make up the vast majority of both OTC and prescription drugs. And since no one wants to be sued for telling a woman something is safe and having it turn out not to be so, the general recommendation is not to take anything at all.
If in doubt, always ask a pharmacist. There are certain drugs I would never recommend, even if they are class C, and there have been some post exposure studies showing that some drugs look safe, even if no randomized double blind studies have been done. I have a whole list of OTC drugs that I would feel comfortable recommending… but still, ask your pharmacist before you take anything if you’re pregnant.
It’s also important to look at the need and balance the benefits vs the harms in each case. For example (looking at WhyNot’s excellent list), insulin isn’t definitely known to be safe, but if the expectant mother is an insulin-dependant diabetic, not taking it puts both her and the baby at very serious risk, so in practice she will continue taking it. In general colds are unpleasant but don’t put the mother at serious risk, so there is less reason for risking harm to the baby. Chemotherapy is likely to be a very difficult decision due to the risk to the mother of not having it vs the risk to the baby of having it and would be decided after careful discussion between the patient and their medical team.
When my wife was pregnant, the only OTC drug her OB allowed her to take without needing prior authorization was acetominophen, in case she got a headache or a cold. Even then, she only took it as a last resort, she did her best not to take any drugs at all while she was pregnant.
And unfortunately a whole hell of a lot of OTC cold medicines contain one or the other, even if they don’t make fever reducing a prominent symptom relief claim on the front of the box. I accidentally double-dosed myself on ibuprofen on one occasion because I forgot that the sinus pills (then sans box) I just took had it too. I’m sure the frequent pairing of asprin or ibuprofen with cold relief narrows a pregnant woman’s options considerably when she has a cold.