Medicines and Parenthood
For many couples, becoming pregnant is an exciting and beautiful time, but it also raises many questions. One of the most common questions is about medication. Can you still use them if you want to become pregnant or if you are already pregnant? And what about the medication for the man? The answer is not always simple. It requires careful consideration, with the health of both mother and child at the centre.
Medicines during pregnancy
Many women use long-term medication, for example for diabetes, epilepsy, or high blood pressure. When pregnancy is desired, it is wise to discuss this with a doctor at an early stage. Sometimes, treatment can continue safely; in other cases, switching to a safer option is better for the health of the unborn child. Even over-the-counter products are not automatically safe during pregnancy. At the same time, it is important to understand that leaving a condition untreated, or not treating it properly, can sometimes be more harmful for both mother and baby than taking the medication itself.
Even without medication use, every pregnancy carries risks: 10 to 15% ends in a miscarriage and 2 to 4% of babies are born with birth defects. Medication use can sometimes increase that risk, but this risk varies greatly depending on the specific medicine. Some medicines are well studied and considered safe, whereas, others are either known to be harmful or insufficiently researched. Even medicines that may be considered risky do not always cause harm. The impact depends largely on how much of the drug reaches the baby and at which stage of pregnancy it is taken.
Medicines during breastfeeding
Breastfeeding also raises questions about medication. Whether a medicine passes into breast milk depends on several factors. Fortunately, many are safe, while some require caution and a few of them are best avoided, such as certain strong painkillers like oxycodone. In some cases, adjusting the timing of medication may help, and occasionally temporary bottle feeding or stored breast milk can be a solution.
Babies are most vulnerable in the first two months, with this vulnerability being even higher in premature infants or those with health problems. As babies grow older, their sensitivity decreases, and breastfeeding also becomes a smaller part of the total diet as bottle feeding and solid food are introduced.
Medicines and the role of the father
While much is known about mothers and medicine use, less attention is often given to the role of the father. Some medicines can temporarily or permanently affect fertility by lowering sperm quality. This may show as fewer sperm cells, reduced sperm motility, abnormal sperm shape, or even DNA changes within sperm cells. Most medicines, however, do not affect male fertility.
Another important aspect is how sperm cells develop. It takes about three months for a new sperm cell to fully form, and during this time, certain medicines can cause damage. For this reason, with some medicines, such as methotrexate or azathioprine, the use of contraception is recommended for up to three months after stopping treatment, to prevent potentially damaged sperm from fertilizing an egg. This is mainly a precaution, as there is no evidence so far that use by the father increases the risk of birth defects.
And what if the woman is already pregnant? Small traces of medication taken by men can sometimes be found in semen. During sex, these can reach the mother and baby, but the amount is so small that it is very unlikely to have any effect on the pregnancy. That is why condom use is not necessary.
What to remember
Medication use when planning a pregnancy, during pregnancy, or while breastfeeding is rarely straightforward. It requires careful, personalized decisions, weighing the benefits of treatment against the potential risks for mother and child. Fortunately, much is already known, and ongoing research provides more clarity every year. The most important thing is that future parents feel free to ask questions. A healthy start for both mother and child begins with the right information and careful guidance. Gynaecologists, general practitioners, midwives, and pharmacists have the knowledge to guide you and help make the right decisions. Decisions about starting new medication or stopping treatment should always be made together with a healthcare professional.
Be sure to inform your pharmacy if you are pregnant or breastfeeding. We will register this in your pharmacy file and carefully review both your current and any new medication, to ensure they are safe for you and your baby. This also applies to over-the-counter products, such as herbal remedies, vitamins, or supplements. This article is partly based on information from Moeders van Morgen (Lareb), a centre of expertise on medication during pregnancy and breastfeeding. This is general advice. For personal questions about medication and pregnancy, always consult a qualified healthcare professional.
This article is published by the Pharmacist Association of Sint Maarten (PAS), which is dedicated to improving the quality of pharmaceutical care on the island. All pharmacies on the Dutch side of Sint Maarten are proud members of PAS.
