CONTACT: BECKY SOGLIN
Iowa City IA 52242
(319) 335-6660; fax (319) 384-4638
Release: Nov. 26, 2002
UI promotes understanding of medication use during pregnancy, breastfeeding
Knowing whether to take a medication during or soon after pregnancy is a
source of confusion and concern for many women and even their health care
providers. However, University of Iowa Health Care physicians and midwives
with expertise in medication use during pregnancy and lactation (breastfeeding)
are on a mission to educate patients and the professionals who care for them.
"There is general confusion out in the community on giving any woman
who is pregnant any drug," said Wendy Hansen, M.D., UI assistant professor
(clinical) of obstetrics and gynecology. "Providers often have difficulty
finding drug information that helps them care for women during pregnancy and
breastfeeding. It's also not uncommon for women to get mixed messages from
doctors. We're trying to help prevent that."
Hansen recently co-authored an article on the topic for midwives in the
November/December issue of the Journal of Midwifery and Women's Health. Jerome
Yankowitz, M.D., UI associate professor of obstetrics and gynecology and director
of Maternal-Fetal Medicine, and Anne Peacock, UI certified nurse midwife in
the department, also were co-authors of the article which covers safe prescribing
practices for upper respiratory conditions, pain control, gastrointestinal
problems, and psychiatric illnesses and depression.
"There are so many different providers who interact with pregnant women
that disseminating information to these different groups is an important part
of what we do," said Hansen, who also has created a drug-appendix for
emergency medicine physicians to use when they treat pregnant women.
Hansen and Yankowitz said there are misperceptions on both sides of the
spectrum about medication use during pregnancy and breastfeeding, although
most women and their providers lean toward not taking or administering a prescription
"In part, the care providers are fearful that they will harm the baby,
and so is the mother," Hansen said. "Both people have good intentions
yet sometimes we find that not treating is far more dangerous than treating
At UI Hospitals and Clinics, women with life-threatening conditions such
as cancer have received treatment during pregnancy, delivered healthy babies
and maintained wellness. Treatment for depression, which affects up to 15
percent of all women, is a condition which merits a lengthy discussion about
risks and benefits between the mom-to-be and her provider, Hansen said.
"The reflex in the community is to say, 'We'll fix this after you're
pregnant,'" Hansen said. "Sometimes it's appropriate for a woman
to wait until after pregnancy to use a medication and sometimes it's not."
While most women hesitate to take prescription drugs during pregnancy, there
also are misconceptions when it comes to "natural" and over-the-counter
drugs, said Yankowitz, who is co-editor with Jennifer Niebyl, M.D., UI professor
and head of obstetrics and gynecology, of the book "Drug Therapy in Pregnancy."
"Some people think that if they can get it without a prescription,
then it's safe to use at any time. But pregnant and breastfeeding women should
check with their physicians about all uses of drugs that can be obtained over-the-counter,
as well as vitamin preparations, herbs, minerals and any type of complementary
or alternative medicine," Yankowitz said.
For example, when it comes to cold, flu, allergy and runny nose treatments,
women can benefit by discussing with their health care provider what specific
symptoms cause them problems and get a treatment that targets only those symptoms.
"A lot of medicines are meant to cover three or four symptoms from
runny nose to sore throat to cough, but a person may not have all these symptoms
or even need to be treated for them," Yankowitz said.
"Women should not take unnecessary medications and should not take
medications without their health care provider knowing about it. At the same
time, certain medical diseases can be appropriately treated during pregnancy.
It's a bit of a balancing act," he added.
The Food and Drug Administration does not approve or ban medication use
during pregnancy. Instead, it categorizes medications into different safety
levels based on clinical reports and, more often, on animal-based research.
Yankowtiz said the system can be difficult for patients and even physicians
to use. However, the FDA is refining the classification system.
"It cannot be a straightforward system that simply says a drug is safe
to use or not, as some drugs may be worth taking for serious diseases but
not for other conditions," he said.
In addition, to Hansen, Niebyl and Yankowitz, other UI physicians involved
in research on use of medications by pregnant and breastfeeding women include
Scott Stuart, M.D., UI associate professor of psychiatry, and psychology,
and Alicia Weissman, M.D., UI assistant professor (clinical) of family medicine.
As with all medical conditions, it is best to consult with your health care
provider before making any changes to your health care routine during or after
University of Iowa Health Care describes the partnership between
the UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and
Clinics and the patient care, medical education and research programs and
services they provide. Visit UI Health Care online at www.uihealthcare.com.