The World Health Organization defines counterfeit medication as "one which has been deliberately and fraudulently mislabeled with respect to the identity and/or the source. Counterfeiting can apply to both branded and generic products and may include products with the correct ingredients or the wrong ingredients, without active ingredients, with insufficient active ingredients, or fake packaging." 1 Counterfeit medications have become more common in the last decade and, with this, so has the need for health care workers to stay informed about this threat.It is impossible to know exactly how many medications are counterfeit. The Centers for Disease Control and Prevention has estimated that the percentage varies from approximately 1% to 10% in developed countries and could be as high as 30% in countries in Africa, Asia, and Latin America. 2 Commonly counterfeited drugs include antibiotics, antimalarials, hormones, and steroids. 3 Counterfeit medications can lead to resistant bacteria, treatment failure, or death. They may contain insufficient amounts of active ingredients or may contain the proper ingredients but may not have been properly stored and/or shipped. Some medications are delicate and can easily degrade when exposed to varying temperatures or light or when shaken. This can result in a product that may be below needed potency or altogether ineffective. Some counterfeit medications have even been shown to contain toxic ingredients such as lead-based paint. For example, 3 pregnant Argentinean women were treated for anemia with a counterfeit injectable iron product. Two of the women died after being exposed to the toxic ingredients contained in the counterfeit iron. The third woman survived but gave birth prematurely at 26 weeks' gestation. 4 Because of the risks posed by counterfeit medications, it is imperative that midwives and other health care providers stay informed about counterfeit medications so they can help protect women from an increasingly tainted drug supply.