Report from the CDC: Medication Use during Pregnancy and Lactation: An Urgent Call for Public Health Action

Abstract

Questions about medication use during pregnancy and lactation are a concern for women and healthcare providers. Unfortunately, there is little experience with the use of most medications in human pregnancy and lactation at the time they are marketed. Even when information is available, it may not be readily accessible to women and healthcare providers. Nevertheless, medication use by pregnant and breastfeeding women may be beneficial, and even essential, to ensure the health of both mother and child. In addition, almost half of pregnancies in the United States each year are unintended, and medication exposures may occur in the early weeks of gestation before a pregnancy is recognized. For these reasons, it is critical that up-to-date information about the effects of medication use during pregnancy and lactation and the management of maternal conditions be available to women and healthcare providers. A comprehensive, coordinated public health approach that builds on and expands existing activities is needed to generate information about medication use, make that information readily available, and translate it into safe and effective healthcare. Critical components of this system include a central source of up-to-date information, further development and coordination of monitoring and research activities, the availability of counseling services throughout the country, development of standard communication messages, and a panel of experts to provide oversight. This will require collaborative support from government agencies, nonprofit organizations, academic and public health professionals, and healthcare providers to ensure safe and beneficial use of medications during pregnancy and lactation.

African-American and Latina Women Seeking Public Health Services: Cultural Beliefs regarding Pregnancy, including Medication-taking Behavior

“…One was that these women did not plan to become pregnant; all of the pregnancies of the participants were unplanned. This frequency of unintended pregnancies was much higher than that recently reported for a national average of approximately 50 percent 23 . For African-American women the unexpectedness of pregnancy contributed to their…”

Providing Contraception for Women Taking Potentially Teratogenic Medications: A Survey of Internal Medicine Physicians’ Knowledge, Attitudes and Barriers

“…Given the public health burdens of teratogen exposure resulting in birth defects and the subsequent infant mortality and childhood morbidity, there is significant benefit to employing such an initiative. 1,2,6,21,22 Assessment of physician behaviors is complicated and a single institution survey is unlikely to adequately quantify all the factors that affect prescribing practices. These results could inform the design of a larger study of prescribers across geographic regions and medical specialties to better define the barriers to providing contraception to women on potentially teratogenic medications.…”

Drug Utilization Pattern and Potential Teratogenicity Risk among Pregnant Women Visiting Antenatal Clinic: The Case of a Primary Hospital

“…2,4 Medication use during pregnancy has been an issue of concern since the discovery of birth defects resulting from Thalidomide use in early pregnancy during the 1960s. 4,5 Pharmacological treatment should be avoided in pregnancy, unless absolutely necessary. [6][7][8] Pregnant women are generally excluded, for ethical reasons, from randomized clinical trials in drug development.…”