Many women need medication during pregnancy and breastfeeding in order to treat health conditions. However, they often choose to stop their medication. I meet these women in my clinical practice. Many of them have underlying medical problems, anything from common ailments (such as headaches or heartburn) to autoimmune diseases, to heart and kidney disease or even an organ transplant. Naturally, they worry about the medicines they are taking for fear that they might harm their baby. Leaving medical problems untreated can have serious implications for both the mother and the baby. Very often, stopping medication is more harmful than the actual risks of continuing.
Drug manufacturers cannot advise pregnant and breastfeeding women to continue taking medications that they do not know are safe for both mother and child. Almost all drug formularies and manufacturer patient-information leaflets advise women to avoid using the medicine when they are pregnant or breastfeeding. Different countries have different structures in place to provide information about medicine safety during pregnancy and breastfeeding. In some countries, teratology information services advise women and healthcare providers regarding the risks and benefits of treatment. In other countries, pregnant women can ask their doctor or midwife for this advice. Studies and reports where medicines have been successfully used in pregnancy are essential. However, we desperately need more information as there is a big knowledge gap.
I am the Head of the UK Teratology Information Service (UKTIS), which is part of a group of organisations collectively called the European Network of Teratology Information Services (ENTIS- for short). All of the services in ENTIS offer unbiased information, supporting women and their healthcare providers. Many teratology information services also provide surveillance of medication in pregnancy and breastfeeding and play an important role in contributing to the worldwide literature and knowledge.
Members of ENTIS, including UKTIS, are taking part in the IMI ConcePTION project to help improve access to pregnancy safety information for everyone. We encourage women and health providers to report pregnancies to organisations that study this type of information, to better understand the effects of medicines in pregnancy.
It is a great privilege to work with pregnant women, their babies and their families. In this work, we must strive to improve the data that we collect and provide clear, accurate and unbiased information to improve pregnancy outcome for all.
By Ken Hodson (@ken_hodson on Twitter), Head of the UK Teratology Information Service (www.uktis.org) and consultant obstetrician with a specialist interest in medical problems in pregnancy in Newcastle upon Tyne, UK.
You can find the contact details of your local teratology information service at www.entis-org.eu. If you have questions about medicines in pregnancy and your country does not have a teratology information service, you can contact your doctor or midwife for advice.