Why Pregnancy Changes the Equation

Pregnancy alters how your body works. Medicines may be processed differently, and many can cross the placenta to reach the baby. That’s why decisions around medication in pregnancy are rarely simple “yes or no” answers.

The Evidence Gap

Here’s something not widely understood: most medicines are never tested in pregnancy before being licensed. Pregnant women are excluded from clinical trials, largely for ethical reasons. That means safety data usually comes later, from:

• Animal studies
• Case reports and pregnancy registries
• Observational studies of women who happened to take the medicine

This creates uncertainty. We rarely know if a medicine is completely safe — but that doesn’t mean it’s automatically harmful either.

Balancing Risk and Benefit

Every decision about medicines in pregnancy involves weighing the risks of treatment against the risks of not treating.

If a condition needs treatment (like diabetes, asthma, or high blood pressure), medicines are usually essential. The dangers of leaving the illness uncontrolled far outweigh possible medication risks.

• If it’s for milder symptoms, like a headache, non-drug options may be tried first, or the safest available medicine used at the lowest effective dose.
• Supplements can be valuable (folic acid, vitamin D, iron when needed), but not all are beneficial — and some can be harmful in excess.

Common Examples

• Paracetamol (Tylenol): Still considered safe in pregnancy when used appropriately. Some studies have raised concerns, but the evidence isn’t conclusive. Major health bodies continue to recommend it when needed. Trump’s recent sweeping claims against it are misleading, overly simplistic, and risk discouraging women from safely managing pain or fever.
• Ibuprofen and NSAIDs: Generally avoided, especially later in pregnancy, because of known risks to the baby’s kidneys and heart.
• Antibiotics: Some are safe, others are avoided. Always a case-by-case judgement.
• CBD: Increasingly popular for pain, sleep, and anxiety, but research in pregnancy is extremely limited. Without robust evidence, most doctors advise avoiding CBD products during pregnancy.

Key Takeaways

• Most medicines are not tested in pregnancy — so decisions are made on the best available evidence, not absolute certainty.
• It’s always a balance: what’s safest for both mother and baby depends on the situation.
• Sweeping claims are unhelpful. Medicines like paracetamol remain appropriate when used carefully.
• Supplements and “natural” remedies should not be assumed safe — especially in pregnancy.
• CBD and newer therapies are promising, but without research, should be avoided in pregnancy.

Conclusion

Pregnancy decisions should be guided by evidence and professional advice, not political soundbites. Scare stories may make headlines, but they don’t help expectant mothers make safe, informed choices. If you’re pregnant, the best step is always to discuss any medicine or supplement — whether prescribed, over-the-counter, or “natural” — with your healthcare professional.