Medication Safety During Pregnancy: Dispelling Myths and Understanding Risk

By Didi Abdelsalam

When people hear someone is taking medication during pregnancy, they automatically assume that it will harm the baby. However, Dr. Waggel explains that understanding medication safety requires examining risk in a more organized, structured way. Pregnancy outcomes can be complicated, and sometimes

negative outcomes occur even when no medications are taken, implying that medications are not linked to one another.

One important point Dr. Waggel discusses in the slideshow is miscarriage. She explains that miscarriage not only happens, but it is actually very common, and she notes that it occurs in about “1 in 3 pregnancies.” This means that even healthy pregnancies where a woman takes no medication, can still end in miscarriage. This leads to the conclusion that, if a miscarriage happens while someone is taking medication, it does not automatically mean the medication caused the outcome, but a possibility of a completely different factor.

There is also the opposite situation to consider, and how sometimes a pregnant woman has a health condition but is afraid to take medication since she thinks it could harm the baby. However, untreated illness can also be dangerous, and Dr. Waggel emphasizes that “both untreated pain and fever can negatively impact the baby.” This shows that avoiding medication is not always the safest choice, even

when someone is pregnant. Doctors must weigh the risks of medication against the risks of leaving a condition untreated.

Another key concept is the difference between relative risk and absolute risk. Absolute risk refers to the actual chance that something will happen. For example, congenital anomalies, which are birth defects, occur in about 3–5% of all pregnancies, even when no medications are taken. Relative risk compares how

that number changes with exposure to a medication. Sometimes a study will say a risk doubles, but if the original risk was small, the overall risk may still be low. Understanding the baseline risk helps people interpret research more accurately.

Doctors must also consider dose, timing, and trimester when evaluating medications. The amount of medication taken can affect risk, and the stage of pregnancy matters as well. Some medications may have different effects during early fetal development compared to later in pregnancy. Dr. Waggel also explains

how medications can reach the baby, noting that “the major function of the placenta is to transfer nutrients and oxygen from the mother to the baby and assist in the removal of waste products.” Because the placenta allows certain substances to pass through, scientists must study whether medications can cross

this barrier.

It is important to understand that medical decisions during pregnancy require balancing multiple risks. Rather than assuming that all medications are dangerous, doctors evaluate the baseline risk, available research, the medication's dose and timing, and the potential harm of leaving the illness untreated. By thinking about medication risks in this structured way, doctors and patients can make safer, more

informed decisions.

Reference

Waggel, S. (2026). Maternal, Fetal, and Neonatal Outcomes of Analgesic Use during Pregnancy

[PowerPoint presentation].

Lewis, T. (2013, May 16). 5 Fascinating Facts About Fetal Ultrasounds. Live Science.

https://www.livescience.com/32071-history-of-fetal-ultrasound.html