Obstetrics & Gynaecology

During pregnancy, medications taken by the expectant mother can cross the placenta and enter the developing baby’s bloodstream. The effect that it has on the unborn baby depends on the medication and the trimester in which the medicine is taken. Harmful consequences may include miscarriage, low birth weight, birth defects, or neonatal abstinence syndrome.

Most pregnant women know that it’s wise to avoid taking medications during pregnancy, yet sometimes prescription drug use is necessary even for those who are expecting. Always consult your doctor before taking any medications – whether prescription, over-the-counter or herbal.

The following overview will give you more information on what the U.S. Food and Drug Administration ranks as the least to most harmful classes of drugs during pregnancy:

• Category A: Category A drugs have been tested and found to be safe during pregnancy. Examples include folic acid and Levothyroxine, a thyroid hormone medicine.
• Category B: These drugs are frequently used during pregnancy and do not appear to cause major birth defects or other problems. Category B includes some antibiotics like amoxicillin, insulin for diabetes, and ibuprofin (Advil, Motrin) before the third trimester. Pregnant women should not take ibuprofen during the last three months of pregnancy.
• Category C: These are drugs that are more likely to cause problems for the mother or fetus, and drugs for which safety studies have not been conducted or completed. These drugs often come with a warning that they should be used only if the benefits of taking them outweigh the risks. This is something a woman would need to carefully discuss with her doctor. These drugs include Sudafed, fluconazole (Diflucan) for yeast infections, and albuterol (Ventolin) for asthma. Some antidepressants are also included in this group.
• Category D: These include drugs that have clear health risks for the fetus such as lithium used to treat bipolar disorder, phenytoin (Dilantin) for epileptic seizures, and most chemotherapy drugs to treat cancer.
• Category X: These drugs have been shown to cause birth defects and should never be taken during pregnancy. These include drugs to treat skin conditions like cystic acne (Accutane) and psoriasis (Tegison or Soriatane).

When you become pregnant, it's suddenly not just your own health you have to look after, but also that of your future baby. Here are some tips to give your baby the best possible start in life:

• Eat well: Even if you already eat healthily, you may need to make some adjustments during pregnancy. Eat plenty of fruit, vegetables, grains, lean meat, chicken, fish, eggs and dairy.  Protein and iron rich foods help to build new bones, muscles and organs, while calcium is essential for forming healthy teeth and bones. Make sure to speak to your doctor if you have special dietary needs.
• Exercise: Staying active will boost your health and that of your unborn baby, but pregnant women shouldn't overdo it. It's best to maintain fitness, not to push to the next level of training. Gentle exercise like yoga, swimming, mild aerobics and walking are ideal.
• Eat the right types of fish: Oily fish such as salmon, sardines and tuna contain omega 3 fatty acids, which help develop your baby's nervous system. However, limit white tuna to 6 ounces a week and avoid shark, swordfish, king mackerel, or tilefish, as these have high levels of mercury that can be harmful to your baby.
• Reduce stress: Stress could have an impact on your baby's health, and increase the likelihood of your baby developing birth defects, emotional and behavioural issues, infections, allergies and skin problems. If you're finding it difficult to cope, share your anxiety and fears with your partner, or turn to friends and family for support.
• Avoid alcohol: During pregnancy mothers should abstain from drinking alcohol to eliminate the chance of giving birth to a baby with fetal alcohol spectrum disorder. The toxins in alcohol can reach the unborn child and damage developing cells.
• Quit smoking: Smoking during pregnancy can restrict oxygen supply to your baby and damage your baby’s health. Smoking can also increase the risk of miscarriage and stillbirth, and babies are more likely to be born prematurely and underweight.
• Consume less caffeine: Coffee, tea, diet coke and chocolate all contain caffeine that affects heart rate. Having large amounts raises your risk of miscarriage and a low birth weight baby. Moderate amounts of caffeine appear to be safe during pregnancy. According to the Office on Women’s Health , moderate means less than 200mg of caffeine per day, which amounts to about two mugs of instant coffee.
• Get sufficient sleep: Getting some well-needed rest gives your body time to re-energise and nourishes your growing baby. Try relaxing your mind with meditation, cutting back on tiring chores or napping in the afternoon.
• Have regular check-ups: If there are any problems during the pregnancy, it’s best to know about them as soon as possible by regularly checking on your baby's progress.

About two to three days after childbirth, some women start to feel depressed, anxious and upset. But mild depression and mood swings are common in new mothers—so common, in fact, that it has its own name: the baby blues. The baby blues are perfectly normal and will often fade without treatment within one to two weeks. However, if your symptoms don’t go away or start getting worse, you may have postpartum depression.

Postpartum depression is a more severe and long-lasting depression characterised by intense feelings of sadness, anxiety, or despair. Postpartum depression can prevent new mothers from being able to do their daily tasks. While there is still no known cause, the American Congress of Obstetricians and Gynecologists state that a combination of factors, including hormonal, social and psychological changes, often play a part. 

What are the symptoms of postpartum depression?

Postpartum depression symptoms may include:

• Difficulty bonding with your baby
• Negative feelings towards your baby
• Lack of energy or motivation
• Intense irritability and anger
• Loss of interest in sex
• Lack of joy or pleasure in life
• Feelings of shame, guilt or inadequacy
• Severe mood swings
• Loss of appetite
• Insomnia
• Withdrawal from family and friends
• Thoughts of harming yourself or your baby

If you're feeling depressed after your baby's birth, you may be reluctant or embarrassed to admit it. But it's important to get professional help right away as postpartum depression can interfere with your ability to take care of your child. With treatment and support, you can get back on the road to happy motherhood.

How is postpartum depression treated?

Treatment and recovery time vary, depending on the severity of your depression and your individual needs. Postpartum depression is often treated with counselling and antidepressant medication. With appropriate treatment, postpartum depression usually goes away within a few months.