Medication and the First Trimester

medication and the first trimester

At the beginning of the week I cautioned against going off medication when you get pregnant.  Now I want to write a follow-up, because it actually is important to know any potential dangers with medicine and the first trimester.

As a rule I’ve avoided reading lists of dangers, side effects, and rare pregnancy and birth problems.  They’ll just cause me unnecessary stress, and since pregnant women usually see their doctors at least once a month, I trust mine to keep me informed about anything that will actually/is actually affecting me.  But it is important to know that the first trimester is the time during which to exercise the most caution about what you’re putting into your body.

That’s because the baby’s organs are developing during the first trimester.  By later in the pregnancy most of the vital bits are more or less formed, so there’s less cause for concern.  It’s tricky to know what’s OK and what’s not, which is why all medication decisions should be made with your doctor.  Your own health is also important to your baby, and if you’re feeling so sick you’re not able to take care of yourself – like I was – then safe medications can be important.

My GI explained all of this to me.  After the worst of my morning sickness was over we met, and he explained to me that as a medical professional, he could assure me that the GERD medication I was taking was perfectly safe.  But as a person and a father, he understood the impulse to want to be extra careful, and so I could also try to wean myself off of the medication entirely.  That’s what I ended up choosing to do, and I didn’t go back on it until months later, in the third trimester, when my indigestion became a problem again. At that point I did so under the direction of my midwife.

That’s why I wished I’d talked to my GI or my primary care doctor more about medication and pregnancy, either while still trying to become pregnant, or before making the decision to go off of my medication.  I’m not sure exactly what they would have said to me, but I know at least they would have told me to wean myself off, to not go cold turkey.  I might have gotten a lot less sick if I hadn’t abruptly quit my meds.  Maybe they would have even had me stay on some for a little bit, or switched me sooner to the Zantac, which has existed longer and thus has shown for longer that it’s safe.

I don’t advocate staying on all medicines in the first trimester.  It’s important to go off some, especially during such an important time in the baby’s development.  What’s the most important, however, is to go over any decisions with your doctor, so that you fully understand your specific situation.


*(The above image by Carlos Porto is from