Why Talking About Medications with Your OB/GYN Isn’t Optional
Almost every pregnant woman in the U.S. takes at least one medication during pregnancy. That’s not unusual - it’s normal. But what’s not normal is walking into your OB/GYN appointment without knowing exactly what you’re taking, why, and whether it’s safe. Too many women assume their prenatal vitamins are the only thing that matters. They forget about the ibuprofen they take for headaches, the fish oil supplement from the health food store, or the St. John’s Wort they’ve been using for low mood since college. These aren’t harmless. Some can interfere with fertility. Others can harm a developing baby. Your OB/GYN isn’t judging you. They’re trying to keep you and your baby safe.
What You Need to Bring to Your Appointment
Don’t rely on memory. Write it down. Every pill, capsule, patch, liquid, or injection you’ve taken in the last three months. This includes:
- Prescription drugs: Exact names, doses, and how often you take them. Don’t say “my blood pressure pill.” Say “Labetalol 200 mg, twice daily.”
- Over-the-counter meds: Tylenol, ibuprofen, cold syrup, antacids, sleep aids. Even if you only take them once a month.
- Supplements: Prenatal vitamins, iron, calcium, vitamin D, omega-3s - and don’t forget the herbal stuff. St. John’s Wort, evening primrose oil, black cohosh, red raspberry leaf. Yes, even the ones labeled “natural.”
- Topical products: Creams, patches, or sprays with active ingredients, like lidocaine or menthol.
- Recreational substances: Alcohol, nicotine, cannabis. If you’re using it, tell them. It’s not about shame - it’s about risk.
Pro tip: Take a photo of each medication bottle with your phone. If you forget the dosage, you’ve got a backup. One patient in Melbourne brought a spreadsheet with brand names, dosages, and reasons for each item. Her OB printed it and kept it in her chart. That’s the kind of prep that makes a difference.
What Your OB/GYN Is Looking For
Your OB/GYN isn’t just checking off a list. They’re scanning for three things:
- Teratogens: Drugs that can cause birth defects. Examples include isotretinoin (Accutane), certain epilepsy meds like valproic acid, and lithium. If you’re on any of these and planning pregnancy, you need a plan to switch safely - and it takes time.
- Drug interactions: Some meds reduce the effectiveness of birth control. St. John’s Wort, for example, can cut oral contraceptive levels by half. That’s not a small thing.
- Chronic condition management: If you have high blood pressure, diabetes, thyroid disease, or depression, your medication needs may change during pregnancy. Thyroid meds like Synthroid often need higher doses. Blood pressure meds like ACE inhibitors must be switched to safer options like Labetalol or Methyldopa.
ACOG’s guidelines say every woman planning pregnancy should have a full medication review. That’s not a suggestion - it’s standard care. And it’s even more critical if you’re already pregnant. About 68% of women continue taking meds for chronic conditions during pregnancy. That’s fine - as long as those meds are safe.
Questions You Should Ask - And Don’t Be Shy
Prepare at least three questions before you walk in. Here are the ones that matter most:
- “Is this medication safe during pregnancy - and if not, what’s the alternative?” Ibuprofen is fine for occasional headaches, but not after 20 weeks. Tylenol is usually the go-to. But if you’re on a daily pain med, ask what’s safe long-term.
- “Should I stop this before trying to conceive, and how long before?” Some meds need to clear your system. Others, like folic acid, should be started at least a month before conception to reduce neural tube defects.
- “Is this supplement necessary? Could it be harmful?” Evening primrose oil is popular for “cervical ripening,” but it can trigger contractions. You don’t need it unless your provider says so.
- “What about breastfeeding? Will this still be safe after delivery?” Many meds are safe during breastfeeding, but not all. Antidepressants like sertraline are low-risk. Benzodiazepines? Not so much.
- “Do I need a pharmacist to review this with you?” If you’re on four or more meds, your OB/GYN might refer you to a women’s health pharmacist. That’s not a red flag - it’s a bonus.
One woman in Colorado said her OB told her: “If you’re not sure, don’t take it.” That’s a good rule. Especially when it comes to supplements. “Natural” doesn’t mean safe. Many herbal products aren’t regulated, and their effects on pregnancy are unknown.
What Happens When You Don’t Talk About Your Meds
Stories like this are more common than you think:
- A woman took melatonin nightly for sleep. She didn’t think it counted as a “medication.” Turns out, it may affect ovulation.
- A woman was on gabapentin for nerve pain. She kept taking it during early pregnancy. Her OB had to switch her quickly - it’s a Category C drug with unclear fetal risks.
- A woman used cannabis for anxiety. She didn’t mention it because she thought it was “just weed.” Her baby had low birth weight and needed NICU care.
These aren’t rare. A 2022 study found that 41% of pregnant women felt anxious about admitting they took supplements they considered “natural.” That fear costs lives. The same study showed patients who prepared a list had 40% more productive conversations and 20% shorter appointments. That’s because your provider can focus on solutions, not scrambling to catch up.
What OB/GYNs Wish You Knew
Dr. Laura Riley from Weill Cornell says: “The most important thing I hear is not about pills - it’s about folic acid. Start 400 mcg daily at least one month before conception. It’s the single most effective thing you can do to prevent brain and spine defects.”
Dr. Jen Lincoln reminds patients: “You wouldn’t skip brushing your teeth because you think it’s ‘just a habit.’ Don’t skip telling me about your supplements because you think they’re ‘not real medicine.’”
And here’s the hard truth: Only 38% of OB/GYNs routinely ask about medical marijuana, even though 18% of reproductive-age women use it. That’s a gap. If you’re using it - for pain, nausea, anxiety - say so. There are safer alternatives.
How to Stay on Top of It After Your Appointment
Medication safety isn’t a one-time talk. It’s ongoing.
- Update your list every trimester. Your body changes. Your needs change.
- Use apps like Babyscripts if your clinic offers them. They let you log meds, blood pressure, and symptoms in real time.
- Ask for a written summary. If your OB changes a med, ask them to email or print a note with the new instructions.
- Don’t wait for your next appointment. If you start or stop something, call the office. Even if it’s just a new OTC painkiller.
By the third visit, most patients feel more confident. Why? Because they stop guessing. They stop worrying they’ll forget something. They know their provider has the full picture.
The Bigger Picture: Why This Matters
The OB/GYN medication market is growing fast - $18.7 billion in 2022, and rising. Why? Because more women are entering pregnancy with chronic conditions. In 2010, 44% did. By 2025, it’s projected to be 58%. That means more complex medication needs. More risks. More need for smart, informed conversations.
Technology is helping. Electronic health records now flag teratogens automatically. Pharmacies alert providers if a pregnant patient is prescribed a risky drug. But none of that replaces you telling your OB/GYN what you’re taking.
Final Thought: You’re the Most Important Person in This Room
No one knows your body like you do. No one else will remember that you took that one supplement last week because your friend swore by it. No one else will know that you stopped your antidepressant because you were scared. Your job isn’t to sound perfect. Your job is to be honest. Your OB/GYN’s job is to help you - not to judge you.
So bring the list. Ask the questions. Say the hard things. Your baby’s health depends on it - and so does yours.