Managing Medications During Pregnancy: What You Need to Know

Important Medical Disclaimer: This article provides general educational information about medication management during pregnancy. It is not a substitute for professional medical advice. Every pregnancy is unique, and all medication decisions — including starting, stopping, or changing any medication, supplement, or vitamin — should be made in direct consultation with your OB-GYN or healthcare provider. If you have questions about any specific medication’s safety during your pregnancy, contact your provider immediately.

Pregnancy changes nearly everything about your daily life, and your medication routine is no exception. Prescriptions that were perfectly safe last month may need to be reconsidered. Supplements you never took before — like prenatal vitamins and folic acid — become essential. And the stakes of getting it right feel higher than they have ever been.

According to the CDC, approximately 90% of pregnant women take at least one medication during pregnancy, and roughly 70% take a prescription drug. Managing these medications safely and consistently across nine months requires more than good intentions — it requires a system.

The First Step: A Complete Medication Audit

The moment you discover you are pregnant — or ideally, when you begin trying to conceive — schedule a medication review with your OB-GYN. This is not a conversation to have over a patient portal message. It deserves a dedicated appointment or a thorough discussion at your first prenatal visit.

What to Bring to Your Provider

Compile a complete list of everything you currently take:

• Prescription medications (including dosages and prescribing doctors)
• Over-the-counter medications (pain relievers, allergy pills, sleep aids)
• Vitamins and supplements
• Herbal products and teas
• Topical treatments (acne creams, medicated shampoos, etc.)

Do not assume anything is too minor to mention. Some common over-the-counter products — including certain NSAIDs and acne treatments containing retinoids — are contraindicated during pregnancy.

What Your Provider Will Do

Your OB-GYN will review each medication individually and make one of several determinations:

• Continue as prescribed — the medication is considered safe and its benefits are clear.
• Switch to a safer alternative — a different medication in the same class may have a better safety profile during pregnancy.
• Adjust the dosage — some medications are safe at lower doses but risky at higher ones.
• Discontinue — the medication poses a known risk and is not essential during pregnancy.
• Continue with monitoring — the medication carries some risk but stopping it carries greater risk (common with epilepsy drugs, certain cardiac medications, and some psychiatric medications).

This is where having a reliable tracking system becomes invaluable. A medication reminder app lets you update your regimen immediately after your appointment — removing discontinued medications, adding new ones, and adjusting dosages — so your daily reminders always reflect your current, provider-approved plan.

Prenatal Vitamins: The Foundation

Prenatal vitamins are one of the few supplements that nearly every OB-GYN universally recommends during pregnancy. They are not a nice-to-have — they are a medical recommendation backed by decades of evidence.

Key Nutrients and Why They Matter

• Folic acid (400-800 mcg): Dramatically reduces the risk of neural tube defects like spina bifida. Ideally started at least one month before conception.
• Iron (27 mg): Supports the increased blood volume during pregnancy and prevents iron-deficiency anemia, which is associated with preterm delivery.
• Calcium (1,000 mg): Supports fetal bone development. If the mother’s intake is insufficient, the fetus will draw calcium from her bones.
• DHA (200-300 mg): An omega-3 fatty acid critical for fetal brain and eye development.
• Vitamin D (600 IU): Supports calcium absorption and immune function.
• Iodine (220 mcg): Essential for fetal thyroid function and brain development.

Timing and Absorption Tips

Prenatal vitamins are notorious for causing nausea, especially during the first trimester when morning sickness is already a challenge. Practical strategies:

• Take them with dinner or before bed rather than in the morning.
• Take them with food to reduce stomach upset.
• If nausea is severe, ask your provider about switching to a different brand, a gummy formulation, or splitting the dose into morning and evening halves.
• Separate iron and calcium. These two minerals compete for absorption. If your prenatal contains both, taking an additional calcium supplement at a different time of day may improve absorption of both.

A consistent daily reminder is critical here. Unlike medications where you feel immediate effects when you miss a dose, skipping a prenatal vitamin has no noticeable short-term consequence — which makes it dangerously easy to let it slide. Use a medication reminder app to keep prenatal vitamins locked into your daily routine.

Tracking Medications Across Trimesters

Pregnancy is not a static state. Your medication needs may evolve as your pregnancy progresses.

First Trimester (Weeks 1-12)

This is the period of highest sensitivity for fetal organ development. Medication safety is paramount. You may also be dealing with:

• Nausea and vomiting that affect medication tolerance and timing
• Fatigue that makes remembering doses harder
• Anxiety about medication safety that leads some women to stop medications without consulting their provider (this can be dangerous — always consult your OB-GYN first)

Second Trimester (Weeks 13-26)

Often called the “honeymoon trimester,” nausea typically subsides, energy returns, and medication routines stabilize. This is a good time to:

• Reassess your tracking system and make sure it is working reliably.
• Schedule a mid-pregnancy medication review with your provider.
• Begin noting any new symptoms that might indicate a need for medication adjustment.

Third Trimester (Weeks 27-40)

New considerations emerge:

• Gestational diabetes may require medication or insulin that was not previously part of your regimen.
• Blood pressure monitoring becomes more frequent; preeclampsia may require treatment.
• Your provider may adjust certain medications in preparation for delivery.
• Planning for postpartum — discuss which medications will be safe while breastfeeding, as this may require another regimen change.

For each of these changes, update your medication tracking system immediately. Our guide on tracking medication side effects explains how to document symptoms and responses to medication changes — a practice that is especially valuable during pregnancy when your body is changing rapidly.

Medications to Approach with Caution

The following categories require careful discussion with your OB-GYN. This is not a complete list, and inclusion here does not mean these medications are necessarily unsafe — it means they require an individualized risk-benefit analysis with your provider.

Pain Management

• Acetaminophen (Tylenol) is generally considered the safest option for occasional pain relief during pregnancy, though recent research suggests discussing prolonged use with your provider.
• NSAIDs (ibuprofen, naproxen) are typically avoided, especially after 20 weeks, due to risks to fetal kidney and cardiovascular development.
• Aspirin may be recommended in low doses for women at risk of preeclampsia — but only under medical supervision.

Mental Health Medications

This is one of the most nuanced areas of pregnancy medication management. Depression and anxiety during pregnancy are common — affecting roughly one in seven women — and untreated mental illness carries real risks for both mother and baby, including preterm birth, low birth weight, and postpartum complications.

Some SSRIs have well-established safety profiles in pregnancy. Others are less studied. The decision to continue, switch, or stop a psychiatric medication during pregnancy should always involve both your OB-GYN and your prescribing psychiatrist or mental health provider.

Never stop a psychiatric medication abruptly upon discovering you are pregnant. Sudden discontinuation can cause withdrawal symptoms and a rapid return of the underlying condition. Call your providers and make a plan together.

Herbal Supplements and “Natural” Products

“Natural” does not mean safe during pregnancy. Many herbal products have not been studied in pregnant women, and some carry known risks:

• St. John’s Wort can interact with other medications and affect serotonin levels.
• Certain herbal teas (especially those containing pennyroyal, blue cohosh, or large amounts of chamomile) may stimulate uterine contractions.
• High-dose vitamin A (above 10,000 IU) is associated with birth defects.

Disclose every supplement to your OB-GYN, even if it seems harmless.

Building Your Pregnancy Medication System

A reliable tracking system during pregnancy does not need to be complex. It needs to be consistent.

What to Track

• Medication name, dose, and time for every prescription and supplement.
• Whether you took it — daily confirmation is especially important for prenatal vitamins, which are easy to forget.
• Side effects or symptoms — nausea, headaches, swelling, mood changes. This information is valuable at every prenatal appointment.
• Appointment dates and provider notes about medication changes.

How to Track It

A medication reminder app designed for daily use is the most practical option for most women. It travels with you, it sends reminders, and it creates a log you can share with your provider.

Pair your digital tracking with a physical backup if it gives you peace of mind — a medication section in your pregnancy journal, a chart on the fridge, or a weekly pill organizer on the nightstand.

Preparing for Postpartum

Before your due date, have one more medication conversation with your OB-GYN:

• Which current medications are safe to continue while breastfeeding?
• Will any medications need to restart that were paused during pregnancy?
• What new medications might be needed postpartum (pain management after delivery, mental health support)?

Planning ahead prevents the scramble of making these decisions while sleep-deprived with a newborn.

Your Provider Is Your Partner

Every piece of advice in this article comes with the same caveat: talk to your OB-GYN. Pregnancy medication management is not a DIY project. The internet can provide context and help you ask better questions, but your provider — who knows your medical history, your pregnancy, and your individual risk factors — is the only person qualified to make medication decisions for you and your baby.

Use a medication reminder app to stay organized, stay consistent, and have accurate information ready at every appointment. And for a broader perspective on how medication management evolves across all of life’s major stages, see our guide to medication reminders for every stage of life.

Your health — and your baby’s — deserve that level of attention.