Bacterial Vaginosis, Yeast infections, Thalidamide and Fear | Fit Pregnancy

Bacterial Vaginosis, Yeast infections, Thalidamide and Fear

What prescriptions can I take when I’m pregnant?

Fifty years ago, Thalidomide was yanked off the market.  This sedative drug prescribed to alleviate morning sickness in the 1950s and 60s, caused crippling birth defects. Thousands of babies, born without arms or legs are now adults and while doctors quit prescribing Thalidomide in 1961, the company responsible for manufacturing the drug only apologized for the damage they caused last week. 

We know a lot more these days about drugs, herbs, supplements and illnesses that potentially cause birth defects, miscarriages or damage to pregnant mothers. In fact, an entire field of study has developed dedicated entirely to figuring this mess out.

  • Teratology is the study of abnormal physical development
  • Teratagenic substances are agents or factors that cause or increase the incidence of abnormal prenatal development. 

Because of teratology research, we now know that you can take certain drugs and can’t take others during pregnancy.  But how do you as a parent and healthcare consumer know which are safe? I mean, the mothers who took thalidomide thought they were taking a safe drug too.  Of course, they also thought smoking and drinking during pregnancy were perfectly fine and doctors even recommended smokes and booze for relaxation. Now that we know that lighting up and tipping the bottle are downright unhealthy behaviors, far fewer pregnant women do that sort of thing.  This is a great example of what the poet, Maya Angelou, means when she says, “When you know better, you do better.”

As patients, we have a couple options: 

  • We can trust our doctors and midwives to guide our care, prescribe what they think is most appropriate and essentially do what they recommend or,
  • We can do some of our own research, consider other opinions and then weigh our physicians’ opinions with our own and make choices from there. 

Frankly, I see huge advantages to both options.  Some people aren’t interested or don’t have the resources to do their own homework.  Maybe they don’t have the time, Internet access, mastery of the language or educational background.  Maybe it’s not part of their culture or upbringing to question a physician.  Or maybe, things just go better for them when they leave the medical stuff to the medical folks.  That’s faith in action and it totally works for a huge percentage of the population. 

On the other hand, lots of us need a more hands-on approach when it comes to our own health.  We need ownership of our health care, partnership with our physicians and only then do we feel good about the decisions we make.  That’s a perfectly reasonable approach to take too.  I fall into the latter demographic, but I don’t necessarily think it’s the absolute best way to go.  It’s just best for me.  I’ve taken care of too many patients from all walks of life to think there’s only one way to approach your health.  There are at least as many ways as there are patients and physicians and most of them are pretty good if we live in a country with adequate healthcare access. 

If you fall into the “do your research” group and your doctor prescribes something while you’re pregnant, The Organization of Teratology Information Specialists has a thorough list of drugs, medical conditions and herbal remedies, each with its’ own fact sheet that spells out whether or not it is associated with any pregnancy-related problems. 

If you fall into the other group, you can rest assured, obstetricians are extremely careful about the medications they prescribe, foods they recommend and lifestyle issues they advise parents to consider. 

Because of Thalidomide, doctors and parents are both more aware and more frightened about damage that could happen to their babies.  One could even argue they go a little too far with their worries and restrictions, that some dire warnings are actually based more on fear of lawsuit than proof something might cause harm.  Still, when it comes to fetal and maternal health, erring on the side of caution is the best way to go.

Several readers emailed this week with deep concerns over medications their doctors prescribed to clear up bacterial vaginosis and yeast infections.  The specific drugs named were metronidazole (an antibiotic used for BV and usually called Flagyl) and miconazole (antifungal medication, often prescribed to treat yeast infections).   Each reader mentioned having seen a recent story about babies with birth defects and each came with a prescription printout that warned that the drug should be avoided during pregnancy.  

Well that’s confusing, right?  Their obstetricians prescribed, but the prescription isn’t guaranteed safe.  What’s a mama to do?  Here’s the thing – there are almost no medications that say they’re guaranteed safe to take during pregnancy, even when we know they’re just fine.  That’s because drugs are never tested specifically on pregnant women.  Instead, safety is determined after testing on lab animals doesn’t result in two-headed mice and after countless pregnant patients take the drug safely.  Drug companies are just as careful to avoid lawsuit as doctors and hospitals and therefore, they’re compelled to cover their tushes.

Is it safe to take Flagyl and yeast medication?  Almost certainly yes.  And considering how uncomfortable a yeast infection is and how potentially damaging bacterial vaginosis could be to Mom’s internal landscape, it’s a safer, more comfortable plan to take the darn medications than not to.  Did I say that I guarantee they’re safe?  No and here’s why:  Somewhere between three and five percent of pregnancies result in a child with genetic or developmental abnormalities.  20 percent of pregnancies result in miscarriage.  Is there a link between the drugs we take, chemicals in our environment, illness we treat or don’t treat?  Maybe. We don’t know for sure.  And that’s why there are no guarantees. 

 

Jeanne Faulkner, R.N., lives in Portland, Ore., with her husband and five children. Got a question for Jeanne? Email it to labornurse@fitpregnancy.com and it may be answered in a future blog post.

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This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.

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