Health care

Medication and natural health products

Information to which you should pay special attention Care should be exercised when considering taking any prescription or over-the-counter (OTC) medication or natural health product during pregnancy. Some may be ineffective, dangerous during pregnancy, or harmful for your baby.

If you are pregnant or would like to get pregnant and you take prescription or over-the-counter medication or natural health products, talk to your health professional to see whether you should continue, stop, or change what you are taking.

If you are experiencing discomfort or health problems, it is important to recognize the situation and to choose the treatment best suited to your condition and the stage of your pregnancy. Many people think it is dangerous to take medication during pregnancy. But thanks to research and experience, most illnesses can be treated during pregnancy.

Be just as careful with natural health products (plants, supplements, and vitamins) as with conventional medication. Plants used for cooking, like parsley, basil, and garlic, are generally harmless. But in capsule, tablet, tincture, or extract form, these plants can be more concentrated than when they are used in food.

Information essentielle, à retenirDuring pregnancy, ask a health professional before taking any prescription or over-the-counter drugs or natural health products.

The effects of natural health products at high concentrations are not always known. There may be concerns about potential risks given the lack of data on their use during pregnancy. Furthermore, their exact contents are not always clearly indicated on packaging. Some ingredients could be toxic during pregnancy.

Here are some common situations and some general advice to help you make the right decisions about taking medication during pregnancy.

Medication and pregnancy

Situation What to do? Things to know

You want to get pregnant and you are taking medication for a specific problem like: Anxiety, Epilepsy, Hypertension, Depression, Asthma, Diabetes

Talk to your doctor when you are planning to get pregnant.

  • Your medication may be adjusted.

You are pregnant and you are taking medication.

Talk to your doctor right away to find out whether you should continue, stop, or change your treatment.

  • Although some medications must be discontinued as soon as possible during pregnancy, don’t stop treatment out of fear of harming your baby or endangering your pregnancy without first consulting a professional. For some problems, stopping your treatment could cause more complications for you and your baby than the medication itself.
  • A doctor or pharmacist can tell you if your medication needs to be adjusted.

You were taking medication before you found out you were pregnant, but are not taking it any more.

At your first appointment, tell your health professional what medications you were taking.

  • As a general rule, few medications have an effect on the baby at such an early stage.
  • Ask your doctor or pharmacist for more information about your medication and its effects.

You have a health problem during pregnancy.

See a health professional right away for a health evaluation.

  • Most infections and chronic problems can be treated with medication during pregnancy.
  • Pain can also be relieved.
  • Do not let your health deteriorate because you are afraid of taking medication.

Common discomforts of pregnancy

Information to comfort you and boost your confidenceIf these tips don’t help you feel better, if your condition worsens, or if you have any concerns, call a health professional right away.

Your body changes throughout your pregnancy. These changes sometimes cause discomfort that are generally harmless, but can sometimes be hard to bear. The tables below outline some common types of discomforts as well as tips for relieving them.

Some over-the-counter medication can sometimes be taken for a short time. Talk to a health professional before taking any OTC medication. He or she may

  • Suggest ways to relieve your discomforts without medication
  • Check whether you are taking other products that should not be taken with OTC medication (drug interactions)
  • Advise you about OTC medication that can be taken during pregnancy
    • Explain the best way to take it
    • Tell you the maximum dosage
    • Indicate how long you can take it

Fatigue

Description What to do? Not feeling better?
  • When:
    • Common from the beginning of pregnancy until the end of the 1st trimester
    • May come back in the 3rd trimester
  • Likely causes in the 1st trimester:
    • Increased progesterone
    • Waking to urinate
    • Diminished nutrition due to nausea and vomiting
    • Mood swings and anxiety
    • Decreased caffeine intake
  • Likely causes in the 3rd trimester:
    • Lower back pain
    • Heartburn and acid reflux
    • Leg cramps
    • Difficulty finding a comfortable position
    • Waking to urinate
    • Emotions and concerns about the delivery
  • Try to get more sleep at night (8–10 hours)
  • Take naps if possible
  • Eat a balanced diet
  • Drink enough water
  • Try to get some exercise
  • Get help doing routine tasks if you can.

Talk to your health professional.

Nausea and vomiting

Description What to do? Not feeling better?
  • Likely cause: hormonal changes
  • Frequency:
    • Nausea: 70% to 85% of pregnant women
    • Vomiting: 50% of pregnant women
  • When:
    • They generally appear between the 4th and 8th week after the start of the last period
    • They often peak around the 9th week of pregnancy
    • They are rare after the 20th week
  • Try to rest
  • Eat what you want
  • Avoid getting hungry (going a long time without eating)
  • See if it helps to:
    • Eat smaller amounts more often (small meals and snacks)
    • Avoid strong odours and food textures that make you queasy
    • Avoid drinking when you are eating or feeling nauseated – drink between meals instead
    • Eat a little bit before you get up in the morning – pregnant women are often advised to eat crackers or toast
    • Get out of bed slowly

Talk to your health professional if:

  • The nausea or vomiting is interfering with your daily life. Your health professional may recommend taking over-the-counter or prescription medication
  • You are losing weight

See your health professional right away if:

  • You show signs of dehydration: dry mouth and nose, dark urine
  • You have severe, persistent vomiting

Leg cramps

Description What to do? Not feeling better?
  • Cause: acid build-up (lactic and pyruvic acids) in the leg muscles. This build-up causes harmless but extremely painful cramps. They occur mostly at night.
  • Frequency: over 50% of pregnant women
  • When: during the second half of pregnancy

When you have a cramp, you can:

  • Stretch your leg by pointing your toes upward
  • Massage the affected muscles
  • Get out of bed
  • Walk around

Don’t worry if you feel slightly sore the next day; it is nothing serious.

See your health professional.

Heartburn and acid reflux

Description What to do? Not feeling better?
  • Possible cause: Hormonal changes associated with pregnancy which slow digestion, causing stomach fluids to move up into the esophagus.
  • When: From the start of pregnancy. They can get worse as the pregnancy progresses.

You can:

  • Avoid lying down after meals
  • Sleep with your head elevated
  • Wear loose clothing
  • Change your diet:
    • Eat smaller amounts more often (small meals and snacks)
    • Reduce your intake of fatty foods
    • Avoid stomach irritants like caffeine and spices
    • Avoid eating or drinking a lot before going to bed
  • You can temporarily take an antacid.
  • Talk to your health professional if:
    • Relief is only temporary
    • Symptoms persist despite taking antacids
    • You have to take antacids regularly over the course of several days
    • Your symptoms are accompanied by fever, nausea, and severe vomiting or headaches

Constipation and hemorrhoids

Description What to do? Not feeling better?
  • Causes of constipation:
    • Pregnancy-related hormonal changes that slow digestion
    • Iron supplements
    • Hemorrhoids
  • Cause of hemorrhoids: the growing uterus puts pressure on the veins, which makes them swell
  • When: mostly in the 2nd and 3rd trimesters of pregnancy
  • Eat fibre-rich foods: bran and wholegrain cereal has a lot of fibre
  • Eat dried fruit and fresh fruits and vegetables and drink prune juice
  • Increase your daily water intake
  • If you have hemorrhoids, you can take sitz baths. Applying zinc cream or witch-hazel compresses on hemorrhoids can sometimes relieve the pain

Talk to your health professional, who may prescribe a more effective hemorrhoid ointment or suggest that you:

  • Take dietary fibre or psyllium supplements. If you do, make sure to drink plenty of fluids to avoid making the constipation worse
  • Take a stool softener

Numbness and pain in the hands

Description What to do? Not feeling better?
  • Likely causes: fluid retention in the body (oedema or swelling), which pinches the median nerve in the wrist
  • Frequency: 25% of pregnant women
  • When: especially in the 3rd trimester and mostly at night • Distinctive feature: often affects both hands
  • These problems are harmless and will go away after the baby is born
  • If symptoms are bothersome or painful, you can try an orthotic device or a wrist protector like the ones worn for rollerblading. Wear them whenever you feel pain or swelling, a few hours a day or at night

Talk to a doctor if:

  • You experience weakness in your hand
  • The problem persists after the birth of the baby

Back pain

Round back stretch

Pelvic tilts

Illustrations: Luz design+communications

Description What to do? Not feeling better?
  • Likely causes:
    • Lordosis, i.e., arching of the back to compensate for abdominal weight
    • Ligamentous hyperlaxity: all the body’s ligaments are more relaxed during pregnancy, including pelvic ligaments
  • Frequency: about 75% of pregnant women

The following exercises, when done regularly, can help prevent or relieve back pain during pregnancy. You can:

  • Exercise in the pool, e.g., aqua fitness or swimming
  • Exercise at home or during your daily activities: pelvic tilts while lying down or standing, round back stretch (see illustrations)
  • Ask your health professional or pharmacist if you can take acetaminophen for a few days
  • If the pain returns, persists, increases, or spreads to your legs, talk to your health professional
  • If you are at the end of your pregnancy and you are having back pain that spreads to your abdomen or comes and goes regularly, you may be experiencing your first contractions (see Recognizing the start of labour).

Treating common health problems

Information to which you should pay special attentionIf you have to take acetaminophen, make sure not to confuse it with aspirin or ibuprofen (Motrin® or Advil®). Aspirin and ibuprofen cannot be taken at all times during pregnancy. Only take them if your health professional recommends them.

While you are pregnant, you may wonder about the best way to deal with problems that are unrelated to your pregnancy. Some problems can be more common or more bothersome during this period.

Oftentimes minor health problems do not need to be treated with medication. The table below contains advice on how to find relief. If you think you need to take medication while you are pregnant, talk to your midwife or doctor first. You can also ask your pharmacist.

Common health problems

Problem Possible solutions Talk to your health professional if:

Cold,
Nasal congestion,
Sore throat

You can:

  • Use a nasal saline solution
  • If this does not help, use a nasal decongestant spray for up to three days. Your health professional or pharmacist can advise you. Extended use of this product could make nasal congestion worse
  • Gargle with salt water
  • If you are in a lot of pain, ask your health professional or pharmacist if you can take acetaminophen for a few days
  • Your cough or sore throat lasts for more than three days
  • You have a fever (see Fever)
  • Your general health worsens
  • You have any concerns

Headache 

  • Rest
  • If you are in a lot of pain, ask your health professional or pharmacist if you can take acetaminophen for a few days
  • Your headaches last for more than three days
  • You have a fever (see Fever)
  • Your headaches are accompanied by other symptoms like stomach pains, vision problems, nausea or vomiting, or drowsiness
  • Your general health worsens
  • You have any concerns
Problem When to talk to your health professional?

Symptoms of urinary tract infection

Many pregnant women feel the need to urinate more frequently and in smaller amounts than they did before they were pregnant. Talk to your health professional to see if you could have a urinary tract infection if you:

  • Have trouble starting to urinate
  • Feel a burning sensation when you urinate
  • Go to the bathroom to urinate just a few drops
  • Feel the need to go again right after urinating
  • Have pain in your lower abdomen, especially after urinating
  • See blood in your urine

You may have a urinary tract infection even if you do not have any of these symptoms. It can be diagnosed through a urine test during your regular check-up.

Symptoms of vaginitis

Pregnant women often have more vaginal discharge than usual. Talk to your health professional to see if it could be vaginitis and get treatment if you:

  • Feel a burning sensation in the vulva when you urinate or have intercourse
  • Have itching in the vulva area
  • Notice a change in the color or odour of your discharge

Flu (influenza) vaccine

Pregnant women in the second and third trimester are more likely to suffer flu complications or be hospitalized. They may also transmit the flu to their baby. That is why it is recommended that you get the flu vaccine if you are 13 weeks pregnant or more. If you have a chronic health condition, you should get the flu vaccine as soon as possible, regardless of your stage of pregnancy.

Pertussis (whooping cough) vaccine

Pertussis (whooping cough) is a contagious disease of the respiratory tract that can be serious for young babies. It is recommended that pregnant women be vaccinated against pertussis. The vaccine is usually given when women are between 26 and 32 weeks pregnant. The vaccine can be given for each pregnancy. It protects the woman and her baby during the first few months of baby’s life.

Contact with people with a contagious disease

Information essentielle, à retenirIf you feel sick or have any physical signs that suggest you’ve caught one of these diseases, see a doctor promptly. As a precautionary measure, inform the healthcare facility before you arrive.

Some pregnant women may come into contact with people, especially children, who have contagious diseases.

If you don’t feel sick but you think you have been in contact with someone who has a contagious disease, here is some advice for how to deal with certain diseases.

Pertussis (whooping cough)

If you’ve been in contact with someone who has pertussis (whooping cough) in the 4 weeks before your due date, see a doctor.

Fifth disease (also known as erythema infectiosum or parvovirus B19 infection)

Thanks to their antibodies, over half of pregnant women in North America are protected against fifth disease, and so are their fetuses.

If an unprotected pregnant woman contracts fifth disease, there is a chance the fetus may become infected. In rare cases, the fetus could become severely anaemic and the mother could miscarry.

The risk of complications is more of a factor before the 20th week of pregnancy. The risk is much lower after.

If you come into contact with someone with fifth disease, talk to your health professional. He or she will be able to assess your situation.

Rubella (German measles)

Thanks to the rubella vaccination, German measles is very rare in Québec and the rest of Canada. It’s unlikely that you’ll come into contact with someone who has this disease. If you think you have been, see a doctor (see also Blood tests and urine analyses).

Measles

Measles is a very contagious disease. Pregnant women with measles can have a more serious form of the disease. They also are at greater risk of miscarrying or not carrying their baby to term. There have been no reported cases of congenital defect due to measles, however.

If you think you have measles or have been in contact with a person with measles, promptly contact your doctor, CLSC, or Info-Santé to have someone assess your situation.

Chickenpox

When chickenpox is contracted by a pregnant woman it can cause complications for the mother and baby. The childhood vaccination for chickenpox reduces the risk of exposure for pregnant women. Here is what you should do if you come into contact with a person with chickenpox:

  • If you have already had chickenpox, you can rest assured that your baby is at no risk.
  • If you’ve never had chickenpox or aren’t sure if you’ve had it, see a doctor within 48 hours. If you were born in North America, there is a more than 90% chance that you are protected.
  • If you aren’t protected against chickenpox, you will be given antibodies to help keep you from getting the disease or reduce its intensity if you do get it.

Other contagious diseases

If you come into contact with a person with one of the following contagious diseases, there is no particular danger for your pregnancy or your baby: roseola, hand-foot-mouth disease and scarlet fever.

However, if you are sick and you have any symptoms that may be caused by one of these contagious diseases, see a doctor.

Oral and dental health

Life goes on during pregnancy, and you may need oral or dental care at some point. Hormonal changes make your gums more sensitive, meaning they may become swollen or bleed more easily. This condition is called pregnancy gingivitis. In addition to brushing regularly, you should floss daily. Though your gums may bleed at the beginning, bleeding will go away quickly with proper oral hygiene. Talk to your dentist if needed.

You can continue to see your dentist; just make sure to tell him or her that you are pregnant. If you need dental care, your dentist may tell you when during your pregnancy it is best to receive the treatment you need. He or she may also decide to postpone non-urgent treatment until after the baby is born. And although the best time to get dental care is during the second trimester, you can have cavities, abscesses, and other urgent problems treated at any time during your pregnancy.

If needed, your dentist can X-ray your teeth if he or she covers your abdomen with a lead apron to protect your baby.

When treatment is needed, your dentist may also give you a local anaesthesia (“freeze” you) and prescribe antibiotics in case of infection.


Antibodies: Substances made by the body to fight off disease. Also called immunoglobulins.