Thursday, October 05, 2006

Take two and call me in the morning

I've noticed a different attitude towards pregnant women and medications here in the US as compared to the advice I received from my midwife in Finland. In both countries, there are those who believe nothing is truly safe to take during pregnancy. However, I think everything that is considered OK is fine in moderation. I've popped a few Tylenol over the past few weeks to ease a powerful headache and lower my fever so I could sleep. I see it always a question of balance -- which outweighs the other: the medications questionable harmful effect or the benefit from the comfort of it (ie, make it possible to rest or eat).

What medications are safe to take during pregnancy - OTC
Here in the US, at my first prenatal visit my doctor gave me a sheet with a list of safe to take over-the-counter medications:
  • Tylenol or Extra strength Tylenol (ie, acetaminophen) for minor aches, pains and fevers. NOT aspirin or ibuprofen unless approved by dr.
  • Sudafed or Robitussin for cough. Robitussin DM for cough suppression.
  • Benedryl for allergies
  • Mylanta, Maalox, Riopan, Tums for upset stomach and heartburn.
  • Milk of Magnesia for occasional constipation.
My midwife in Finland only made suggestions when I asked about a specific symptom. I suppose the list in the US is because the volume of patients is much higher so they want to cover all the basics for everyone without having to field all those phone calls.
  • Panadol (paracetamol) was OK for aches, pains and fevers
  • Renni for upset stomachs and heartburn.
  • But she didn't like the idea of taking anything for allergies and even suggested avoiding the anti-histamine eye drops I used during summer.
Morning Sickness medications
I was fortunate not have any morning sickness with Peanut so I don't really know what the stance is toward morning sickness medications in Finland. I did have a dear colleague (Hi K.S.!) who suffered immensely for many weeks with powerful morning sickness and she never mentioned any medications.

The info packet my doctor in the US gave me states there are no medications for morning sickness, yet I know of several moms here who have taken various pills to help alleviate the nausea and vomiting.

Flu Shots
Its that time of year again. My US doctor told me at the last visit their office usually gets a supply of flu vaccinations for pregnant mothers and it is a recommended shot. He said I can get it elsewhere, but just to make sure its not a live virus.

My midwife in Finland was opposed to me getting a flu shot during pregnancy.

The flu shot seems to cause a large amout of debate over the thimerosal (a preservative which contains mercury) it contains, its general effectiveness and belief that it can actually cause the flu.

From what I've read, here's the scoop:
Thimerosal - Yes, its in there in most vaccines, but in trace amounts, says the CDC:
Is it safe for pregnant women to receive an influenza vaccine that contains thimerosal?
Yes. A study of influenza vaccination examining over 2,000 pregnant women demonstrated no adverse fetal effects associated with influenza vaccine. Case reports and limited studies indicate that pregnancy can increase the risk for serious medical complications of influenza. One study found that out of every 10,000 women in their third trimester of pregnancy during an average flu season, 25 will be hospitalized for flu related complications.
General Effectiveness - that is, will the vaccination prevent you from getting the flu?
Not entirely. There are hundreds of strains of the flu virus each year and the vaccination is made to prevent what is guessimated to be the most widely spread. This years vaccine actually contains three strains.

The CDC claims:
With the flu shot, when the "match" between vaccine and circulating strains is close, the vaccine prevents influenza in about 70%-90% of healthy persons younger than age 65 years.

Can you get sick from the vaccine?
Its a killed virus so its not possible to become infected by the shot itself. Any illness that you get after the vaccination is coincidental.

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