It is important to understand how drugs are classified according to their safety in pregnancy.  In Australia drugs are categorised as A, B, C, D or X according to their safety in pregnancy.

Category A drugs have been taken by a large number of pregnant women for many years with no evidence of any adverse effects on the fetus ever having been reported.

Category B drugs, likewise, have never been shown to have any adverse effects but have only been taken by a limited number of pregnant women.

Category C drugs have been known to have effects on the fetus but these are not necessarily effects that may be harmful nor particularly relevant during the first trimester.  For instance, it is best to avoid sleeping tablets late in the third trimester but they have no effects in the first trimester and therefore are safe to take.

Category D and Category X drugs are known to cause fetal malformations and must never be taken in pregnancy.

You can be assured that if I ever prescribe a drug for the treatment of any condition in pregnancy that I am perfectly comfortable with it’s safety.  I will never prescribe a category D or X medication; almost always I will prescribe Category A and sometimes Category B drugs.  If I ever prescribe a Category C drug I will explain why it is safe for you to use at that time but not safe to use later in pregnancy.

Nevertheless, I understand that there is a great reluctance for any women to take any medication in pregnancy and this is completely understandable.  However, there are times when the benefits of taking medication outweighs any potential risk but it is always up to you.


All antihistamines, including modern non-sedative antihistamines such as Claratyne and Zyrtec, are completely safe.

Steroid nasal sprays such as Rhinocort can be safely used during your entire pregnancy. Vasoconstrictive nasal sprays should be used for no more than 48 hours.

Zovirax cream is safe to use in pregnancy.

Non-steroidal anti-inflammatories (Nurofen, Voltaren, Aspirin, Brufen, Mobic, Celebrex) must not be used at any stage in pregnancy. If you have inadvertently taken these, please call me.

Paracetamol (Panadol, Herron) is completely safe at all stages of pregnancy.

Codeine-based analgesics (Panadeine, Panadeine Forte, Mersyndol) are all safe in pregnancy, but are very constipating and can be addictive with prolonged use. Please discuss these medications with me if you plan to use them for more than a few days.

The common pregnancy multivitamins (such as Blackmore's Pregnancy Gold, Elevit and Swisse) are all safe to use.

Some vitamins and natural herbal remedies can potentially be harmful. Please discuss any other brands with me before taking them.

If you have been prescribed an SSRI such as Zoloft, please do not stop taking this medication. It is very effective, completely safe and should be continued throughout pregnancy and breast-feeding if your treating clinician has recommended it.

Please remember to advise me or your anaesthetist if you are taking these medications as they can interact with one particular pain-killer.

The ideal advice is that you should completely abstain from alcohol during pregnancy.

Cigarette smoking is harmful at all stages of pregnancy. It can cause restriction of your baby's growth, worsening of high-blood pressure conditions and a higher chance of placental bleeding. It is also associated with a higher risk of SIDS.

I recognise that it may be very difficult to stop smoking, particularly if you are a heavy smoker, but even a moderate reduction is beneficial to your baby. I recommend you completely stop smoking as soon as possible in pregnancy.

During pregnancy, I will recommend that you are vaccinated against influenza and pertussis (whooping cough). If you are not immune to rubella or chickenpox, I will organise a postnatal vaccination for you, but please do not have these vaccinations while you are pregnant. If you are inadvertently vaccinated against rubella or chickenpox in pregnancy, please do not panic, as no adverse reactions have ever been reported.

Any other vaccinations should be discussed with me, as some are contraindicated in pregnancy.