How to Prepare for Medication Discussions with Your OB/GYN During Pregnancy and Breastfeeding

When you’re pregnant or breastfeeding, every pill, supplement, or over-the-counter remedy matters more than ever. What was fine before might now carry risks you didn’t know about. That’s why talking openly and clearly with your OB/GYN about medications isn’t just a good idea-it’s essential. Yet, most people walk into these appointments unprepared, forgetting what they’re taking or assuming natural means safe. The truth? Even herbal teas and vitamins can interfere with pregnancy or breastfeeding. You don’t need to be a medical expert. You just need to know what to bring, what to ask, and how to speak up.

Start with a Complete Medication List-No Exceptions

Your OB/GYN doesn’t just want to know about your prescription drugs. They need the full picture: every supplement, every cold medicine, every CBD gummy, every tea you drink daily. A 2022 CDC study found that 90% of pregnant women take at least one medication during pregnancy. Many of those aren’t prescriptions. They’re things you picked up at the drugstore without thinking twice.

Start by gathering everything. Open your medicine cabinet. Look in your purse. Check your kitchen shelf. Write down:

Prescription drugs: Exact name, dosage, and how often you take it. Don’t say "my blood pressure pill." Say "Labetalol 100 mg, taken twice daily."
Over-the-counter meds: Ibuprofen, acetaminophen, antacids, sleep aids-even if you only use them once a month.
Supplements: Prenatal vitamins, iron, fish oil, magnesium. Include brand names. "Nature Made Prenatal" is different from "Garden of Life."
Herbs and teas: Ginger for nausea? Chamomile to relax? Peppermint? Even these can affect hormone levels or uterine contractions.
CBD or cannabis products: If you use them for pain, anxiety, or sleep, tell your provider. Only 38% of OB/GYNs routinely ask about this, but the risk is real.
Recreational substances: Alcohol, nicotine, vaping-be honest. Your provider isn’t there to judge. They’re there to help you stay safe.

Pro tip: Take photos of each bottle or pill container with your phone. If you forget a name or dose, you can show the picture. Patients who bring photos reduce appointment time by 15-20 minutes and increase the quality of their discussion by 40%, according to Colorado Women’s Health data from 2022.

Know What’s Safe-and What’s Not

Not all medications are created equal during pregnancy. The FDA used to label drugs with categories A, B, C, D, and X based on risk. While that system is being phased out, the principles still matter. Here’s what you need to know:

Safe options: Acetaminophen (Tylenol) for pain, levothyroxine for thyroid issues, insulin for diabetes, and certain blood pressure meds like labetalol and methyldopa.
Use with caution: Ibuprofen and naproxen are okay early in pregnancy but should be avoided after 20 weeks-they can affect fetal kidney function and reduce amniotic fluid.
Avoid entirely: Isotretinoin (Accutane) for acne, warfarin (blood thinner), and certain antidepressants like paroxetine. These are linked to birth defects.
Don’t assume natural = safe: Evening primrose oil is often used for PMS, but it can trigger contractions. St. John’s Wort reduces birth control effectiveness by up to 50%. Black cohosh? It may stimulate labor. Always check.

One patient on Reddit shared how she brought a spreadsheet with every supplement-including brand names and doses-and her OB printed it to keep in her file. That’s the level of detail that makes a difference.

Ask These 7 Key Questions

You don’t have to be afraid to ask. Your OB/GYN expects these questions. In fact, patients who prepare specific questions report 74% more confidence in their treatment plan.

"Is this medication safe during pregnancy?" Don’t just ask if it’s "okay." Ask if it’s been studied in pregnant people. Many drugs haven’t.
"Is there a safer alternative?" For example, if you’re on a medication for anxiety, is there one with more pregnancy data? Sertraline is often preferred over paroxetine.
"Should I stop this before trying to conceive?" Some meds need to be cleared from your system months before pregnancy. Folic acid, for example, should start at least one month before conception to prevent neural tube defects.
"Will this affect breastfeeding?" Some drugs pass into breast milk in small amounts. Others don’t. Your provider should tell you which ones are safe.
"What are the risks if I don’t take this?" Sometimes, not treating a condition (like high blood pressure or depression) is riskier than the medication itself.
"Do I need to change my dose?" Hormonal changes during pregnancy can alter how your body processes drugs. Many women need higher doses of thyroid medication or insulin.
"Where can I find reliable info on this drug?" Ask if they recommend LactMed (a free NIH database) or MotherToBaby for evidence-based answers.

Breastfeeding woman with safe and unsafe supplements shown as checkmarks and red Xs in vibrant illustration.

Don’t Let Time Limits Silence You

Most OB/GYN appointments are 15-20 minutes. That’s not enough time to cover everything. If you feel rushed, say so. You can say: "I have a list of medications and questions I really want to go over. Can we take a few extra minutes?"

Patients who prepare ahead get better outcomes. A 2022 survey from Empire OBGYN showed that 74% of women felt more confident in their care when they came with prepared questions. On the flip side, 28% of negative reviews on Healthgrades mention rushed medication reviews.

If your provider dismisses your concerns or says "it’s fine," ask for a second opinion. Or ask to speak with a pharmacist who specializes in women’s health. About 65% of OB/GYNs refer complex medication cases to these specialists because they’re better trained in drug interactions.

What About Breastfeeding?

Breastfeeding changes the rules again. Some medications that are safe in pregnancy aren’t safe while nursing. Others are fine. Here’s what to focus on:

Safe: Acetaminophen, ibuprofen (in moderation), most antibiotics like penicillin and cephalexin, SSRIs like sertraline.
Use with care: Codeine (can cause infant drowsiness), pseudoephedrine (can reduce milk supply), and benzodiazepines like diazepam (can build up in baby’s system).
Avoid: Lithium, chemotherapy drugs, and radioactive iodine used in thyroid scans.

Remember: Just because a drug is "natural" doesn’t mean it’s safe for your baby. Herbal teas like sage or parsley can reduce milk supply. Licorice root may raise blood pressure. Always check.

Use the free LactMed database from the National Library of Medicine. It’s updated daily and gives you exact data on how much of a drug enters breast milk and what effects it might have.

What If You’re Already Taking Something Risky?

It happens. Maybe you’ve been on an antidepressant for years. Or you have epilepsy and need a seizure med. Or you’re managing high blood pressure. Stopping suddenly can be dangerous.

Your OB/GYN won’t panic. They’ll work with you. Many conditions require ongoing treatment during pregnancy. The goal isn’t to stop everything-it’s to switch to the safest option possible. For example:

Fluoxetine (Prozac) is often preferred over other SSRIs during pregnancy.
Insulin is the gold standard for gestational diabetes.
For migraines, acetaminophen and magnesium are first-line; triptans are used cautiously.

And if you’re on a medication with limited data? Your provider may refer you to a maternal-fetal medicine specialist. That’s not a red flag-it’s a sign they’re taking your care seriously.

Woman and doctor surrounded by transforming question marks about medication safety, glowing book in background.

Prepare Early-Don’t Wait Until the Last Minute

Start gathering your list at least 7-10 days before your appointment. That gives you time to:

Check expiration dates.
Call your pharmacy to confirm dosages.
Look up any supplements you’re unsure about.
Write down your questions.

Don’t rely on memory. A 2022 survey from Advanced OB/GYN NJ found that 33% of first-time patients couldn’t recall exact doses. Photos of bottles help. So does a simple spreadsheet.

Also, check your insurance. About 62% of plans require prior authorization for certain OB/GYN medications. If you’re switching to a safer drug, make sure it’s covered before your appointment.

Why This Matters More Than You Think

Every year, preventable medication errors cost the U.S. healthcare system $2.3 billion in women’s health alone. Many of those errors happen because patients didn’t speak up-or didn’t know what to say.

But you’re not just protecting your baby. You’re protecting yourself. Medication interactions can cause high blood pressure, gestational diabetes, or even preterm labor. Your OB/GYN is your partner in this. But they can’t help if they don’t know the full story.

There’s no shame in being prepared. No shame in asking questions. No shame in saying, "I don’t understand." The most empowered patients are the ones who come with lists, photos, and questions. And guess what? They get better care.

Can I keep taking my antidepressants during pregnancy?

Yes, many antidepressants are safe during pregnancy, but not all. Sertraline and citalopram are commonly used because they have the most safety data. Stopping abruptly can increase the risk of relapse, which can be more harmful than the medication. Always work with your OB/GYN and a psychiatrist to make the safest choice.

Is it safe to take ibuprofen while breastfeeding?

Yes, ibuprofen is considered safe in moderation while breastfeeding. Only tiny amounts pass into breast milk, and studies haven’t shown harm to infants. But avoid long-term daily use. Acetaminophen is often preferred for ongoing pain.

What supplements should I avoid during pregnancy?

Avoid high-dose vitamin A (over 10,000 IU), black cohosh, dong quai, and evening primrose oil unless directed by your provider. These can trigger contractions or affect hormone levels. Stick to prenatal vitamins with folic acid, iron, and DHA-those are proven safe.

Do I need to stop my birth control before trying to get pregnant?

Yes. Stop hormonal birth control at least one month before trying to conceive. This gives your body time to return to its natural cycle. Start taking folic acid at least one month before stopping birth control to reduce the risk of neural tube defects.

Can I use CBD oil while pregnant or breastfeeding?

No. The FDA strongly advises against using CBD during pregnancy or breastfeeding. There’s not enough research to confirm safety, and animal studies show potential harm to fetal development. Even topical CBD products can absorb into your bloodstream. Stick to approved alternatives like prenatal yoga, warm baths, or guided meditation for stress.

Why does my OB/GYN care about my herbal tea?

Because many herbal teas contain active compounds that affect hormones, blood pressure, or uterine contractions. For example, chamomile can have mild sedative effects, and sage can reduce milk supply. Even ginger, while helpful for nausea, can interact with blood thinners. Your provider needs to know everything you’re putting into your body.

What if I forget to mention something at my appointment?

It’s never too late. Call your OB/GYN’s office or message them through their patient portal. Say: "I realized I forgot to mention I’ve been taking [X]-can we review it?" Most clinics encourage follow-ups. It’s better to speak up late than to risk a problem.

Next Steps: What to Do Today

You don’t need to wait for your next appointment. Start now:

Open your medicine cabinet and take photos of every bottle.
Write down everything you take daily-even if you think it’s "just a vitamin."
Download the LactMed app or visit lactmed.ncbi.nlm.nih.gov to check your medications.
Write down 3 questions you want to ask your OB/GYN.
Call your pharmacy if you’re unsure about doses or expiration dates.

Being prepared isn’t about being perfect. It’s about being honest. And when you show up with your list, your photos, and your questions-you’re not just a patient. You’re an active partner in your care. And that’s how you get the safest, most informed care possible.