Fact Sheets

Answers to Your Frequently Asked Questions about Pregnancy & Breastfeeding Exposures

Our Fact Sheets answer frequently asked questions about many common exposures during pregnancy and breastfeeding, including medications, recreational substances, cosmetic treatments, health conditions, infections, vaccines, and more. Available in English and Spanish, our content summarizes available scientific information on whether people and their developing babies are at risk because of an exposure in their environment. Our Fact Sheets are meant for general information purposes and should not replace the advice of your healthcare provider.

Quick, easy-to-understand information on 275+ exposures and how they may impact pregnancy or breastfeeding

MotherToBaby Fact Sheets are listed below by category of exposure. All medications are listed by generic name. To locate the generic name of your medication, look for the ‘Active Ingredient’ listed on your medication bottle or packaging. Generic names can also commonly be found in parentheses after the medication’s brand name.

Our experts are constantly authoring and updating our database.. If our current collection does not include an exposure of interest to you, or if you have additional questions after reading a Fact Sheet, please contact our team so we can address your exposure.


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Fact Sheets

Dana Howe, a communications director for a non-profit called Vaccinate Your Family and soon-to-be mom, joins host Chris Stallman to discuss some common questions and fears surrounding vaccination during pregnancy. She helps debunk common myths to set the record straight. Howe holds a degree in biology and community health and a master’s degree in health communication.

Resources mentioned in this episode:

Vaccinate Your Family

www.VaccinateYourFamily.org



Ep. 79 Transcript

  You’re listening to the Mother 2 Baby podcast, medications and more during pregnancy and breastfeeding. Ask the experts with your host, genetic counselor and mom of four, Chris Stallman.

This episode contains evidence based information that’s current as of the day recorded and may change as more data becomes available. To get the very latest information about this topic or other topics in pregnancy and breastfeeding, please contact a mother to baby specialist at 866 626 6847 by text at 855 999 3525 or through our website at mothertobaby.

org.

Welcome to another episode of the mother to baby podcast. My name is Chris Stallman, and I’m a genetic counselor, a mom of four, and a teratogen information specialist. So what that means is that I talk to people, so healthcare providers, patients, family members, and the general public, about exposures that can happen before pregnancy, during pregnancy, while breastfeeding, and in cases of adoption.

And an exposure can be anything, so it could be a medication you’re taking, a chemical at your workplace, Or a vaccine. And that’s what we’re going to be talking about today. Not just vaccines, but how and why they are so important. Our guest today is Dana Howe, communications director for a nonprofit called Vaccinate Your Family.

She holds a degree in biology and community health and a master’s in health communication. She is also a very soon to be mom. Hi, Dana. Welcome to the show. Hi, Chris. Thank you so much for having me. I’m really happy to be here. Our pleasure. So first and foremost, how are you feeling and how is your pregnancy going?

I am feeling pretty good. It is, um, this is going to be my first baby, so I have, um, I’m going through this, you know, journey for the first time, learning a lot along the way. It’s been really interesting how it’s intersected with my professional work with Vaccinate Your Family a little bit. Um, but overall feeling Good.

I’m in my third trimester and due next month. So things are getting real around here. That’s amazing. Congratulations, and I hope that the remainder of your pregnancy and delivery is smooth and safe. Thank you. So can you tell us a little bit about the organization you work for called vaccinate your family?

Yes, absolutely. So I am the communication director at vaccinate your family. Um, we are a nonprofit organization that was originally founded in 1991, formerly called every child by two, started by former first ladies, Rosalynn Carter and Betty bumpers of Arkansas. Um, In response to measles epidemics that were happening at the time, and the need to vaccinate our nation’s children against the vaccine, preventable diseases of the time our mission today remains to protect people of all ages from vaccine, preventable diseases.

Um, and we do that through a mix of communication work, um, trying to educate and arm trusted messengers with good information about vaccines as we serve as the subject matter experts and try to work with trusted messengers, community based organizations, um, leaders. Parents often really health decision makers, um, to spread good evidence based information about vaccines.

We also work in vaccine policy and then we follow the science basically to stay on top of the latest vaccine recommendations that are coming through and all the, there are new vaccines. There’s a lot of really exciting work being done. Um, and I actually joined during the coded pandemic. So it’s been a really interesting time as a health communicator to watch how the experience of going through the pandemic has.

impacted the way that we all think about the vaccines that we need, not just against covid, but against all vaccine preventable diseases. I would agree. Um, as someone who was part of the efforts when mother to baby was answering a lot of the questions about the new vaccines during the pandemic, it really, it really did change our perspective.

And of course, you know, I’m a mom. I have my own perspective. And, you know, really soon you’re going to be a mom too. And so can you share a little bit about your personal experiences with vaccination and pregnancy? Yeah, absolutely. So, um, you know, I work in vaccines. I work in public health. I have always had a high level of vaccine acceptance in my family growing up myself.

I’m generally happy to get the recommended vaccines at the recommended times, um, but pregnancy has been a really sort of interesting time where there are now a few recommended vaccines during pregnancy. Um, The vaccine, which is important for protection against whooping cough or pertussis that you can pass antibodies onto your baby when you get it.

When you’re pregnant, flu and cobit are more important than ever to get while you’re pregnant. There are extra benefits to getting it. Um, to getting them while you’re pregnant, you can pass some immunity onto your baby, but also getting sick with flu or COVID during pregnancy is something you really want to avoid.

It’s more dangerous because your immune system doesn’t work the same way while you’re pregnant. So if you were to get sick, you are at higher risk because you’re less able to fight off those infections. So that extra boost is really important. Um, and then we now have a maternal RSD vaccine as well that can pass antibodies on to babies.

I’m concerned about RSD certainly as someone who’s about to have a newborn in the middle of RSD season. And the ability to pass some antibodies on and get that vaccine during pregnancy is something that I don’t want to miss out on and I’m actually really excited about. But, I will say. So far, I’ve gotten three out of those four vaccines, and in making my own health decisions during this pregnancy, um, I’m very aware of all the things that we weigh when we’re pregnant, um, it does feel in some ways like a lot of vaccines, and I feel that way even as someone who is, for the most part, Excited to get them.

Of course, I’m not excited for if I feel a little since the next day, like, that’s not great, but I’m happy that I have the opportunity to get them. But still, I thought about, you know, the timing of those vaccines. What is available at my doctor’s office? What information am I getting from my doctors? So, you know, personally.

My doctor, my doctor’s office had Tdap available a little bit sooner. So I just said, sure, did that at like 28 week appointment. And then at my 32 week appointment, I actually proactively asked about the RSV vaccine because I, you know, work in vaccines. I was curious, like, so do you have it here? Are you giving the RSV vaccine?

And they did, and they said we also have flu available. So I did RSV and flu at the same time at that appointment, and then I’m scheduling my COVID vaccine separately at a pharmacy. So, you know, I’m very aware of, as I navigate this time, like, what’s available to me in which places, how do I feel after each vaccine?

I know that’s definitely a concern. Um, and. You know, recently I got a little head cold and it was a good gentle reminder of how much Being sick stinks, especially while pregnant and how much I, how much I have been weighing this thing of like, okay, I’m like many people who, um, when I’ve gotten my COVID vaccine, the next day I feel a little under the weather in, in past vaccines like that.

Immune response. And so I’ve been like, oh, when is going to be a good time to do that? I’m putting it off. I’m noticing myself being a little like, well, it’s already hard to feel good. In your third trimester of pregnancy, do I really want to like, you know, take a sick day? Am I going to be like, how’s it going to feel?

Um, but then I actually got sick with just a head cold and I was like, no, we got to go get that vaccine because this is even just this head cold is much worse than that day after the vaccine feeling. So it was a good little reminder for me that those. transient, mild, you know, for me, it’s like 24 hours of fatigue, soreness, um, after a vaccine that sometimes we see is still worth it, but it can be, it can be tough to convince yourself that.

Um, so that’s just a little bit of what I’ve been experiencing as I kind of navigate this from a personal perspective. So what are some common myths you hear about regarding vaccines and pregnancy or breastfeeding? Yeah, so I am lucky. Something that’s been really interesting is I have quite a few friends who are navigating pregnancy at the same time as me, so it’s kind of been a topic of conversation.

I’m also in some, um, like Facebook groups, mostly out of curiosity as a first time mom navigating this. I’m in like a due date group, which is a real interesting slice of people from all over the world who are Do at the same time or the same month that I am, um, sometimes vaccines come up in there that can be interesting and then, you know, I work in vaccines professionally and we kind of keep tabs on what some myths are.

About vaccines and pregnancy and breastfeeding. I think the big thing that sticks with me is during pregnancy. There are so many things that we’re told to watch out for, or to not put in our bodies. Yes, and I think that it can put people in a very defensive frame of mind as far as. like exposures. And I know this is the work that mother to baby is doing all the time.

Then we’re so grateful for. Um, but I think it makes pregnant people wary of vaccines and susceptible to myths, especially about vaccine safety. So I think some things that I’ve heard Are that certainly about the concerns about specific vaccine ingredients, and I think that that comes down to that anxiety and hyper vigilance and, you know.

In our work at vaccinate your family, we have done a lot of breaking down to a really sort of digestible level. The reason why the ingredients and vaccines are. Not something that we need to be concerned about. Right? Like you’re exposed to more aluminum when you drink a can of soda or seltzer than when you take a vaccine and just kind of right sizing that those exposures on those fears, um, and kind of, you know, Reinforcing that these are things where we have more safety data, more evidence to support that the benefits outweigh any potential risks, then like anything else we put in our bodies, then the prenatal vitamins that we’re taking, then, you know, really like any eating out at any restaurant, you know, the list goes on.

This is something that we actually do have a lot of evidence to support the use of, um, another thing that I hear sometimes. Definitely. I want to talk about the new R. S. V. vaccines because they are newer and I think people feel like it’s not viewed as safe by some folks because the R. S. V. vaccines. Are a new vaccine, um, and, you know, for me, I think, yeah, it’s relatively new, but it’s a type of vaccine that’s been around for a long time.

It’s undergone that extensive testing. And I think that people, it’s easy to consider again, because we’re in this reactive, like, fear based, uh, wanting to avoid exposures place. We forget to weigh the benefits of the thing. Um, the benefits of getting vaccinated. And we forget about the risks of not vaccinating.

And I think that’s something that, um, especially with RSV, I’m thinking about, like I said, the risk of not vaccinating is having a newborn during RSV season. That’s a really, that’s a significant risk that you have much less control over. Um, and I think that, um, you know, weighing all of those things and kind of being aware of my own.

Yeah. Cognitive bias toward I think we’re really biased toward inaction for like I can stay safe by avoiding Something during pregnancy because there’s so many things like that right that we’re told to avoid So I think that it’s easy to have a bias towards saying I’m gonna make sure I don’t do anything that could On my baby, the action being get a vaccine when actually the choice to not vaccinate is not a risk free choice, but our brains don’t like that.

They kind of go, wait, wait, wait. Um, I think we’re more afraid of. Um, potential outcomes for things that we do choose to do versus choose to not do. Um, but of course, when we take a step back, thinking about the risks associated with. Not vaccinating and the benefits that come when we do choose to vaccinate.

On top of all the safety data that we have. Um, I think it’s actually, like, a really exciting opportunity to get to using the example of the vaccine for some people who are concerned about the number of shots that infants get. Getting the maternal vaccine now is actually a way to get 1 less. Shot for a newborn baby, because there are options right now for either a maternal RSV vaccine or an antibody that’s given to newborns to ways to protect baby against RSV.

But it’s exciting as a expecting mom to be like, okay, this is 1 thing I can do to do 1 last shot for my baby. Which I would get if that was the only option, but. Um, it’s like, you know, just, just reframing it as a positive thing to kind of be able to, without any risk to myself, like the risk that would come from getting sick, be able to pass antibodies onto my baby during this time window is actually really exciting.

Um, so kind of taking those myths and trying to get to a positive place of like, well, we have the opportunity to pass some protection on. Um, and we don’t want to miss that window of opportunity. Wow. We’re pregnant. When you mentioned, you know, thinking about myths specifically, you also mentioned something that unfortunately is not a myth, but does contribute to the myths.

And that whole thing is what you can and cannot do during pregnancy. And I’m so glad you mentioned it and we’re not going to go too far, but I’m so appreciative of it because I don’t think that we, and by we, I mean society in general, mention this enough. My goodness. There is so many different things that were all, there’s so much conflicting information.

There’s so much fear around doing the very simple things. It’s like, is my bath water too hot? Did I wait too long to get the vaccine? You know, what if, you know, I missed the window because of the season or it wasn’t available where I am. And now, you know, it would be a better idea for my baby to get the RSV.

You know, there’s so many different things. And I just want to say, I know we’ve said it a couple of times before, and I know that folks in our business say it all the time to the people we’re with, especially, but you’re doing a good job. If you’re out there and you’re pregnant or you’re trying to get pregnant or you were just pregnant and or maybe you’re breastfeeding or maybe not, but you might have a newborn or a newly adopted child on your hands, I’m, I’m here to tell you, you’re doing a good job.

You are, and it’s hard out there. And I just so much Dana appreciate not only what you do and everything you’ve said, but I just appreciate so much that you’ve mentioned. That there is a lot out there for a person who is pregnant to navigate and a lot of it Is the am I doing it right? And how can you not?

At some point, even for a second, make that question with everything you see. Don’t eat that lunch meat unless it’s cooked. Make sure you’re doing X, Y, or Z. Make sure you’re not doing X, Y, or Z. And again, you, Dana, are doing it right. And everyone out there making that effort, which I know you are. We know you, we see you, and we know that you’re doing a good job.

So keep up the good work. Yeah, I so appreciate that. And I think It just, if you’re anxious about vaccines during pregnancy, of course you are, because we’re anxious about everything that we’re putting in our bodies, and I think there are so many messages that we receive from our communities, from healthcare providers sometimes, from our family sometimes, about, yeah, to be in a place of, you know, vigilance, and fear, and to do it right, and So, you know, I have friends who have never worried about it before, but are having trouble with anxiety just around food decisions because they’re pregnant.

Um, and it’s, I think, been a really interesting eye opening experience. And, you know, if we’re suddenly really anxious about our dietary choices, of course we’re going to be anxious about a vaccine that we know less about or that, you know, has the power to, you know, Be interacting with our immune systems like it makes sense.

So I definitely want to say like this isn’t to say. Oh, just don’t worry about it. Right? Right. We’re conditioned to feel. worried and it means we care. Um, but it, there’s a lot of stress that comes with it too. So I appreciate that. And yeah, that’s, that’s a big thing. And then what we hear about is how you’re supposed to reduce stress in pregnancy.

But again, I mean, we could honestly, we could have, and we, we very well may actually this entire, body of work and your experience is so inspirational, we might end up doing a, Hey, you know, we should just talk about some of the silly things we hear in pregnancy, but what I would also love to get to. So aside from the myths, right, what are some of the other frequently asked questions do you get about vaccines in the pregnancy breastfeeding space?

Yeah. So I actually recently was kind of scrolling through the due date group that I was telling you because I think such an interesting Like, Slice of Life, different from other Facebook groups I’m in, where it’s like people from all over and, um, you know, the thing that we have in common is that we’re due the same month, so I was like, this is, you know, the comment section, it’s not for everyone, but it is really interesting, just from a, like, what’s on people’s mind, um, kind of perspective, and something that I came across Several times that I worry about from a health communication perspective is that people really feel like vaccines during pregnancy are pushed on them by their care providers and that I thought was an interesting trend.

It’s not everybody, right? But it came up more than once that I think it comes down to, like, a communication and a trust and information issue where, um, You know, care providers are strapped for time. They’re doing their best. Obviously want to give them the benefit of the doubt, but the way that we’re presenting information about vaccines to pregnant people is making people go like, Whoa, I don’t, I feel like I’m being that it’s assumed that I have to do this.

And people are coming to groups and saying, like, can I say, no, can’t like, do I have to do this? Mm hmm. And You know, it sets up kind of an adversarial relationship that I think, you know, as a communicator, I’m like, Ooh, I wonder how we can do a better job coming into those conversations with information and feeling like we’re making an informed decision so that when our care provider says, Oh, you know, you can do the Tdap today.

Do you want to do it? It doesn’t feel like we don’t interpret that as. Get your Tdap and that being the first time that we’ve thought about it, but you know, in my experience, my, my care providers, who I really like, didn’t bring up the Tdap vaccine to me until it was the week that we were going to do it.

And they just said, Oh, you know, it is time for the Tdap vaccine. Here’s the, you know, information sheet about it. Do you have any questions? And. If I didn’t know a lot already, which I do because it’s my job, about the Tdap vaccine, if I didn’t see it coming and I hadn’t anticipated it, it might feel, and I think for many people does feel, just this, like this thing that’s really blase, casual, and doctors who give vaccines all the time, I think do treat vaccines casually sometimes.

Because they are an amazing public health tool that are safe and they work well and we love them because they prevent illness and are extremely safe and have very few side effects. So, as a care provider, you’re like, vaccine time. Woo. But as someone who’s in a place of vigilance and worry about what’s coming into their body, especially at the doctor’s office, potentially, I think I would love for everyone to.

Be able to anticipate that vaccine conversation coming in a positive way, like, oh, I know what that is. I know how I’m going to benefit from it. I already, like, if I have some questions, I know what to ask because you probably don’t. I mean, I’ve had that experience. You’re in a conversation with a care provider.

You are hearing about something for the 1st time. You don’t have your questions ready to go. Like, they come later, and then you end up on Google, and that’s not what we want, so. Yeah, that’s, that’s definitely true. I mean, you know, Google and other search engines, you know, have their place certainly. Um, but I, you had mentioned earlier, um, I believe what you had said was a trusted messenger, meaning a place of information that is based on available, um, evidence and, um, While there’s certainly other forms of information, I think knowing where and how to get that trusted information is really important, just sort of generally speaking, and then to your point, when you go into your provider, right, you want, and we hope, and that’s the goal, is that the person or the group that you’re speaking with is a trusted source of information, and as a provider, also, not necessarily in this space, I do understand that feeling when I go in as, well, Of course, I know what I’m talking about.

I’m a provider. I’ve been doing this for a while. So the two sides of it are completely different and coming from completely different places. And I think it’s, it’s wonderful when we can come together. As long as you realize, you know, it helps if you have some information going in. And it helps if your provider also knows how to address, explain, and fill in the gaps for the information either that you may not have or that you may not fully understand or that you may have.

So, again, I do love that it ends up being a two sided piece, right? We say all the time, you know, you have to advocate for yourself as a patient, which is absolutely true. But from the provider piece, you know, we do like to say, hey, you know, you have to make sure that your patient has this information. In that magical place when all of those things can happen in a way that everyone’s comfortable with, that’s where we are.

Until then, we need to keep looking for information and looking for the best way to give and support that information as well. Yeah, absolutely. You know, going back to your previous question, the other thing that one, the other thing that comes to mind for me about just frequently asked questions, things that come up about pregnancy and vaccines, I do think there are a lot of concerns about vaccine reactions during pregnancy and by that I do just mean sort of the side effects that can happen when you get a vaccine.

That, like, feeling a little bit sick. Um, everybody’s different, so I don’t want to claim to know what someone else’s, you know, vaccine reaction looks like. I think they’ve gotten, um, it’s something that’s been talked about more because I do think, anecdotally, The COVID 19 vaccines, people are experiencing that, um, you know, some vaccine side effects.

Many people get them from seasonal flu shots to many people, you know, children get them after their routine vaccines. You might feel a little gross for a day or two. It is normal and it is expected. It doesn’t happen to everyone, but I think it really throws people off. And when you’re pregnant and you already feel bad, and it is hard to get through the day at work.

And Honestly, I really get this. My friends, like, we are already pregnant, probably working during pregnancy, probably worried about the amount of sick time that we have, if we’re lucky enough to have it, um, you know, thinking about our schedules, maybe you have other kids, and the weekend’s not a good time to get a vaccine and be down and out.

We feel like there is not a lot of buffer for feeling unwell and it’s hard to choose something like getting a vaccine that you have a guest might make you feel kind of not well for 24 hours. It’s hard to choose to do that. Yeah. Um, and people are definitely asking like, Oh, how did you feel and worried that during pregnancy, you might actually feel worse.

I will say that hasn’t been my experience. I think there’s probably a few different reasons for that. I’m like, well, I’m already taking it easy, so I haven’t noticed it as much. Or, you know, like, maybe my immune system’s working a little differently. So it hasn’t been, like, it hasn’t been worse for me, I’ll say, after I’ve gotten vaccines during pregnancy.

Uh, to just put that out there, but I was concerned on a personal note concerned like, well, it’s already a lot. How am I going to feel for the day after I get these vaccines? Am I going to have to call in sick? And I think, you know, we can’t dismiss those are real like decision making kind of things that we’re weighing in our day to day lives.

Yes. 100%. And I, I, again, I appreciate that because not everybody has a sick day. Not everybody can take a sick day. And again, it’s, it’s sort of how things are presented. You know, there’s lots of, of other issues, but you know, I can tell you from the, how you feel piece. that during my pregnancies, especially my last two, if there was anything I even thought was going to make me feel even more fatigued, I was like, I don’t even know what more fatigue looks like.

More, more fatigue probably looks like me just not being awake at all. Right. Um, and, and that’s real. Now, I do want to say that I did choose to, and had vaccines available to me during all my pregnancies. And that’s something that our family had decided was a personal choice. But I do want to, you know, say that even though I work in the field, I’ve had those thoughts.

These aren’t, these are typical thoughts. It’s okay to have these thoughts. You know, however that weighs into your decision is completely up to you and maybe a conversation with your healthcare provider. But I, I did want to say, you know, yeah, I, I’ve definitely thought about that. And then I was like, well, you know what, I really am more worried about this.

And then I weighed it, but it is absolutely typical to have those thoughts. Like I don’t want to have to go to Walgreens. What if I have to miss a day at work? I don’t want to feel sick. I definitely don’t want to feel tired. And then again, you know, if it’s all part of your decision making. then that is something that a lot of people have typically experienced.

So, Dana, before we let you go today, is there a final thought you would like to leave our audience with? Well, I would just say, you know, I mentioned a lot of vaccines by name, um, and I would encourage anybody who is thinking about, is pregnant, um, knows somebody who is, if you’re looking for more information about the vaccines that are recommended during pregnancy, what they are, why they’re recommended, what the benefits are.

Um, we have some great information at vaccinateyourfamily. org. Um, there is some pregnancy specific resources as well as information about accessing vaccines during pregnancy. So I would just say, please check it out. Um, come with an open mind. I, we say do your own research and I support that. Do your own research.

We have, you know, all our sources come to vaccinateyourfamily. org and, um, I hope you’ll take the time to kind of learn more about the vaccines that are recommended during pregnancy so that when it comes time to talk to your provider about them, you can go in feeling informed and ready to have that conversation and make the vaccine decision for your family.

Because that’s the goal. The goal is making sure that you have the information that you can use to make the decision. That is best for yourself and your family and you know, wonderful organizations like vaccinate your family do have evidence based information that can help you with your decision making and we will be happy to put information on how to find vaccinate your family in our show notes.

Dana. Yes. Well, thank you so much. Oh, thank you. I thank you. Doesn’t even cover it. So happy to have you here today. So happy to talk about this. And as you know, you know, vaccines are more and more a part of some of the recommendations that we have at all points in the life cycle. So we would love to have you back on the show in the future if you’re ever ready to do so.

Yeah. Absolutely. It’s been a pleasure. Great. Dana. Thank you so much. And that’s going to do it for this episode of the mother to baby podcast. Be sure to hit that subscribe button. So that way you never miss a new episode and you can go back and listen or relisten to some of those older episodes as well.

You can find us on iTunes, Spotify, Audible, or however you like to listen to podcasts. And if you want to be on the podcast, or if you have an idea for the show, we would love to hear from you. Please feel free to email us at contactus at mothertobaby. org. And Mother2Baby is here to answer your questions about exposures before and during pregnancy.

While breastfeeding or if you have questions about exposures and adoption, you can reach us by phone at 866 626 6847 by text at 855 999 3525. You can visit us on our website, Mother to baby. org. And there you can chat with an information specialist. You can look at our many blogs, information pages, our hundreds of fact sheets that are available free in English and in Spanish.

And you can also listen to our podcast. Or find out how you can participate in our pregnancy studies. If you would like to support the mother to baby podcast, as well as all of the ways we get critical pregnancy and breastfeeding health information to you at home, we have a new way to do just that.

Encircle is our new monthly giving society that helps ensure we can continue to provide our services at no cost. Join the community today and encircle parents and babies in health. Members will be recognized on the podcast and website. Visit mother2baby. org slash donate today. Until next time, remember.

Mother2Baby is here for you. Take care. Mother2Baby is a service of the non profit organization of Territology Information Specialists and supported by the Health Resources and Service Administration of the U. S. Department of Health and Human Services. It’s made possible through generous donations from listeners like you.

To learn more about Mother2Baby, please visit mother2baby. org.


Fact Sheets

By Elizabeth Salas, MPH, Teratology Information Specialist, MotherToBaby California

If you have Multiple Sclerosis (MS) and are currently pregnant, breastfeeding, or planning a pregnancy, where do you go when you have questions about MS or MS treatments? In this day and age, the first place you might go is the Internet. With no shortage of information at our fingertips, it may seem the answers to all of our questions are just a web search away. But when it comes to chronic conditions and treatments in pregnancy, reliable and accurate information isn’t always easy to find, and the answers may not be so simple. So let’s try a different approach, shall we? First, let’s start with the facts!

The Good News

Studies about MS and pregnancy are encouraging. To date they show MS does not affect a woman’s ability to get pregnant. For most women with MS, they are less likely to have a relapse during pregnancy especially in the 3rd trimester. Research shows pregnancy does not worsen MS or the progression of the disease1. MS during pregnancy also does not increase the risk for birth defects, and does not increase the risk of major complications in pregnancy, during delivery, or for the newborn2. In fact, some studies suggest pregnancy may have a protective effect for women, by slowing down or reducing the progression of MS – although more research is needed to confirm this finding3.

Making Progress in Treating MS

 Ten years ago only a handful of treatments were available to treat MS. These medications, such as Betaseron® (Interferon Beta-1b) or Avonex® (Interferon Beta-1a), are called disease modifying medications because they slow down the natural course of MS while reducing the number and severity of relapses. Today there are twice as many disease modifying medications available – but the big question here is what do we know about these treatments during pregnancy or lactation?

The somewhat frustrating answer is that there is very little information about the safety of the newest medications during pregnancy or lactation. For this reason, standard practice has generally suggested women with MS stop treatment with disease modifying medications at least 1 menstrual cycle prior to attempting to conceive4. Older medications used to improve symptoms during a relapse, such as Solu-Medrol® (methylprednisolone) or prednisone, have been around since the 1950s5 and much has been published on their use in pregnancy6. (For more information about prednisone/prednisolone in pregnancy and lactation, see our Fact Sheet.) Regardless of which medications you may be taking, it’s important for women with MS to plan their pregnancies and discuss treatment and options with your doctor before trying to become pregnant.

But what if your pregnancy, like nearly half of all pregnancies in the United States, was not planned? You may still have many questions about how your MS – and any medication you may be taking to treat it – could impact your pregnancy, such as: Could my medication have an effect on my developing baby? Will additional tests be needed during pregnancy to make sure my baby is all right? Should I continue taking my MS medications during pregnancy? If I stopped my medication, when can – or when should – I start taking them again? Can I breastfeed while taking these medications? The questions may seem overwhelming, but the good news is there are specialists who can answer your questions and they are just a phone call away!

Making The Call

Hello and thank you for calling MotherToBaby. We’re here for you!

I am a counselor with MotherToBaby, a group of experts dedicated to providing women, healthcare providers, and the general public with accurate and up-to-date information on exposures during pregnancy and breastfeeding. We answer questions about everything from medications and cosmetics, to chronic conditions, like multiple sclerosis. Our service is FREE, confidential, and available for you. To speak to a counselor, call us toll free at (866) 626-6847.

Making A Difference

Every pregnant woman wants a healthy pregnancy. After personally talking to pregnant women with chronic conditions for nearly a decade, one thing has become very clear: we need better answers about how medications affect pregnancy. MotherToBaby has a follow-up program for pregnant women with MS, regardless of whether they are currently taking medication. We are learning more every day thanks to pregnant women with MS who are sharing information about their experiences. If you’d like to know more about current programs on MS and pregnancy, please contact one of our MotherToBaby Pregnancy Studies experts toll free at (877) 311-8972. You can help us make a difference, and together we can find the answers.

Elizabeth Salas
Elizabeth Salas is the Lead Teratology Information Specialist for MotherToBaby California, a non-profit that provides information to healthcare providers and the general public about medications and more during pregnancy and breastfeeding. She is based at the University of California, San Diego, and is passionate about the work MotherToBaby is doing to promote healthy moms, healthy pregnancies and healthy babies.

MotherToBaby is a service of the international Organization of Teratology Information Specialists (OTIS), a suggested resource by many agencies including the Centers for Disease Control and Prevention (CDC). If you have questions about medications, vaccines, diseases, or other exposures, call MotherToBaby toll-FREE at 866-626-6847 or call the Pregnancy Studies team directly at 877-311-8972. You can also visit MotherToBaby.org to browse a library of fact sheets, as well as visit our Autoimmune Diseases and Pregnancy page.

Interested in more information about MS and pregnancy? Check out MotherToBaby’s March 2014 blog, “MS: The Diagnosis that Doesn’t Mean Missing Out on Motherhood!”

References:

1. Baird, S. M., & Dalton, J. (2013). Multiple sclerosis in pregnancy. Journal of Perinatal & Neonatal Nursing, 27 (3), 232-41. doi: 10.1097/JPN.0b013e31829d98c5.

2. Tsui, A., & Lee, M. A. (2011). Multiple sclerosis and pregnancy.

Current Opinion in Obstetrics and Gynecology, 23(6):435-9. doi: 10.1097/GCO.0b013e32834cef8f.

3. Roullet, E., Verdier-Taillefer, M. H., Amarenco, P., Gharbi, G., Alperovitch, A., & Marteau, R. (1993). Pregnancy and multiple sclerosis: a longitudinal Study of 125 remittent patients. Journal of Neurology, Neurosurgery, & Psychiatry, 56(10):1062-5.

4. Houtchens, M.K., & Kolb, C. M. (2013). Multiple sclerosis and pregnancy: therapeutic considerations. Journal of Neurology, 260(5):1202-14. doi: 10.1007/s00415-012-6653-9.

5. Clinical Pharmacology [database online]. Tampa, FL: Elsevier/Gold Standard, Inc.; 2014. URL: http://www.clinicalpharmacology.com. Updated August 2013 (Methylprednisolone) and September 2013 (Prednisone).

6. Briggs, G.G., Freeman, R. K., & Yaffe, S. J. (2011). Drugs in Pregnancy and Lactation (9th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.


Fact Sheets

Dr. Emily Caffrey, a certified health physicist with the Health Physics Society, joins host Christ Stallman, CGC to talk about different types of radiation and their potential effects on a pregnancy.

Links Mentioned in This Episode:

Health Physics Society’s Ask The Experts

https://HPS.org



Ep. 76 Transcript

 You’re listening to the MotherToBaby podcast, medications and more during pregnancy and breastfeeding. Ask the experts with your host, genetic counselor and mom of four, Chris Stallman.

This episode contains evidence based information that’s current as of the day recorded and may change as more data becomes available. To get the very latest information about this topic or other topics in pregnancy and breastfeeding, please contact a mother to baby specialist at 866 626 6847 by text at 855 999 3525 or through our website at mothertobaby.org.

Welcome to another episode of the mother to baby podcast. My name is Chris Stallman, and I’m a genetic counselor, a mom of four, and a teratogen information specialist. So what that means is that I talk to people, so patients, family members, healthcare providers, the general public, about exposures that can happen before pregnancy, during pregnancy, while breastfeeding, and in cases of adoption.

Thank you And an exposure can be anything. So it could be a medication you take. It could be a vaccine. It could be a hair treatment. And in some cases it could be in the place where you work. Today we’re going to talk about a very specific exposure, radiation. And we have a very special guest to talk with us today.

Dr. Emily Caffrey is the program director and an assistant professor for the master’s in health physics program at the University of Alabama at Birmingham. She is also a certified health physicist that specializes in calculating radiation doses from environmental sources of radiation. Dr. Caffrey, welcome to the show.

Thanks for having me. Excited to be here. Great. So let’s get started today. We’re going to talk about radiation. Can you tell us a little bit about what radiation is and how people are exposed to it? Yeah, absolutely. Um, you know, radiation is just a form of energy. So there’s two types of radiation. There’s non ionizing radiation and ionizing radiation.

So non ionizing radiation are lights, microwaves, your cell phone emits non ionizing radiation, things like that. There’s also ionizing radiation, and that type of radiation is a little bit higher energy, um, that makes charged particles. Um, and that’s the kind of radiation you get when you’re talking about a CT scan or an x ray, something like that.

Um, that’s ionizing radiation. Uh, and I, and I just want to point out that radiation is all around us. It was present when life first evolved on Earth. It was present when dinosaurs lived. It’s still present today. Uh, we live in a radioactive world, and I think a lot of people don’t know that. So I’d like to start with, radiation’s all around you, and it has been your whole life.

Um, natural radiation comes from space, and it comes from living things that are in the Earth. The Earth’s crust is radioactive. You may, if you live in a place that has high radon, um, you may have heard of radon coming from Earth up into your basement. That’s a really common source of exposure. Um, and our human bodies and cells have adapted over time to respond to and repair the small amounts of damage you might get from these low levels of ionizing radiation.

So some of the more common forms of radiation, like you described, light, microwaves, CTs, would that also include mammograms and would that increase risks to a pregnancy? Yeah, that doesn’t include mammograms. The mammogram is again a low energy type of x ray that’s used to image the breast tissue to look for cancer usually.

Um, and You know, just like all other types of, of diagnostic imaging procedures, and I think we’ll talk a little bit more about this as we get into it, um, you really aren’t at risk when you have a low, a low, a diagnostic imaging procedure, those are very low doses, your, your pregnancy is not at risk, the unborn child, not at risk from those types of exposures.

And I’m really glad that we can talk about that and hear about that again, because it is the kind of thing, you know, if. certainly if you need it in pregnancy, it’s a good idea to get your cancer screenings. Absolutely. Dr. Caffrey, can you tell us a little bit about the Health Physics Society? Yeah. And I like to tell people like health physics is a profession you’ve never heard of, but the health physics society is the professional society for health, which are radiation protection professionals.

So we are the profession that is devoted to the safe use of radiation. Um, so anywhere radiation is used, whether that’s a hospital, a nuclear power plant, um, the government and military installations, um, there’s gonna be a health physicist, a radiation safety officer, someone there making sure that the people and the environment are safe from that ionizing radiation.

So you may not see us, but we are there making sure that we’re following regulations and keeping people safe. When you mentioned earlier that radiation comes from space, I got to say, I love hearing that. I think that that’s such a cool and exciting thing. So let’s talk about cosmic ionizing radiation. So what is that specifically?

And does that increase risks to a pregnancy? Yeah, it’s space is always fun, right? And we’re talking about sending astronauts to Mars and things, right? Radiation. So, you know, one component of your natural radiation dose that you get just by living here on Earth is from outer space, and that’s called cosmic radiation.

Um, so particles and electromagnetic magnetic waves from outer space, um, come and hit and impact Earth. So you may have heard of solar flares and things like that. And the sun flings off all these charged particles. So those come and hit Earth. Now, Earth is actually pretty well protected. We have this magnetic field that’s around Earth that deflects a lot of those particles.

Think of it as like a shield around Earth. And then our atmosphere, like a literal atmosphere above us, also protects us from a lot of that radiation, but not all of it. So some of that radiation is going to come in and actually get into Earth, like where you and I are sitting here right now. Um, and, and, and, There’s more at the north and south poles and as you go higher in elevation because at the north and south pole the magnetic field that protects us is weaker and at higher altitudes you’re just physically closer to the radiation coming from space.

So if you’re, um, your background radiation dose, if you’re at the North Pole or if you’re standing on top of a 14 year in Colorado is going to be higher than me sitting here in my office in Huntsville, Alabama, which is basically at sea level, right? So it’s just a small difference, but it does change a little bit.

Um, but you know, cosmic radiation contributes Um, about 5 percent of our average total background dose. So that’s a very low, low number. You and I just living on Earth, which is radioactive, get about 3 millisieverts per year. And a millisievert is just a unit of radiation, uh, dose that we, that we use to count, you know, when we’re talking about radiation doses, that’s just a number we, a unit that we use.

Um, so you and I get about 3 millisieverts per year, and about 5 percent of that 3 millisieverts is from cosmic space radiation. Um, and I, and I want to add to that background radiation doses are too low to increase your risk of pregnancy or cause any harm to your unborn child. We are not worried about background radiation doses or doses that are lower, um, in, in than, especially not background, but lower than three is definitely not a concern.

And we’ll talk a little bit more about what levels you might want to start thinking about, about, you know, where, at what levels you might want to be concerned, but definitely not at background levels. Great. Okay. So thinking about space occupation, what’s out there? What about radiation exposure for someone who’s working as a flight attendant?

I got to tell you, I got this question for the very first time, maybe six or seven years ago. And until then, it never even occurred to me. I was like, yeah, of course, there’s radiation in the atmosphere. So I’m going to stop talking and let you give us this answer. Yeah, and I’m really glad you asked that question because we hear this concern a lot, both from flight attendants, pregnant women that travel for work a lot, uh, pilots, right?

We hear this question a lot. And I think people, uh, I certainly didn’t before I got into this field, didn’t think about flight attendants being, uh, people that are exposed to COVID. More than average, right? Um, but when you fly up high, especially people that fly transcontinental flights that go over those poles where you have a higher radiation dose, they get a higher radiation dose in the background.

They actually, in some cases, get higher radiation doses than workers at nuclear power plants, but higher does not mean there’s a problem. So let’s back up for just a second. Um, so the amount of exposure that you get from flying is significantly lower than, um, The exposure needed to cause any harmful effects to your, to your unborn child or to you, the pregnant, pregnant person, rightly, that we’re not concerned.

Um, and just to give you some context, right, we talked about 3 millisieverts as our background radiation dose. Um, the radiation dose needed to cause harmful effects is roughly, and again, there’s a lot of research on this that’s ongoing all the time as we improve our models, but we’re talking roughly 100 millisieverts.

Um, and again, millisieverts just being a unit of radiation dose, so 3. Is your background radiation dose, and 100 is what we’re talking about for harmful effects. Um, and then to talk a little bit more specifically about flight, so how much radiation do you get in a flight? Well, your radiation exposure during a commercial flight is about 0.

01 millisieverts per hour of flying time. So to get to 100 then right? That means you need if you do some quick division. That means you need about 10, 000 hours during your pregnancy to reach the amount of radiation that might be harmful. I don’t think anyone is even flight attendants, right? You’re not flying in 10, 000 hours.

You really aren’t quite safe from as a as a flight attendant or a pilot or even just someone that travels a lot while you’re pregnant. That’s it’s not of concern. Excellent. And I’m so glad that you mentioned, you know, it could be higher than 100. wherever we start out. But that alone doesn’t necessarily mean that there is a problem.

We have to have more information. We have to have all the pieces and that’s so important for all exposures. But again, certainly for one like this, where you may not have known or you may not have remembered, it’s like, oh, there’s radiation all around us. Oh, wait, it also depends on how much we’re being exposed to.

Now, for my favorite thing to ask all of the guests on the show, when I get the opportunity, what is the most interesting question about radiation and pregnancy that you or the Health Physics Society has received? Yeah. And I’m, and again, this is a great question. We get hundreds of questions from pregnant women and thousands of questions from the general public.

Yeah. Um, and you know, it’s kind of, I didn’t pick something like when I was thinking about this, I didn’t pick something light hearted because this, this particular question that I’m going to throw is one that has stuck with me and it’s the one I that just reminds me of why talking to people and using my knowledge to explain why things are okay or not okay or what you need to be concerned about and what you shouldn’t be concerned about is so important.

Um, and so about, about a year ago, we had a woman right in, um, an Italian woman and she had had a diagnostic x ray of her pelvis before she knew she was pregnant. And her, her gynecologist told her the pregnancy was probably more risky because of the x ray. And she specifically asked us if she should terminate her pregnancy.

And under Italian law, you know, that was very time sensitive because she only had a week to make such a like, insanely impactful life decision. Um, and so I was so glad that she found us because I just want to be really clear here. The answer to that question is absolutely not. A diagnostic x ray, even to the pelvis, um, is not going to cause any harm to your unborn child.

And just the relief that we were able to provide, um, that, that soon to be first time mom was just like overwhelming. She wrote back to us, um, several times over the course of, you over the course of her pregnancy just to check in and she told us she sent us an email saying that her son was born happy and healthy and she was just so grateful and so relieved because she didn’t know right and and so being able to offer that service and being able to help people understand and make massive decisions is just really amazing.

Uh, it gives me the warmth, like, that is amazing. I am not only so glad that the society exists and that folks like yourself are out there giving this information. I’m so glad they found you. I’m so glad that, you know, it seemed like a good outcome for them. That’s wonderful and so important. And it is one of those things where, you know, you don’t know what you don’t know.

The good news is in a lot of cases, there are people, um, again, like you and the health physics society that are out there assisting with some of this information that isn’t as commonly available. So thank you so much. What a great story. So Emily, if someone has a question specific for the health physics society, so radiation.

Or even, you know, concerns in the pre pregnancy or after pregnancy planning stage. How did they get to your organization to find this information? Yeah, thanks for asking that. Um, so you can find us at hps. org, hps. org. That’s the website of the Health Physics Society. And you’ll see a little Ask the Experts button.

And you just click that button and you’ll see our webpage. Um, there’s a webpage specifically for pregnancy and radiation. And on that web page are a couple of videos that the Health Society has produced. There are fact sheets about radiation and pregnancy. There are Q& A’s from, uh, not only some, some basic Q& A’s that we have written, but also, um, some stories that other people have, other questions that people have written in with.

We, we anonymize them, of course, and we post some of those to our website. And we cover everything from, um, background radiation, to pregnancy and flying, to what if I need a medical procedure, to I’m a lactating mom that’s breastfeeding, you know, and I have to have this nuclear medicine procedure, you know, if, am I okay, what should I do?

Um, I think the medical industry does a good job of providing information, but I think people sometimes still want, you’re still overwhelmed, right? When you, you have a child and you are doing something in the medical realm, like those are two very overwhelming things. In and of themselves. And so when you have another question that didn’t get answered, please reach out to us and we’re always happy to help.

That’s awesome. And we are going to put information for the Health Physics Society in the show notes. Something else, um, that I was just thinking of, I, you know, talk to people all day. That’s my job. But if I forget to ask my doctor or healthcare provider something, or if I’m traveling or busy, I might not always have the opportunity to connect with them, and I will say that sometimes I turn to Google.

So it’s great to know where they can find this information. Providers are wonderful. They give good information. Sometimes I do not have it in me to wait 30 minutes on the phone. You know, life is busy. So it’s great to know that we can find this information online as well. Dr. Caffrey, before I let you go for this episode, um, cause I would love to have you come back and talk more about radiation.

Is there a final thought that you would like to leave our audience with? Yeah, I think, you know, I think the thing I want to emphasize is that radiation can be scary. You can’t see it. You can’t feel it. You don’t know it’s there. Like anything you can’t see and you don’t know is there. Can be scary, but I just I want to emphasize that our bodies evolved in this radioactive world.

They have repair mechanisms for low doses. And we know from population studies from epidemiological studies. That the amount of radiation used in these diagnostic procedures, so x ray scans, mammograms. Um, even to the pelvis area are just not are way too small to cause harm to your unborn child. So you don’t need to worry about those types of procedures.

You know, and if you are concerned or you had a specific procedure or you had a nuclear medicine procedure, you know, those are things that experts can talk to you about and counsel you through, um, to make sure that you’re getting up to date information. And it’s so important to remember to ask those questions because diagnostic procedures can prevent a lot of issues that are harmful to your baby, right?

And, or could be harmful to your, to your unborn child and, or yourself, right? As the pregnant woman, like, um, There are actual harms that can be done by not having a CT scan when it’s clinically indicated, and the radiation dose should, should be something that you think about, um, and, and be aware of and educated about, but it should not stop you from getting a diagnostic procedure that could potentially save your life or your unborn child’s life.

So radiation’s scary, but we, um, myself, the Health Physics Society, and all of my topic editors and experts are here to help. Hps. org or through the mother’s baby website, there are links, um, and you can find us online and we are, please reach out. We are happy to help. Absolutely. And thank you. Thank you for the reminder that, you know, these procedures, MRIs, CTs, and so forth are not done lightly.

They are done because someone needs it, especially during pregnancy and you, you probably do need it. So please feel free to contact. The health physics society or mother to baby with any questions that you have. Dr. Caffrey, it was my pleasure to speak with you today. Thank you so much for being on the show, giving us all this great information, and we hope to have you back in the future.

Thank you so much for having me. It’s been a pleasure. And that’s going to do it for this episode of the mother to baby podcast. Be sure to hit that subscribe button. So that way you never miss a new episode and you can go back and listen or relisten to some of those older episodes as well. You can find us on iTunes, Spotify, Audible, or however you like to listen to podcasts.

And if you want to be on the podcast, or if you have an idea for the show, we would love to hear from you. Please feel free to email us at contactusatmothertobaby. org. And Mother 2 Baby is here to answer your questions about exposures before and during pregnancy while breastfeeding, or if you have questions about exposures and adoption, you can reach us by phone at 866 626 6847.

Buy text at 855 999 3525. You can visit us on our website, mothertobaby. org. And there you can chat with an information specialist. You can look at our many blogs, information pages, our hundreds of fact sheets that are available free in English and in Spanish. And you can also listen to our podcast. Or, find out how you can participate in our pregnancy studies.

If you would like to support the MotherToBaby podcast, as well as all of the ways we get critical pregnancy and breastfeeding health information to you at home, we have a new way to do just that. Encircle is our new monthly giving society that helps ensure we can continue to provide our services at no cost.

Join the community today and encircle parents and babies in health. Members will be recognized on the podcast and website. Visit mothertobaby.org/donate today. Until next time, remember, MotherToBaby is here for you. Take care. MotherToBaby is a service of the nonprofit organization of Teratology Information Specialists and supported by the Health Resources and Service Administration of the U.S. Department of Health and Human Services. It’s made possible through generous donations from listeners like you. To learn more about MotherToBaby, please visit mothertobaby. org.


Fact Sheets

Better Safety Info in Pregnancy Starts with Your Referral

Prescription medications and vaccines currently come to market with little to no information on the safety of the product when used in human pregnancy. This leaves health providers like you in a bind when treating pregnant patients and female patients of reproductive potential. MotherToBaby Pregnancy Studies are rigorously designed cohort studies that aim to provide critically needed product safety information – and your patient referrals make all the difference.

“Counseling people who are pregnant and/or breastfeeding regarding the risks or safety of drug treatments is often complicated by a lack of information about the nature, magnitude, or even existence of a teratogenic risk in humans.”


Adam et al., 2011

Our Pregnancy Studies Depend on Health Providers Like You

We’re studying a variety of medications, maternal health conditions, and vaccines. Here’s a list of ongoing studies for which we’re currently accepting patient referrals.

Refer Now

Referring your patient is fast and simple. Just fill out our Refer a Patient form and our experienced research team will take it from there to contact your patient and tell them more about the study. You can also call us to take your referral by phone toll-free at 877.311.8972. We’re open Monday – Thursday from 7am-7pm Pacific and Friday 7am-6pm Pacific, excluding public holidays.

The Power of Your Patient Referral

We understand the challenges that you face when deciding on treatment courses when your patient is pregnant. The goal of MotherToBaby Pregnancy Studies is to provide you with the scientific evidence that is needed so you can better weigh the risks and benefits to person who is pregnant and their pregnancy, thus allowing you to identify a treatment plan that maximizes disease management and minimizes maternal and fetal/infant risk. Our research has been instrumental in identifying previously unrecognized human teratogens as well as ruling out substantial risk for other medications and vaccines – and these studies would not have been possible without health providers like you who referred their patients.

Your patients trust you with good reason – after all, you have their health interests as your top priority. We find that when women who are pregnant and/or breastfeeding are referred to us by their trusted health provider – whether their OB/GYN or a specialist – they are more likely to participate in our studies. By taking the time to refer your patient, you are helping us generate data that will lead to improved product safety information in pregnancy, thereby providing you and your patients with the evidence you need to make more informed treatment decisions.

The results of our studies are published in peer-reviewed medical and scientific journals and presented at scientific meetings. Our results can also be used to update the product label, and they are incorporated into resources that are widely used by clinicians and/or patient populations for information on pregnancy and lactation exposures, including our own MotherToBaby fact sheets as well as LactMed (National Library of Medicine), Reprotox, and TERIS. Last but most certainly not least, both study participants and their referring providers are sent a summary of our findings and a PDF of any publications.

“Enrolling your patients in a pregnancy exposure registry can help improve safety information for medicines used during pregnancy and can be used to update drug labeling.”


U.S. Food & Drug Administration: Pregnancy Registry Information for Health Professionals

When Your Patients Look to You, You Can Look to Us

MotherToBaby is dedicated to providing evidence-based information about medications and other exposures during pregnancy and while breastfeeding. In addition to our pregnancy studies, we have a dedicated team to provide no-cost teratogen information services tailored to the needs of both health professionals and women who are pregnant and/or breastfeeding. Women who are pregnant and/or breastfeeding who enroll as participants into our studies benefit from one-on-one access to our experts and the piece of mind that knowledge and increased monitoring brings to their pregnancy.


Answers to Commonly Asked Questions

health-provider-woman-pill-art

Our studies observe women who are pregnant and/or breastfeeding already exposed to certain medicines or vaccines or who have been diagnosed with specific conditions.

Will my patient be asked to take a medication or change their treatment plan?

No. Our studies are strictly observational; your patient will not be asked to change any part of their health care routine, including their medications.

My patient has recently become pregnant and has been exposed to a medication/vaccine you are studying. What should I do first?

All patients who become pregnant while taking a study medication or who have a health condition of interest (regardless of how it is being treated) should be referred to our research team by calling 1.877.311.8972 or completing our online referral form.

My patient who is pregnant hasn’t been exposed to a medication/vaccine you are studying. Can they participate in one of your studies?

Potentially yes. Most of our studies also enroll people into comparison groups. Refer your patient to us by calling 1.877.311.8972 or completing our online referral form, and we’ll screen them to see if they qualify.

If my patient enrolls, what will I be required to do?

All you need to do is refer your patient to us. Women self-enroll, so after you make the referral nothing further is required from you.

Do you have materials I can use to educate my patients or colleagues about your studies?

Yes! We can provide you with patient-friendly materials for your office, such as brochures (in English & Spanish), a fact sheet about Pregnancy Study Participation and referral cards that you can hand to your patients. We also have informational materials for other healthcare providers. Health providers can order materials by visiting our Material Request Form or by contacting our Research Team via email at MotherToBaby@health.ucsd.edu.

See our complete list of Frequently Asked Questions for Healthcare Providers.


About MotherToBaby Pregnancy Studies

MotherToBaby Pregnancy Studies are ongoing observational studies– known as pregnancy studies or pregnancy registries—to track the effects of certain medications, vaccines, and health conditions on pregnancy and infant outcomes. MotherToBaby Pregnancy Studies are conducted by the non-profit Organization of Teratology Information Specialists (OTIS), the nation’s leading authority on the benefits and risks of medications and other exposures during pregnancy and lactation. They are coordinated under the leadership of Christina Chambers, PhD, MPH, a perinatal epidemiologist and Professor of Pediatrics at the University of California San Diego’s School of Medicine in the Center for Better Beginnings. With over 20 years of excellence running pregnancy studies, our extensive experience and robust team provide rigorously designed cohort studies to aid the scientific study of exposures during pregnancy and provide much-needed information on teratogenic risk to healthcare partners.

Refer a Patient to Our Studies

Better medication safety information are needed to make informed treatment decisions for pregnant patients.