You already know this but a surprising number of medical professionals don’t: pregnant women aren’t just fat versions of average women (who, themselves, aren’t just mini versions of men). Which means you can’t necessarily medicate a pregnant women like you would any other woman, who you can’t just medicate like any ol’ guy.
That’s before you even consider the consequences of passively medicating a growing fetus.
This, it turns out, presents a problem that researchers are only now beginning to look into. Given shifts in the pregnant woman’s metabolism, among many other changes, it’s any doctor’s guess as to what and how much medication to prescribe to pregnant women who are battling cancer, depression, or the flu — not to mention WMD-type viruses.
Here’s an example of the problem the pregnant body presents: the American College of Obstretrics and Gynecology recommends giving patients amoxicillin during an anthrax scare. But how much? Who the hell knows!
But an obstetrics researcher in Seattle recently concluded there’s no
way to give a pregnant woman enough of the antibiotic to be effective.
Kidney function is so revved up during pregnancy that even in high
doses, amoxicillin is excreted before it can work its magic. Think of
it as trying to fill a bathtub with the drain open, suggests Jason
Umans, an internist and maternal-fetal pharmacologist at Georgetown
University. “In emergencies, you always hear, ‘Treat the pregnant women
first!’” he says. “The joke should be ‘Yeah, how?’”
The good news a few dozen doctors, ethicists and government officials have launched a movement of clinical research they’re calling the Second Wave (the first was when officials realized women are mini-men in terms of medicine, or, anything else). They’re hoping to gather more data so that doctors no longer have to wing it with their expecting patients.
But what about the baby!!!!! Settle down, these, pioneer researchers say.
“Everyone thinks, Oh, my God, research on pregnant women! All kinds of
ethical flags go up,” says Ruth Faden, director of the Berman Institute
of Bioethics at Johns Hopkins University. “We don’t have to start with
high drama.” There’s enough “low-hanging fruit,” she says, “that we
could keep lots of medical researchers busy for a long time.”
In fact, two-thirds of women take up to five drugs during pregnancy and through labor. But only a dozen are FDA approved for pregnancy and those are all stuff for the labor and birth like induction meds and the epidural. The ones for high blood pressure or diabetes are any doctor’s educated guess.
What was your experience with meds during pregnancy? Did you and the doc just make it up as you went?