Medication management during pregnancy: role of the pharmacist

Nardin Samuel, Adrienne Einarson

A community pharmacist is frequently the first healthcare professional who is asked to give advice regarding medication use during pregnancy. As 50% of pregnancies are unplanned, a woman often discovers she is pregnant while already taking a medication and visits a pharmacy which is easily accessible, to enquire if she has harmed her baby by this action. Following a review of the literature, of which there is a paucity on this topic, we found that pharmacists often do not feel equipped to dispense teratology information and frequently refer the woman to her attending physician, without giving any information. In addition, it was clear that even when they did give information, it was not necessarily evidence-based and at times, inaccurate and based on their own opinions. In this article, we have attempted to make pharmacists aware of all the sources that are available, to enable them to perform this important role as a member of the health care team. These include websites, texts, evidence-based literature, teratogen information services and more. With the knowledge extracted from various resources, following critical appraisal of the data, they should be more comfortable and feel better equipped to transfer this information to a pregnant woman. In conclusion, while there may be a lack of adequate information regarding use of certain medications during pregnancy, pharmacists should be able to integrate available information with their medication expertise, to make appropriate individual risk/benefit decisions. This requires active engagement with pregnant women, rather than automatically referring them to their physician, thus establishing the pharmacist role as an essential member of the health care team.