Unplanned pregnancies: a case for clinical trials

Businesswoman contemplating medicine at deskNot every pregnancy is planned. Even for women that want to have a baby, there’s nearly always a gap between getting pregnant, and realizing that they are pregnant. So what happens to a woman in that space of time when she’s taking prescribed drugs or self-medicating for a minor illness? More often than not, doctors don’t know the answer.
The first 12 weeks of a pregnancy are crucial: events at this early stage can determine what happens to the fetus during the rest of the pregnancy and post-birth. Academic research suggests that problems later on might well stem from what happens right at the beginning of a pregnancy.

Even something as simple as a headache, indigestion or a cough takes on a new dimension in pregnancy. Women usually self-medicate for such ailments; so what happens if they don’t know they’re pregnant? A good safety profile for the general population doesn’t always mean that an over-the-counter drug has been approved for use in pregnancy. And herbal medicines have no guarantees of safety either. Yes, there are disclaimers on patient information leaflets – but how many people actually read these? Most of us don’t bother with the small print when taking drugs we’ve relied on for years.

If a rapidly growing fetus is already vulnerable, it’s even more so if women are unaware that they’re pregnant. Often, by the time these women get to their doctors – who, invariably, tell them to stop taking whatever medicine they’ve been taking – it’s impossible to know whether their actions have had a negative impact on their unborn child. Why? Because there are so few clinical trials measuring the effects of drugs on fetuses.

Many people are reluctant for pregnant women to participate in clinical trials, because such trials might put the fetus at risk. But this lack of information means that women who are unaware that they are pregnant, and continue to take medicines, are already putting their unborn children at risk. If there are risks on both sides, wouldn’t it be better to protect them from the outset?

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