Symptomatic treatment

There are a number of conditions that, although not dangerous, may require symptom relief during pregnancy. 

Nausea and vomiting, for instance, are very common.  You may already be suffering from “morning sickness” just because you are pregnant.  Add to this the fatigue, irregular meals and motion sickness that often accompanies travel and you may have a real problem.

An old but often effective remedy for this is ginger root, available in tablet form but equally effective if powdered and mixed with tea or even if you simply nibble on the root itself.  Another proven remedy is a combination of pyridoxine and doxylamine, available in Canada under the trade name Diclectin®  (It used to be available in the United States as Bendectin®.).  Other useful anti-nausea medicines include EmetrolÒ (a liquid preparation of sugars and phosphoric acid) and various antihistamines. 

The latter usually require a prescription, however, and the liquid can created quite a mess in your luggage.  Scopolomine patches and tablets, often used for motion sickness, have also been tried for morning sickness.  Until more clinical evidence is available, however, we would not recommend their routine use.

As mentioned elsewhere, we normally do not recommend the use of anti-diarrhea medicines during pregnancy.  Both Loperamide (Imodium®) and diphenoxylate (Lomotil®) are probably safe in pregnancy, however, if the diarrhea is really severe.  Even though there has been no proven harm from it, we advise our pregnant patients not to use bismuth subsalicylate (Pepto-Bismol®) because bismuth is a heavy metal (like lead and arsenic) and the “subsalicylate” part is similar to aspirin.

For headaches, aches and pains, our most common recommendation is acetaminophen (Tylenol®).  Aspirin has sometimes been recommended in small doses to prevent toxemia or other pregnancy complications, but it is not routinely recommended during pregnancy for pain relief.  The common non-steroidal analgesics such as ibuprofen and naproxen could theoretically cause harm to the baby if used near your due date.  For severe pain, therefore, we still recommend the use of narcotics such as codeine or oxycodone.  These sound dangerous, but actually are safe for the baby.

Skin preparations such as insect repellents and sunscreens are considered safe to use in pregnancy in normal amounts.  Although it has been demonstrated that DEET (the active ingredient in most insect repellents) crosses the placenta, no ill effects from this have been shown.  Medical studies show it to be safe in concentrations up to 20% in the second and third trimesters of pregnancy.  There is also little evidence that it is of any harm in the first trimester.