How to Prepare for and Ask the Right Questions About Medications During Your OB/GYN Visit

When you’re planning a pregnancy, already pregnant, or breastfeeding, the medications you take - even the ones you think are harmless - can make a real difference. That’s why talking openly and clearly with your OB/GYN about everything you’re taking isn’t just a good idea. It’s essential.

Most women take at least one medication during pregnancy, according to the CDC. That includes prescription drugs, over-the-counter pain relievers, vitamins, herbal teas, and even supplements you picked up at the health food store. But not all of them are safe. Some can affect your baby’s development, interfere with your hormones, or cause unexpected side effects. The good news? You don’t have to guess. With the right preparation, you can turn your OB/GYN visit into a clear, confident conversation that keeps you and your baby protected.

What to Bring: Your Medication List

Don’t rely on memory. Write everything down. Start with your prescription meds: name, dose, how often you take it, and why. For example: Levothyroxine 75 mcg, one pill daily for hypothyroidism. Don’t say "my thyroid pill." Be specific.

Next, list every over-the-counter drug you use - even if it’s just for headaches or colds. That means ibuprofen, acetaminophen, antacids, allergy pills, and sleep aids. Write the brand name and dosage: Ibuprofen 400mg, one tablet every 6 hours as needed. Many women don’t realize that even common painkillers like ibuprofen can be risky after 20 weeks of pregnancy.

Now, the part people forget: supplements and herbal products. This includes prenatal vitamins, fish oil, magnesium, iron pills, and anything labeled "natural." Don’t skip things like St. John’s Wort, evening primrose oil, or black cohosh. These aren’t just harmless teas - they can affect your hormones, trigger contractions, or interfere with birth control. One patient in Perth told her OB/GYN she took "just a little evening primrose oil for PMS" - only to find out it could bring on labor early.

Pro tip: Take photos of all your pill bottles with your phone. If you forget the exact dose, you can pull up the picture. It’s faster than guessing, and your provider will thank you.

Why This Matters: Safety During Pregnancy and Breastfeeding

Your OB/GYN isn’t just checking if your meds are safe - they’re checking if they’re the best option. For example, if you’re on an antidepressant like sertraline, they’ll know it’s one of the safest choices during pregnancy. But if you’re on something like isotretinoin (Accutane), they’ll need to make sure you’ve stopped it at least a month before trying to conceive - because it causes severe birth defects.

Medications are grouped by risk levels: Category A (safe), B (likely safe), C (risk not ruled out), D (evidence of risk), and X (clear danger). Most drugs fall into C or D, which means your provider has to weigh the benefits against the risks. If you’re managing high blood pressure, for instance, they’ll switch you from lisinopril (not safe) to labetalol or methyldopa (safe during pregnancy).

And it’s not just about pregnancy. If you’re breastfeeding, some meds pass into breast milk. Zoloft? Generally fine. Xanax? Not recommended. Your OB/GYN can help you find alternatives that won’t affect your baby’s sleep, feeding, or development.

What to Ask: 7 Essential Questions

Don’t wait for your provider to ask. Come prepared with your own questions. Here are the most important ones:

1. Is this medication safe during pregnancy? Don’t assume it is. Even if your doctor prescribed it before, pregnancy changes how your body handles drugs.
2. Is there a safer alternative? If you’re on a medication with a higher risk rating, ask if there’s another option with better safety data.
3. Should I stop taking this before I get pregnant? Some meds need to be cleared from your system weeks or months before conception.
4. Will this affect my fertility? Certain medications - like some antidepressants or thyroid meds - can impact ovulation or sperm quality if you’re trying to conceive.
5. Is this safe while breastfeeding? Many women assume they’ll stop meds after birth, but you might need them long-term. Ask if the drug passes into milk and how much.
6. What if I accidentally took this while pregnant? Don’t panic. Just tell them. Many medications are fine if taken once or twice before you knew you were pregnant.
7. Do I need to get any tests because of this medication? For example, if you’re on thyroid medication, you’ll need TSH levels checked every 4-6 weeks during pregnancy. If you’re on lithium, you’ll need kidney and thyroid monitoring.

Common Mistakes and How to Avoid Them

Most patients mean well, but they miss key details. Here’s what goes wrong - and how to fix it:

• "I didn’t think it counted." Herbal teas, CBD oil, melatonin, and even some probiotics can interact with your meds or pregnancy. List them all.
• "I forgot the dose." Use your phone photos. Or write it down the night before.
• "I stopped it last month." Tell them when you stopped and why. Did you feel better? Did you run out? Did your doctor say to stop? Context matters.
• "I take it only when I need it." That’s still use. If you take ibuprofen for cramps once a month, say so. Your provider needs to know the frequency.
• "My GP said it was fine." General practitioners aren’t trained in reproductive pharmacology. OB/GYNs know how drugs behave differently during pregnancy. Don’t assume your primary care doctor’s advice applies here.

What Your OB/GYN Won’t Tell You - But Should

Many OB/GYNs focus on the big risks: alcohol, smoking, opioids. But they often miss the quiet ones. A 2023 study found only 38% of providers routinely ask about medical marijuana - even though 18% of women of reproductive age use it. CBD gummies, hemp oil, and cannabis creams are increasingly common. They may seem harmless, but they can affect fetal brain development.

Another blind spot? Over-the-counter cold and flu meds. Many contain pseudoephedrine or phenylephrine - which can restrict blood flow to the placenta. Your OB/GYN should know what’s in those pills, not just the brand name.

And don’t assume your prenatal vitamin is enough. Many women take extra iron, vitamin D, or omega-3s - but too much can be harmful. Your provider should check your levels and adjust doses accordingly.

What Happens After the Appointment

After your visit, you’ll likely get a plan: stop this, start that, monitor this blood level, or switch to a safer drug. Don’t wait to act. If you’re told to stop a medication, ask: When exactly? How do I wean off? Do I need to taper? Suddenly stopping some meds - like antidepressants or blood pressure pills - can cause withdrawal or rebound effects.

Also, ask if your insurance will cover the new prescription. Many OB/GYN-safe meds require prior authorization. If you’re told to switch to a new drug, call your pharmacy ahead of time to make sure it’s covered. Otherwise, you might show up for your next visit with no meds at all.

Keep your updated list handy. Bring it to every visit - even if you’re just there for a Pap smear. Your medication needs change as your body changes. What’s safe in the first trimester might not be safe in the third. And if you’re breastfeeding, your list will look different again.

Final Tip: You’re the Expert on Your Body

Your OB/GYN is the expert on medications. But you’re the expert on how you feel. If something doesn’t feel right - if a new pill makes you dizzy, if your mood dropped after switching meds, if your baby seems fussier after you started a new supplement - speak up. Don’t wait for your next appointment. Call the office. Send a message through the patient portal. Your voice matters more than you think.

Preparing for your OB/GYN visit isn’t about being perfect. It’s about being honest, organized, and proactive. The more you share, the better they can protect you. And that’s the whole point.