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

When you're planning a pregnancy or already pregnant, every pill, supplement, or over-the-counter medicine you take matters more than ever. What seemed like a harmless painkiller or herbal tea before could now carry risks you never considered. The truth? Medications aren't just for treating illness-they can affect your fertility, your baby's development, and your breastfeeding journey. Yet most women walk into their OB/GYN appointments without a clear plan for discussing what they're taking. That’s a gap you can close-and it starts with preparation.

What You Need to Bring to Your Appointment

Don’t rely on memory. Your brain is already juggling sleepless nights, cravings, and anxiety. Write it all down. Start at least 7 days before your visit. Gather every prescription, supplement, and OTC drug you’ve taken in the last 3 months. Include:

• Exact brand and generic names (e.g., “Nature Made Prenatal Multivitamin” not just “prenatal vitamin”)
• Dosage and frequency (e.g., “Levothyroxine 75 mcg, taken every morning on an empty stomach”)
• How often you take it (daily, as needed, twice a week)
• Reason for taking it (e.g., “for migraines,” “for anxiety,” “for thyroid”)
• Any herbal products, teas, or supplements-even if you think they’re “natural” and safe

Many patients forget about things like St. John’s Wort, evening primrose oil, or CBD gummies. These aren’t harmless. St. John’s Wort can cut the effectiveness of birth control pills by half. Evening primrose oil might trigger early contractions. CBD use is rising, but there’s still no solid safety data for pregnancy-and most OB/GYNs aren’t even asking about it. A 2022 survey found that only 38% of providers routinely screen for medical marijuana, even though 18% of reproductive-aged women use it.

Pro tip: Take a photo of each medication bottle with your phone. If you forget the dosage, you’ve got a backup. Some OB/GYN offices now print these lists and file them in your chart. One patient on Reddit said her OB printed her spreadsheet and kept it in her file-“made my prenatal visits so much smoother.”

What to Ask Your OB/GYN

You’re not just there to hand over a list. You’re there to get clarity. Bring these questions with you:

• “Is this medication safe during pregnancy-or should I stop before I conceive?”
• “Are there safer alternatives if I’m trying to get pregnant?”
• “Will this affect my chances of getting pregnant?”
• “What happens if I keep taking this while breastfeeding?”
• “Is there a pregnancy safety category for this? (A, B, C, D, or X)”

Don’t be afraid to ask for specifics. If your doctor says “this is safe,” ask how they know. The FDA’s Pregnancy and Lactation Labeling Rule (2015) requires drug labels to include safety info-but 42% of commonly prescribed meds still lack clear data. That means your doctor’s judgment matters. Ask if they’ve seen other patients take this drug safely. Ask if they’ve checked the latest guidelines from the American College of Obstetricians and Gynecologists (ACOG).

ACOG recommends that all women planning pregnancy review their meds during prepregnancy counseling. Why? Because 90% of pregnant women take at least one medication. And 68% continue meds for chronic conditions like hypertension, depression, or thyroid disease. You’re not alone. But you need to know if your meds are helping-or risking.

Why OB/GYNs Are Different Than Your Primary Care Doctor

Your family doctor might review your meds once a year. Your OB/GYN reviews them every visit-especially if you’re trying to conceive or already pregnant. Why? Because reproductive health changes everything.

• OB/GYNs check for teratogenic effects (drugs that can cause birth defects). Most primary care providers skip this.
• They know which blood pressure meds are safe during pregnancy (like labetalol or methyldopa) and which aren’t (like ACE inhibitors).
• They understand how hormonal birth control interacts with antidepressants, antibiotics, or seizure meds.
• They know that Synthroid doses often need to be increased by 25-50% during pregnancy-and that TSH levels must be checked every 4 weeks.

But here’s the catch: OB/GYNs aren’t trained to manage complex polypharmacy. If you’re on four or more medications for diabetes, autoimmune disease, or mental health, they’ll likely refer you to a women’s health pharmacist. That’s not a failure-it’s smart coordination. Your OB/GYN’s job is to protect your reproductive health. Other specialists handle the rest.

What to Do If You’re Already Pregnant and Taking Meds

If you’re already pregnant and realize you’ve been taking something you shouldn’t, don’t panic. Don’t stop cold turkey. Call your OB/GYN. Some meds need to be tapered. Others need to be switched immediately.

For example:

• Advil, Aleve, or other NSAIDs? Avoid after 20 weeks-they can affect your baby’s kidney development and reduce amniotic fluid.
• Antidepressants like Zoloft or Prozac? Many are considered low-risk during pregnancy and breastfeeding. Stopping suddenly can be more dangerous than continuing.
• Acne meds like Accutane? These are Category X-strictly forbidden during pregnancy. If you’re on it and thinking of conceiving, you need to wait at least one month after stopping.

The key is timing. The first 8 weeks of pregnancy are when organs form. That’s the most sensitive window. But even later, some meds can affect growth, brain development, or lung function. Your OB/GYN needs to know what you’re taking now, not just what you took last year.

What About Breastfeeding?

Many women assume if a drug is safe in pregnancy, it’s safe while nursing. Not true. Your baby’s liver is still immature. What passes into your breast milk can build up.

Some safe options during breastfeeding:

• Acetaminophen (Tylenol) for pain
• Penicillin and cephalosporin antibiotics
• Most SSRIs like sertraline (Zoloft)
• Levothyroxine (Synthroid)

Some to avoid or use cautiously:

• Codeine (can cause breathing issues in babies)
• Lithium (concentrates in breast milk)
• Chronic opioid use (risk of sedation in infant)
• Many herbal supplements (lack safety data)

Always ask: “How much of this gets into breast milk? And how will it affect my baby’s weight, sleep, or feeding?” Your OB/GYN can refer you to LactMed, a free NIH database that gives detailed info on drug safety during breastfeeding.

Common Mistakes and How to Avoid Them

• Mistake: Thinking “natural” means safe. Solution: List every herb, tea, or supplement-even if you bought it at a health food store.
• Mistake: Forgetting to mention vitamins. Solution: Folic acid is critical-start 1 mg daily at least one month before conception. It reduces neural tube defects by up to 70%.
• Mistake: Waiting until you’re pregnant to ask. Solution: Start the conversation 3-6 months before trying to conceive. That’s when adjustments matter most.
• Mistake: Being embarrassed to talk about mental health meds or substance use. Solution: Your OB/GYN has heard it all. Honesty saves lives.

A 2022 survey by Colorado Women’s Health showed patients who prepared a full medication list had 40% better discussion quality and saved 15-20 minutes per visit. That’s time you can use to ask the real questions: “Can I still have a vaginal birth?” “Will this affect my milk supply?” “Is there a safer version?”

What’s Changing in 2026

The field is evolving fast. In 2023, ACOG updated its guidelines to include CBD and medical marijuana in routine screening. A new app from GW Medical Faculty Associates lets hypertensive pregnant women log blood pressure meds in real time-89% of users stick with it. And by mid-2024, ACOG plans to release a free patient checklist app to help you prepare for your visit.

Meanwhile, researchers are testing genetic tests (like CYP2D6) to predict how your body processes antidepressants. This isn’t sci-fi-it’s already being piloted in academic OB/GYN clinics. The goal? To match you with the safest, most effective drug based on your DNA.

One thing won’t change: the need for you to speak up. No one else knows your body like you do. No one else will ask you about your supplements, your stress, your sleep, or your cannabis use. That’s why your preparation matters.

Preparing for your OB/GYN visit isn’t about being perfect. It’s about being informed. You’re not just a patient-you’re the most important person in your reproductive care. Bring your list. Ask your questions. Push for clarity. Your future self-and your baby-will thank you.