The Challenges of Medication Use During Pregnancy in the Context of Reduced Medical Research Funding

Pregnant women often face complex decisions regarding medication use, as many drugs lack comprehensive safety data for this specific population. A recent controversy stemming from a 2025 FDA panel highlighted doubts about the safety of common antidepressants during pregnancy, exposing the broader issue of limited research in this field. Despite the fact that in the U.S., most pregnant women—over 90%—take at least one medication, a significant number of these drugs are not thoroughly studied for safety during pregnancy. Approximately 20% of women use medications with preliminary evidence of potential harm but without conclusive data, increasing uncertainty for healthcare providers and patients.

Researchers specializing in maternal and child health are working to evaluate medication safety, identifying drugs that may pose risks such as birth defects or pregnancy loss. Progress in understanding medication effects has been slow, primarily due to the underfunding of research efforts. Current monitoring systems and databases are vital, but they are endangered by ongoing reductions in research funding, which hinder the ability to generate new evidence and update safety profiles.

Historical events, like the thalidomide tragedy of the 1960s, led to decades of excluding women of childbearing age from early clinical trials. This protective stance, combined with ethical and legal hurdles, has contributed to a lack of human data on drug safety during pregnancy. Most drug approvals are based on animal studies that often do not accurately predict human outcomes. Consequently, the safety of many new medications remains unknown for pregnant women, forcing them and their healthcare providers to make choices without solid evidence.

Between 2010 and 2019, about 90% of FDA-approved drugs contained no human data concerning pregnancy risks. Many medications lack enough evidence to assess their safety, with estimates suggesting it takes more than two decades to establish reliable safety profiles. As a result, many pregnant women discontinue necessary treatments out of concern for fetal harm, which can adversely affect both mother and child. For example, stopping seizure medications—despite their known risks—may increase the likelihood of fetal death due to uncontrolled seizures.

Discontinuing treatments for depression, high blood pressure, and other conditions also poses dangers, including increased risks of preeclampsia, placental abruption, preterm birth, and fetal growth restrictions. Conversely, untreated health issues in the mother can lead to worse outcomes. Moreover, stopping antidepressants can heighten the risk of maternal depression relapse, affecting fetal development and increasing substance use or inadequate prenatal care.

In addition to clinical challenges, pregnancy registries for tracking medication outcomes are often limited by small sample sizes and lack of comparative data, further complicating evidence collection. Post-Dobbs v. Jackson Supreme Court decision, privacy concerns and legal risks make women even more hesitant to share pregnancy or medication-related information, further hindering data collection.

Funding for research into medication safety during pregnancy is critically insufficient. Although initiatives by federal agencies like NIH and CDC exist, overall research funding has stagnated or decreased, delaying progress in understanding drug effects. Expanding and funding more comprehensive studies are essential for making evidence-based recommendations for medication use in pregnancy.

Ongoing reductions in research investments threaten to slow advances needed to prevent adverse pregnancy outcomes like stillbirths, infant mortality, and maternal deaths. Ensuring dedicated funding to maternal health and medication safety research is vital to foster informed medical decisions, optimize maternal and fetal health outcomes, and address longstanding gaps in knowledge.

[Source: https://medicalxpress.com/news/2025-08-pregnant-women-tough-choices-medication.html]