Routine Drugs in Pregnancy

Author: Amrutha Balagopal, PhD, Biotechnology

Medical Reviewer: Azuka Chinweokwu Ezeike, MBBS, FWACS, FMCOG, MSc (PH)

Highlights

•  Ensuring a healthy foundation for your pregnancy is essential
• Routine medications support the proper growth and development of your baby while minimising complications
• Folic acid, iron, calcium are key prenatal vitamins
• Side effects are usually mild and can be managed under proper guidance
• Taking medications under medical supervision is vital to keep you and your baby safe.

Introduction

While pregnancy is a life-changing phase for every woman, it is often accompanied by numerous queries, especially in terms of medications. “Will folic acid and other supplements adversely affect my baby?” or “Do I really need those extra vitamins if I’m eating healthy?” are some of the common concerns among pregnant women. Thankfully, routine medications prescribed during pregnancy are generally safe and recommended for a healthy pregnancy to keep you well and ensure the best for your baby.

The term “routine drugs” means medications that are taken regularly at the same time and through the same route for a particular period. Unlike the prescribed medications used to treat a medical condition, these drugs are given to prevent deficiencies, enhance the health of both the mother and the baby, and mitigate any associated risks. During pregnancy, your body serves more than one person with limited resources and fuel. That’s precisely why you need extra care and nutrition to stay healthy and strong.

This article will guide you through the routine medications taken during pregnancy, their importance, recommended dosages, and possible side effects. You will also understand why medical supervision is essential, allowing you to have a clutter-free mind and truly enjoy the beautiful phase of motherhood.

Why take routine drugs in pregnancy?

When your body works harder to serve both you and your baby, even a balanced diet and healthy lifestyle can sometimes fail to meet the nutritional requirements during pregnancy [1]. This is where routine pregnancy medications, primarily vitamins, minerals, and supplements, come into play. Prenatal supplements or vitamins include:

• Folic acid
• Iron
• Calcium

These supplements act as an extra layer of nutrition/protection for you and the baby. 

Essentially, routine medications:

• Lower risk of pregnancy complications
• Reduce anaemia and fatigue
• Prevent or reduce the risk of birth defects
• Support bone and teeth health [2]

These drugs should be an essential aspect of prenatal care, as they give a stronger and healthier foundation for your pregnancy. Medical supervision is always advised to make sure you receive the best care possible.You can now confidently tell your pregnant friend or relative that routine medications in pregnancy are beneficial, or won’t you? 

Essential Routine Drugs in Pregnancy

Folic Acid

Folic acid is a type of vitamin B (folate) that helps in the development of the neural tube (a structure in the developing baby), which takes place within the first 28 days after conception. The brain and spinal cord develop from the neural tube. When the neural tube fails to close completely, it can result in abnormalities known as neural tube defects. Some of the common defects include:

• Spina bifida (a condition where there is a gap in the spine, causing nerve damage)
• Encephalocele (where brain tissue grows through an opening in the skull)
• Anencephaly (a condition in which a baby is born without parts of the brain and skull)

Make sure to include legumes, eggs, and leafy greens in your diet, as they are good sources of folic acid. The World Health Organization (WHO) recommends that women take 0.4 milligrams of folic acid daily, starting from the time they are trying to conceive until the end of the first trimester.

Iron

It is an essential micronutrient with numerous functions in the body, including oxygen transport and enzyme activity. Haemoglobin helps transport oxygen in the body, and that is why you need iron, especially during pregnancy. 

Iron primarily helps in haemoglobin production. It also helps in the development of the brain, and builds up reserves for the first few months after birth. Insufficient levels of iron cause:

• Anaemia
• Premature birth
• Low birth weight
• Increased rates of cesarean delivery
• Postpartum complications such as haemorrhage (bleeding) [3]. 

Remember, you can avoid anaemia and associated side effects by getting an average of 30-60 milligrams of elemental iron daily. It is commonly given in the form of:

•  Ferrous sulfate heptahydrate
•  Ferrous fumarate 
•  Ferrous gluconate

Seafood, lean meat, nuts, and raisins contain good amounts of iron.

Calcium

It is the most abundant mineral in our body and has important roles in bone and teeth development, blood clotting, and muscle contraction. Babies are born with around 300 bones. This is why mothers need additional amounts of calcium during pregnancy, as the baby draws all the calcium for growth directly from their mothers. 

Women develop complications such as pre-eclampsia and eclampsia, leading to maternal deaths, and osteoporosis at later stages in life due to low levels of calcium.  Research has shown that calcium supplementation during pregnancy improves maternal and infant bone health while preventing preeclampsia and preterm births [4]. 

Calcium is absorbed from your diet and supplements with the help of vitamin D, and calcium requirements vary from person to person. The World Health Organization (WHO) recommends 1500-2000 milligrams of calcium every day throughout pregnancy (in populations with low dietary calcium intake), and even while breastfeeding. Foods rich in calcium include milk, yoghurt, cheese, and broccoli. 

Intermittent Preventive Treatment for Malaria

Malaria is common in some countries, such as tropical and sub-tropical regions of Africa, parts of the Americas, and Asia. As pregnant women are more prone to infections, you must take the necessary precautions. Malarial infection during pregnancy can lead to complications such as miscarriage, stillbirth, preterm birth, maternal anaemia, and death.

Key malaria prevention programmes by the WHO, along with insecticide-treated nets (ITNs) and Indoor residual spray (IRS), help prevent malaria and protect future generations [5]. WHO recommends administration of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) to reduce the disease burden. This is given in at least 3 doses, 4 weeks apart, starting from the second trimester

Routine Vaccines

Some vaccines are recommended in pregnancy to protect the baby.  The most common is the tetanus toxoid vaccine. The WHO recommends tetanus toxoid vaccination for all pregnant women, depending on previous tetanus vaccination exposure, to prevent tetanus in the newborn.

Vitamin C and Vitamin D are not routinely recommended in pregnancy, unless under special circumstances.

Are the side effects of routine pregnancy drugs common?

These medications are generally safe and well-tolerated, but occasionally they may cause some side effects.The common side effects include:

• Nausea and vomiting
• Digestive problems - Iron can sometimes cause stomach cramps and constipation. You could experience bloating and gas, too
• Sore teeth and gums and teeth staining
• Dark stool

To help avoid side effects from routine pregnancy medications and supplements, always follow the dosage instructions given by your healthcare provider and consult them before making any changes. Self-medication has never helped anyone and, in turn, can adversely affect our health.

Conclusion

Pregnancy is one of the most fulfilling journeys in life.. It is natural to have concerns about the medications you need to take, but they are important to give both your body and your baby the support they need. Though side effects can occassionally occur with these medications, they can be managed under the guidance of your healthcare provider. Remember, these routine medications offer you the best possible health foundation so that you and your baby can see a beautiful tomorrow together.

Frequently Asked Questions (FAQs)

1.   Does folic acid pose any risks or side effects?

Excess amounts can lead to mild side effects such as nausea or loss of appetite. Severe allergic reactions such as hives, itching, swelling of the face and lips can rarely occur. If you notice any of these symptoms or experience trouble breathing, reach out to your medical team immediately. 

2.  Are these routine medications going to be the same for all pregnant women?

Yes, routine medications are the same and considered essential for a healthy pregnancy, as recommended by the WHO. The dosage may, however, vary from person to person depending on your stage of pregnancy, diet, and overall health.

3.   Will these routine medications make me gain weight?

No. There is no evidence that these medications cause weight gain. The weight gain during pregnancy is mainly due to hormonal changes and increased appetite, not the supplements.

References

1.  Mousa A, Naqash A, Lim S. Macronutrient and Micronutrient Intake during Pregnancy: An Overview of Recent Evidence. Nutrients. 2019; 11(2):443. https://pubmed.ncbi.nlm.nih.gov/30791647/ 

2.  Wanjari MB, Late SV, Sharma R, Munjewar PK. A critical evaluation of prenatal supplements: Are they meeting the mark? J Family Med Prim Care. 2023; 12(12):3048–54. https://pubmed.ncbi.nlm.nih.gov/38361856/ 

3.  Benson AE, Shatzel JJ, Ryan KS, Hedges MA, Martens K, Aslan JE, et al. The incidence, complications, and treatment of iron deficiency in pregnancy. Eur J Haematol. 2022; 109(6):633–42. https://pubmed.ncbi.nlm.nih.gov/36153674/ 

4.  Kumar A, Kaur S. Calcium: A Nutrient in Pregnancy. J Obstet Gynaecol India [Internet]. 2017 [cited 2025 Sep 26]; 67(5):313–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561751/. 

 5.  Minwuyelet A, Yewhalaw D, Siferih M, Atenafu G. Current update on malaria in pregnancy: a systematic review. Tropical Diseases, Travel Medicine and Vaccines [Internet]. 2025 [cited 2025 Sep 26]; 11(1):14. Available from: https://pubmed.ncbi.nlm.nih.gov/40399982/.

Disclaimer:
The information provided on this website is for general educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Published September 30, 2025