With the many dilemmas doctors face, some will make decisions not to prescribe (especially if the woman's health condition is not urgent or life-threatening). They may take a cautious approach to 'avoid everything' to protect the baby (but occasionally their decision will be motivated by a desire to avoid litigation). This can be frustrating for the woman if she feels she needs to be treated or is not given the option of considering the risks herself. She may even feel unfairly treated if she is denied a medication like pain relief. This is where decisions can become difficult for everyone involved.
Medication categories for pregnancy
To help caregivers make decisions about what (if anything) they should prescribe to pregnant women, most prescribing medication books provide a worldwide 'pregnancy rating' for each medication. These are as follows:
Category A -
Controlled studies show no risk.
Adequate, well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester of pregnancy.
Category B -
No evidence of risk in humans
Adequate, well-controlled studies in pregnant women have not shown increased risk of fetal abnormalities despite adverse findings in animals or in the absence of adequate human studies, animal studies show no fetal risk. The chance of fetal harm is remote, but remains a possibility.
Category C -
Risk cannot be ruled out.
Adequate, well-controlled human studies are lacking, and animal studies have shown a risk to the fetus or are lacking as well. There is a chance of fetal harm if the drug is administered during pregnancy; but the potential benefits may outweigh the potential risks.
Category D -
Positive evidence of risk.