Doctors generally face risks themselves when prescribing medications during pregnancy, because they often prescribe them with a degree of uncertainty. This is because in the majority of cases there is insufficient evidence to definitely prove that a substance is completely safe or that substance 'X' will definitely cause problem 'Y'. This means that when a woman is unwell, or needs medications to treat a health condition, there tends to be elements of doubt attached to the complete safety of many prescribed medications. The bottom line is:
There is much we do not know.
There are some drugs that have been well researched, making decisions to use or avoid them easy to make. For a few drugs, their effects were so dramatic (and tragic) it was easy to draw logical conclusions. This was the case with 'isotretinion' (or accutane), a tablet used to treat acne. A report in 1984 on accutane described 35 pregnancies of women taking the medication during the first 12 weeks of pregnancy. Only 6 babies were born normally, while the remaining 29 babies had birth defects (15 live births and 14 miscarriages). Now, when this medication is prescribed to women, a pregnancy test is done beforehand and she is advised to use two forms of contraception while on the medication. The drug should also be stopped at least 3 months before trying to conceive a baby.
Some medications are prescribed commonly during pregnancy, with seemingly no affect on newborn babies. This leads caregivers to conclude that they are relatively safe. However, for many medications there is still uncertainty about their safety, or the potential risks to babies. This is because: