Being pregnant is a confusing maze of medical mysteries. Dealing with routine medical issues like a mild illness or even a headache can become it’s own byzantine snarl of conflicting medical advice. Even a box of herbal tea comes with a warning label: Consult your doctor before using if you are pregnant or breastfeeding.

This isn’t because everything under the sun is part of a vast conspiracy to harm you and your unborn baby. It’s because no one really knows whether the vast majority of foods, drugs and supplements are safe for pregnant women. Not even your doctor.

That’s because there’s been very little medical testing done on pregnant women. For probably obvious reasons. The New England Journal of Medicine is arguing that it’s time for a change.

Calling pregnant women “therapeutic orphans”, the study authors make a strong case for including pregnant women in medical trials:

Therapeutic options for pregnant women should be informed by scientifically rigorous data on the efficacy and safety of each medication, just as they are for nonpregnant patients. Without data to guide risk–benefit assessments and prescribing information, some physicians are reluctant to recommend medications to their pregnant patients, who, in turn, are hesitant to take even necessary medications. The failure to properly treat a pregnant woman’s condition can negatively affect not only her well-being, but also that of her fetus. Ironically, the effort to protect the fetus from research-related risks by excluding pregnant women from research places both women and their fetuses at greater risk from unstudied clinical interventions and may also result in a dearth of therapeutic options specifically developed for pregnant women.

As it stands, very few medications have ever been tested on pregnant women. Your doctor is not a whole lot better informed than you are about what a given drug will do to you or your unborn baby. Once you get into those boxes of herbal tea and supplements, forget it. You’re both flying blind.

Or at least, without the benefit of rigorous clinical trials.

As beneficial as it would be to have pregnant participants in human trials of new medicines, I have a hard time imagining volunteering for such a trial while being pregnant. Not only does it seem like an unnecessary risk to my personal self and baby, but it seems like a lot of work for my hormone-addled brain and body.

Of course, as scary as being a trial subject seems, it probably beats the alternative. In the absence of controlled trials, each pregnant woman becomes a lab rat in a large, uncontrolled experiment as soon as she takes a medication that hasn’t been tested on pregnant women. Pregnant women have medical concerns and needs just like everyone else.

What about you? Would you participate in a clinical trial for a new drug while pregnant? Do you wish other people would so you’d have more information about your own medical care?

Photo: Pink Sherbert Photography

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