Not necessarily. The decision about whether to continue a medication during pregnancy depends on several factors such as the condition being treated, the severity of your symptoms, the type of medication you take, and the degree of risk to the fetus. Ultimately, it’s a decision you should make together with your provider based on what’s best for you and your pregnancy. And the ideal time to discuss it is before you become pregnant.
In some cases, it may make sense to continue your current regimen unless something changes during pregnancy. While the diabetes drug metformin (and generic) appears to pose little risk to the fetus, for example, uncontrolled blood sugar can increase your risk of birth defects, miscarriage, and stillbirth.
Sometimes switching to a different drug may be the best choice. In general, older drugs with a history of safe use during pregnancy are preferred to newer drugs that may be slightly more effective, but whose safety is uncertain. For example, older high blood pressure drugs such as labetalol (Trandate and generic) and methyldopa are preferred over newer ACE inhibitors such as enalapril (Vasotec and generic) and lisinopril (Prinivil, Zestril, and generic).
If there are no good alternatives or the risks are not well known, you should consider other options. You may be able to reduce your dose or discontinue the drug for the period during pregnancy when it is most likely to cause a problem—say, the first trimester. Or ask your provider if you can wean off certain medications before becoming pregnant. For example, if you take a drug for mild depression you might be able to substitute nondrug measures such as cognitive behavior therapy and increased physical activity. However, you need to be monitored closely and if symptoms return, it may be better for both you and your baby to treat them with medication. By themselves, poorly managed anxiety, depression, and other mental disorders have been linked to increased risks, including premature birth and low-birth weight.