Medication use during pregnancy and lactation: an urgent call for public health action.

Questions about medication use during pregnancy and lactation are a concern for women and healthcare providers. Unfortunately, there is little experience with the use of most medications in human pregnancy and lactation at the time they are marketed. Even when information is available, it may not be readily accessible to women and healthcare providers. Nevertheless, medication use by pregnant and breastfeeding women may be beneficial, and even essential, to ensure the health of both mother and child. In addition, almost half of pregnancies in the United States each year are unintended, and medication exposures may occur in the early weeks of gestation before a pregnancy is recognized. For these reasons, it is critical that up-to-date information about the effects of medication use during pregnancy and lactation and the management of maternal conditions be available to women and healthcare providers. A comprehensive, coordinated public health approach that builds on and expands existing activities is needed to generate information about medication use, make that information readily available, and translate it into safe and effective healthcare. Critical components of this system include a central source of up-to-date information, further development and coordination of monitoring and research activities, the availability of counseling services throughout the country, development of standard communication messages, and a panel of experts to provide oversight. This will require collaborative support from government agencies, nonprofit organizations, academic and public health professionals, and healthcare providers to ensure safe and beneficial use of medications during pregnancy and lactation.