Drugs, Medication and Birth Defects in Grand Rapids, MI

A teratogen is any substance that interferes with the normal development of a fetus and can increase the risk of birth defects. While medical science has identified many medications and drugs that can be harmful in pregnancy, it is not always possible to predict exactly how exposure will affect an individual fetus.

In Grand Rapids, where many families receive prenatal care through Spectrum Health, Trinity Health Grand Rapids, Metro Health, Mercy Health, and local OB/GYN clinics, it is important to understand how medications and other substances may impact pregnancy and where to go for local support.

Understanding Birth Defects and Baseline Risk

The risk of a birth defect for any baby is about 4% (4 in 100), even when a pregnant person:

  • Avoids alcohol and illegal drugs
  • Uses no medications or only those known to be safe
  • Has a healthy diet and normal pregnancy

This means that birth defects can occur even when a woman does everything “right.” Medications and drugs are only one of many factors that can influence fetal development, along with:

  • Maternal health (e.g., diabetes, high blood pressure, infections)
  • Nutrition and vitamin levels (e.g., folic acid)
  • Genetic factors
  • Environmental exposures (e.g., some chemicals, radiation)

In Michigan, seasonal factors such as long, cold winters can also affect health—respiratory infections, asthma flare-ups, and depression can become more common, sometimes requiring medication during pregnancy.

Teratogenic Drugs and Birth Defects

A teratogenic drug is one that is known to increase the risk of birth defects when taken during pregnancy. The risk depends on:

  • Type of drug
  • Dose (how much you take)
  • Frequency (how often you take it)
  • Gestational age (stage of pregnancy when exposure occurs)
  • Individual response of the fetus

Some medications and substances known or strongly suspected to cause birth defects or serious fetal harm include:

  • ACE (angiotensin converting enzyme) inhibitors
  • Angiotensin II receptor blockers (ARBs)
  • Isotretinoin (a powerful acne medication)
  • Alcohol
  • Cocaine
  • High doses of vitamin A (especially in supplement form, not from food)
  • Lithium
  • Male hormones (androgens)
  • Some antibiotics
  • Some anticonvulsant (anti-seizure) medications
  • Some cancer-fighting (chemotherapy) medications
  • Some drugs that treat rheumatic or autoimmune conditions
  • Some thyroid medications (in high or inappropriate doses)
  • Thalidomide
  • Warfarin (a blood-thinning medication)

Important: Never stop or change a prescription medication on your own. In Grand Rapids, always speak with your OB/GYN, primary care provider, or a pharmacist at Spectrum Health, Trinity Health Grand Rapids, Metro Health, Mercy Health, or a local community pharmacy before making any changes.

Illegal Drugs and Pregnancy

The teratogenic effects of some illegal drugs (such as cannabis and amphetamines) are not fully understood because high-quality medical studies are limited. However, risks may include:

  • Poor fetal growth
  • Premature birth
  • Behavioral and learning problems later in childhood
  • Increased risk of pregnancy complications

If you use illegal drugs or misuse prescription medications, you can get confidential help in the Grand Rapids area through:

  • Kent County Health Department – substance use and maternal health programs
  • Local hospital-based addiction services (e.g., through Spectrum Health or Trinity Health)
  • Community mental health and addiction treatment centers

Pregnancy Risk Categories for Medications

In the United States, medications used during pregnancy are assigned risk categories based on available safety data. Traditionally, these have been labeled:

  • A, B, B1, B2, B3, C, D, X

While the FDA is moving toward more detailed labeling, you may still see these categories in older materials. In general:

  • Category A

    • Taken by a large number of pregnant women
    • No proven increase in birth defects

  • Category B (B1, B2)

    • Limited use in pregnant women
    • Animal studies have not shown increased risk (B1/B2) or data are limited

  • Category B3

    • Limited human data
    • Animal studies show some risk, but it is unclear if this applies to humans

  • Category C

    • May cause harm to the fetus due to their effects, but not necessarily birth defects
    • Effects may sometimes be reversible
    • Potential benefit may outweigh potential risk

  • Category D

    • Have caused, or are suspected to cause, birth defects
    • May still be used if the health benefit to the mother is considered greater than the risk to the fetus (for example, in serious illness)

  • Category X

    • High risk of birth defects
    • Should not be used during pregnancy

This classification applies only to recommended doses. Higher or inappropriate doses can greatly increase risk.

Your doctor or pharmacist in Grand Rapids can explain what category your medication falls into and what that means for your pregnancy.

When Medications Are Necessary During Pregnancy

About 8% of pregnant women need to take ongoing medication for existing health conditions. In West Michigan, common chronic conditions that may require medication include:

  • Epilepsy (seizure disorders)
  • High blood pressure (hypertension)
  • Diabetes (type 1, type 2, or gestational)
  • Thyroid disorders
  • Asthma and other lung diseases
  • Autoimmune or rheumatic conditions

Acute illnesses and pregnancy complications may also require medication, such as:

  • Respiratory infections (e.g., pneumonia, which is more common in cold Michigan winters)
  • Urinary tract infections
  • Pre-eclampsia and other pregnancy-related conditions

Why Stopping Medication Can Be Dangerous

Avoiding needed prescription drugs can be harmful for both mother and baby. For example:

  • Asthma

    • Stopping asthma medications can reduce oxygen levels in the mother’s blood
    • This can slow the growth of the unborn baby and increase the risk of complications

  • Epilepsy

    • Stopping anti-epileptic medications can lead to more frequent or severe seizures
    • Seizures can cause injury, miscarriage, or other complications for both mother and fetus

  • Diabetes

    • Poorly controlled maternal diabetes greatly increases the risk of birth defects, large birth weight, stillbirth, and complications at delivery
    • Proper treatment with insulin or other prescribed drugs is critical

Without appropriate treatment, the health and welfare of both the mother and her unborn baby may be at increased risk. In Grand Rapids, high-risk pregnancies are often co-managed by maternal-fetal medicine specialists at major hospitals such as Spectrum Health and Trinity Health Grand Rapids.

General Recommendations for Medication Use in Pregnancy

Talk to Your Grand Rapids Healthcare Provider

Always be guided by your doctor, midwife, or obstetrician. General recommendations include:

  • Provide a complete list of all substances you use, including:

    • Prescription medications
    • Over-the-counter (OTC) medicines (cold and flu remedies are common in Michigan winters)
    • Vitamins and nutrition supplements
    • Herbal and complementary therapies (e.g., herbal teas, supplements, CBD products)

  • Be honest about lifestyle substances, including:

    • Tobacco or vaping
    • Alcohol (including occasional or social drinking)
    • Illegal drugs or misuse of prescription medications

Non-prescription drugs and complementary medicines can also be harmful to the unborn baby. “Natural” does not always mean “safe in pregnancy.”

Do Not Stop Long-Term Medications on Your Own

If you take medication for a chronic illness:

  • Do not stop or change the dose without talking to your doctor
  • If you are concerned about your medication in pregnancy, ask whether:
    • A safer alternative is available
    • The dose can be adjusted
    • Extra monitoring (blood tests, ultrasounds) is recommended

In Grand Rapids, you can discuss this with:

  • Your primary care doctor or OB/GYN
  • A maternal-fetal medicine specialist (high-risk pregnancy specialist)
  • A pharmacist at any hospital or community pharmacy

Folic Acid and Preventing Neural Tube Defects

Folic acid is a B-vitamin known to reduce the risk of neural tube defects (such as spina bifida) in the developing baby.

General recommendations:

  • Start folic acid supplements before conception, if possible
  • Continue through at least the first trimester (first 12 weeks)
  • Follow the dose recommended by your doctor or midwife

This is especially important in Michigan, where many pregnancies are unplanned and where winter diets may be lower in fresh produce. Your Grand Rapids provider can help you choose the right prenatal vitamin.

Local Resources in Grand Rapids, MI

If you are pregnant or planning a pregnancy in the Grand Rapids area and have questions about medications or drugs, you can seek help from:

  • Your GP / Primary Care Provider
  • Midwife or Obstetrician (OB/GYN)
  • Hospital-based prenatal clinics at:
    • Spectrum Health
    • Trinity Health Grand Rapids
    • Metro Health
    • Mercy Health
  • Pharmacists at local pharmacies (Meijer, Walgreens, CVS, hospital pharmacies, independent pharmacies)

For help with alcohol or drug use during pregnancy:

  • Kent County Health Department – maternal and child health, substance use resources
  • Grand Rapids Public Health / local community health centers
  • Local drug and alcohol counseling services and mental health providers
  • Hospital-based addiction treatment programs

Many of these services offer confidential counseling, support groups, and referrals tailored to pregnant women and families in West Michigan.

Key Points to Remember

  • Certain drugs, including some prescription medications, alcohol, and illegal drugs, are known to cause birth defects if taken during pregnancy.
  • The baseline risk of a birth defect is about 4% for any pregnancy, even when no drugs are used.
  • Risk depends on the type of drug, dose, frequency, timing in pregnancy, and individual fetal sensitivity.
  • Some medications have not shown increased risk in animal studies, and human use suggests they are relatively safe.
  • For some drugs, animal studies show risk, but it is not clear if this applies to humans.
  • Some medications with known risks may still be used when the benefit to the mother outweighs the risk to the fetus.
  • Stopping necessary medications without medical advice can be dangerous for both mother and baby.
  • Always discuss any medication, supplement, or drug use with your Grand Rapids healthcare provider before and during pregnancy.

If you live in the Grand Rapids, MI area and are pregnant, planning to become pregnant, or concerned about a medication you’re taking, schedule an appointment with your local OB/GYN, primary care physician, or midwife to review your medications and create a safe treatment plan for you and your baby.