When you’re pregnant, every decision you make feels a little bigger. From what you eat to how you sleep or what medications you take, you’re constantly thinking about what’s best for your baby.
So if your health care provider says you need antibiotics, it’s only natural to pause and ask, “Are antibiotics safe during pregnancy?”
The short answer: Yes. Many antibiotics are safe. Used correctly, they can protect both you and your baby.
We spoke with Stephanie Amaya, MD, an OBGYN with Banner - University Medicine, to learn about when antibiotics are used, which ones are safest and how to take them wisely.
Are antibiotics safe during pregnancy?
“Yes, antibiotics are generally safe in pregnancy,” Dr. Amaya said. “They are always used for C-sections and for many people during vaginal birth.”
Antibiotics fight bacterial infections and are often essential to prevent more serious health problems. Still, Dr. Amaya noted that safety depends on several factors.
“Like any medication, safety factors include when you take the antibiotic during your pregnancy, how long you take it and the strength or dose,” she said.
Your health care provider will carefully consider these factors before prescribing anything, choosing the safest and most effective option for your stage of pregnancy.
When would I need an antibiotic during pregnancy?
Because your immune system shifts during pregnancy, you may be more likely to get certain bacterial infections. Some are minor but others can be serious if left untreated.
“If left untreated, these conditions are associated with significant maternal and fetal morbidity, including kidney infections, preterm birth and low birth weight,” Dr. Amaya said.
Antibiotics work to rid the body of bacteria that may not normally live there. They may also reduce your baby’s risk of infection during childbirth.
Common infections treated with antibiotics in pregnancy
Here are some common reasons antibiotics might be prescribed during pregnancy:
- Urinary tract infections (UTIs): UTIs are common in pregnancy. They can cause pain or burning when you pee. If untreated, they can spread to your kidneys and trigger preterm labor.
- Group B strep (GBS): About 1 in 4 pregnant women carry this bacterium. It can cause severe problems for the baby, including bloodstream infections, pneumonia and meningitis. You’ll be tested in your third trimester and if you test positive, you’ll receive antibiotics during labor to keep your baby safe.
- Kidney infections: These can be serious and may require hospital care.
- Sexually transmitted infections (STIs): Certain bacterial infections, like chlamydia or syphilis, need antibiotic treatment to prevent harm to your baby.
- Skin or surgical site infections: If bacteria enter through your skin or during surgery, antibiotics can help prevent the infection from spreading.
What research says about antibiotic safety
It’s normal to worry about taking medications during pregnancy but the data proving antibiotics’ safety is reassuring.
“Large studies have found no increased risk of major congenital malformations (birth defects) with first-trimester exposure to most commonly prescribed antibiotics,” Dr. Amaya said. “Antibiotic use during pregnancy is justified when it is clinically indicated and when selecting those antibiotics that have established safety profiles.”
When used properly, antibiotics are an important tool for keeping you and your baby healthy.
Antibiotics that are safe to take during pregnancy
Some antibiotics have long records of safety in pregnancy.
Commonly used safe antibiotics include:
- Penicillin
- Amoxicillin
- Cephalosporins
- Ciprofloxacin
- Levofloxacin
- Vancomycin
- Clindamycin
- Metronidazole
“These antibiotics have been studied extensively and are not linked to birth defects or major pregnancy complications when used as directed,” Dr. Amaya said.
That said, even safe medications should be used only when truly needed. Your provider will weigh the risks and benefits before prescribing anything.
Antibiotics to avoid during pregnancy
Not all antibiotics are safe in pregnancy. Some can affect a baby’s bone and tooth development or cause other complications.
“Tetracyclines should be avoided because they can affect bone growth and cause tooth discoloration in the fetus,” Dr. Amaya said. “Nitrofurantoin should be avoided in the first trimester but is generally safe in the second or third trimesters.”
Other antibiotics that are often avoided include aminoglycosides (such as streptomycin) and certain sulfonamide drugs. These may be used only when no safer alternatives exist and the infection is severe.
Your provider’s goal is to protect both you and your baby. Never take leftover antibiotics or start a new prescription without checking with your health care provider first.
When antibiotics are not needed
Antibiotics only work against bacterial infections, not viral ones.
If you have a cold, the flu or COVID-19, antibiotics won’t make you feel better or shorten the duration of your illness. Taking antibiotics when you don’t need them can actually be harmful. It can lead to antibiotic resistance, which makes infections harder to treat in the future. It can also upset your gut and vaginal microbiome and lead to side effects such as yeast infections.
If you’re unsure whether you need antibiotics, talk to your provider. They can help you understand what’s causing your symptoms and recommend the safest treatment.
How to take antibiotics safely during pregnancy
If your provider prescribes antibiotics, follow their instructions closely. Here are some tips:
- Take the full course: Even if you start to feel better, finish all doses. Stopping early can allow the infection to return or become resistant.
- Follow directions: Some antibiotics should be taken with food, while others should be taken on an empty stomach. Read the label carefully. Ask your pharmacist if you have questions.
- Watch for side effects: Mild nausea or loose stools can happen. If you develop a rash, itching or swelling, contact your provider right away.
- Ask about probiotics: Antibiotics don’t just kill harmful bacteria. They can also affect the helpful bacteria that support digestion, vaginal health and immunity. This can lead to mild side effects, such as loose stools, nausea, or yeast infections. Your provider may suggest probiotics to help restore balance in your gut.
- Stay hydrated: Water helps your body process medication and flush out bacteria.
What if I took antibiotics before I knew I was pregnant?
If you took antibiotics before realizing you were pregnant, don’t panic. Most antibiotics prescribed for common infections are considered safe.
Still, as with any medication, tell your provider what you took and when. They can review your medical history, reassure you and determine if any follow-up is needed. In most cases, brief exposure to antibiotics early in pregnancy does not cause harm.
Questions to ask your health care provider
If your provider recommends antibiotics during pregnancy, it’s always okay to ask questions. Here are a few that can help you feel confident about your care:
- Is this antibiotic safe for my stage of pregnancy?
- What are the possible side effects?
- Should I take it with food?
- Are there any foods, drinks or supplements I should avoid?
- What should I do if I miss a dose?
- Do I need to take a probiotic afterward?
Takeaway
Antibiotics can be a safe and important part of a healthy pregnancy. They treat infections that, if ignored, could cause harm to both you and the baby.
If you think you may have an infection or have questions about antibiotics while pregnant, talk to your provider or a Banner Health specialist. They’ll help you understand your options and make the safest choice for you and your growing baby.
