ADHD Weekly, March 4, 2021

Many women plan to have a child at some point during their lives. For women who have ADHD, this planning includes considering the challenges of pregnancy and the complexities of ADHD.

There are many reasons women choose to become mothers; there are also many reasons women decide not to have or raise children. The choice to become a parent is deeply personal.

There are several things to be aware of before you make the decision to have children. Understanding the potential challenges for a woman with ADHD can help you make decisions that contribute to a more successful pregnancy.

More women taking ADHD medications

A 2018 study noted a dramatic increase in the percentage of young women who had a prescription filled between 2003-2015 for an ADHD medication:

• In 2015, the highest number of prescriptions filled were for women who were 20-24 years old (5.5 percent), followed by ones for teens 15-19 years old (5.4 percent), and women who were 25-29 (4 percent).
• From the number of prescriptions filled in 2003 to the number of prescriptions filled in 2015, the largest increase was among women 25-29 (700 percent).

When presenting these numbers, researchers specifically stated a public health concern regarding pregnancy and ADHD medications. Almost half of pregnancies in the United States are unplanned, and research into the possible effects on either a pregnancy or a developing baby is limited.

Medications and pregnancy

Lead researcher Kayla N. Anderson, PhD, says collecting and understanding these numbers is part of the CDC’s Treating for Two: Safer Medication Use in Pregnancy initiative. Medications for ADHD can increase the risk for pregnancy loss and harm to the developing baby, which are important health concerns for women who may become pregnant.

“We want to provide this information to the public, so women can take this information and feel empowered in making their healthcare decisions,” Dr. Anderson says. “This is a really important topic area. We consider it a public health question.”

Dr. Anderson says she hopes women will use this information to open important conversations with their prescribers about medication management and their family-planning goals. Just as importantly, she hopes the numbers will be useful in conversations about public health.

“For us, we’re really interest in providing information for the safety of these medication before and during pregnancy,” she says.

If you take medications to help manage your ADHD symptoms and you decide you want to become pregnant, talk with your doctor about preparing for pregnancy.

Reassurance for unplanned pregnancies

About 45 percent of pregnancies are unexpected. You might have become pregnant before stopping your medication. Should you be worried for your developing baby?

While medication for ADHD is not likely to cause immediate harm to a developing baby, it is something you should discuss with your healthcare provider. Research indicates stimulant medications in the early stages of pregnancy are unlikely to contribute towards birth defects. Continuing on medication once you know you are pregnant is not recommended.

While some ADHD medications may cause side effects or development concerns in pregnancy, many do not. Safety of these medications for developing babies is not well established, and the possibility of pregnancy loss is slightly increased over the average risks for most women. If you suspect you’re pregnant, make an appointment with your doctor right away to discuss your options and the best methods for you to continue treatment.

Options without medication

If you discontinue medication, your next step is to plan the behavior treatments and lifestyle supports that will continue your treatment during this time. There are many non-medication tools to use to build your skills and help you effectively manage ADHD symptoms. Among them are:

• Counseling. Working with a mental health practitioner can help you address the feelings you have about living with ADHD and learn new techniques and coping strategies.
• Coaching. A trained ADHD coach works collaboratively with clients by providing encouragement, feedback, and practical suggestions to address specific challenges.
• Exercise. Exercise can be an important adjunct treatment for individuals with ADHD, improving cognitive functions, boosting sleep quality and duration, and enhancing self-esteem—all important factors during pregnancy.

Always discuss any non-medication, herbal, or dietary options you might consider with your doctor; some preparations described as “natural” can be harmful to a developing baby.

More resources when considering pregnancy:

• ADHD Medication and Pregnancy
• ADHD, Pregnancy, and Prenatal Risk
• I’m Pregnant. Should I Still Take My Meds?
• Number of Women, Girls Filling ADHD Prescriptions Increases
• Researchers Consider Role of Maternal Diet in ADHD

Join the discussion: Are you planning a pregnancy or hoping to have children in the future? What suggestions have you received to manage ADHD symptoms during this time of life?