Can You Take Ativan (Lorazepam) While Pregnant?

Using Ativan in late-term pregnancy can increase a baby’s risk of side effects, but there are many alternatives pregnant women can use to safely manage anxiety.

Lorazepam and Pregnancy

Almost 19% of pregnant women suffer from a mental health disorder like depression, bipolar disorder or anxiety. Before they became pregnant, they may have used a prescription medication to treat their mental health disorder. However, some women hesitate to take these medications during pregnancy due to the potential risks involved.

Anxiety treatments may include Ativan, the brand name of the benzodiazepine lorazepam. Ativan is FDA-approved to treat patients with acute anxiety disorders. However, women with anxiety disorders who are currently pregnant or planning to be should speak with their doctor to weigh the benefits and risks of taking Ativan during pregnancy.

Do you or someone you love have questions or concerns about pregnancy and don’t know where to turn for help? Get support and answers from the American Pregnancy Association at 1-800-672-2296.

What We Know About Maternal Use of Benzodiazepines

Benzodiazepines like Ativan used to be classified as Category D drugs by the U.S. Food and Drug Administration (FDA). This meant there was evidence that these drugs could be risky for an unborn baby. The Category D rating stemmed from older studies that seemed to show an increase in fetal malformations like cleft palate when mothers used benzodiazepines during pregnancy.

In 2014, the FDA reformed the pregnancy rating system and removed the old pregnancy categories. Around the same time, more studies were being done on how benzodiazepines impacted pregnant women. Newer studies indicate that there is not a clear link between benzodiazepine use and the risk of fetal malformations. In addition, the Centers for Disease Control and Prevention (CDC) noted that even if there is an increased risk for fetal malformations, it may not be due to a benzodiazepine. Instead, it may be due to the mother’s medical condition that the benzodiazepine is prescribed to treat.

However, benzodiazepines like Ativan can still pose risks to an unborn baby.

Effects of Ativan Use on the Unborn Baby

When a pregnant woman takes Ativan, the fetus may be at risk for side effects, especially if the benzodiazepine is taken during the late third trimester. Babies born shortly after the mother has taken a benzodiazepine have had symptoms like:

• Sedation
• Slowed breathing
• Withdrawal
• Problems feeding

Old studies concluded that benzodiazepines like Ativan were linked to malformations like cleft lip and palate. Based on newer evidence, however, the data supporting this is no longer clear. As a result, neither the CDC nor the Ativan package labeling mentions cleft lip or palate.

Babies Born Addicted to Ativan

Babies who are born addicted to benzodiazepines like Ativan can have symptoms that interfere with their development, including:

• Drowsiness
• Absent reflexes
• Problems suckling

Symptoms of Benzo Withdrawal and Toxicity in Newborns

When a baby exposed to benzos during pregnancy is no longer getting the drug, they can go into withdrawal. This is especially true of babies with long-term exposure to benzos, and it can even occur in those exposed to the drug while the mother is in labor. Benzo withdrawal symptoms in a newborn include:

• Vomiting
• Jitteriness
• Tremors
• Being easily startled
• Crying

These symptoms can occur shortly after birth and last up to several weeks in some cases.

Alternatives To Taking Ativan While Pregnant

Pregnant women with anxiety disorders may see their symptoms intensify during pregnancy. Alternatives to Ativan treatment that can offer some relief to pregnant women may include clinical and recreational therapy, such as cognitive behavioral therapy, yoga, meditation, aromatherapy and massage.

When choosing an alternative anxiety medication, it’s important to find one that is effective and has a good safety profile. Pregnant women with anxiety can talk to their doctors about antidepressants like selective serotonin reuptake inhibitors (SSRIs), which can be an alternative to Ativan during pregnancy.

The safest route is to stop taking benzodiazepines, but this is sometimes not an option. Additionally, pregnant women who use Ativan should not abruptly stop — quitting cold turkey could result in severe withdrawal symptoms. It is also important for women with anxiety disorders to be monitored throughout their pregnancy, whether they are taking medications or not.

Finding Help for Ativan Use While Pregnant

Do you or someone you love have questions or concerns about pregnancy and don’t know where to turn for help? Get support and answers from the American Pregnancy Association at 1-800-672-2296.

Deciding whether to stop taking Ativan during pregnancy depends on many unique factors, so it’s important for pregnant women to discuss their options with their doctor. This conversation should ideally occur before conception, but if that’s not the case, the mother should contact her physician as soon as possible. The earlier a plan is created to keep the mother and baby healthy, the better.

If you or someone you love is struggling with Ativan use and anxiety, The Recovery Village is here to help. Contact us today to learn more about individualized treatment options that can work well for you and your needs.

Editor – Jonathan Strum

Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more