Is Botox Safe During Pregnancy?

Obstetricians advise against cosmetic procedures during pregnancy.


Jan. 10, 2008 — -- Most mothers-to-be already know the basic dos and don'ts of pregnancy: Get plenty of rest, no smoking and no drinking — but what about cosmetic procedures like Botox?

Despite little research to determine what, if any, effect wrinkle-eraser Botox could have on pregnant women and their unborn children, obstetricians and cosmetic surgeons overwhelmingly told that they would not advise their pregnant patients to get injections of the popular drug.

"I can't tell you it's not safe, but I can tell you it's not advisable," said Donnica Moore, the president of Sapphire Women's Health Group based in New Jersey. "In pregnancy our general premise is that any type of medical treatment or intervention that justifies the risks … is OK to use, but there is no medical justification for Botox cosmetic in pregnancy."

The lack of research surrounding the use of Botox during pregnancy should be a deterrent, said Moore, an obstetrician, who said she would never advise one of her patients to get Botox.

"As long as the evidence is conflicting or confusing, we should err on the side of not doing whatever the intervention is," said Moore.

And as for women who get Botox before they become pregnant, there is no way of knowing whether there will be any long-term effects on the unborn child, according to Moore.

"If this is something [a pregnant woman] did before she was pregnant, there's nothing that she can do about it now," Moore told "And as I said, we don't know of any definite risks."

Botox is the trade name for botulinum toxin A, one of the toxins produced by the botulism bacteria that causes food poisoning. The compound is safe when injected beneath the skin and it works by weakening or paralyzing muscles or blocking nerves, thus causing wrinkles and lines to be less visible.

The effects last about three to four months. But according to the Food and Drug Administration, side effects can include pain at the injection site, flulike symptoms, headache and upset stomach.

Part of the reason there is so little research about cosmetic procedures during pregnancy is that in order to weigh the effects of the process, doctors and scientists would have to actually perform the procedures on pregnant women, said Roxanne Guy, the former president of the American Society of Plastic Surgeons.

"Nobody really wants to study drugs during pregnancy, unless it's something that's life saving," said Guy. "This is because you'd always worry there may be some bad outcome for the baby."

"It's probably not [harmful], but I still think it's bad medicine to do something like that during pregnancy," added Guy.

Doctors urge pregnant women to remember that the combination of hormones and increased blood flow will make your face "glow" anyway during pregnancy and suggest that cosmetic procedures are likely to go unnoticed amid an already-transforming body.

"There are so many changes in the skin during pregnancy," said Robert Zurawin, an associate professor in the department of obstetrics and gynecology at Baylor College of Medicine in Houston. "Most people get puffy and gain or lose weight, so there's really no reason to do Botox during pregnancy."

"Why waste your money when you don't know what you'll look like after nine months?" added Zurawin.

"One of the bonuses of pregnancy is that if you had any wrinkles before [you got pregnant] they're not going to show as much during pregnancy," said obstetrician Moore.

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