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With GLP-1 use surging among women of reproductive age, ACOG has released its first formal guidance on using these medications around pregnancy and lactation. The bottom line: stop GLP-1s 1–2 months before conception, avoid them during pregnancy, and proceed with caution during breastfeeding. An international expert consensus and multiple meta-analyses support the call for restraint — while urging more research into this data-scarce area.
GLP-1 receptor agonists are increasingly common — and so are women of reproductive age taking them. With roughly 1 in 300 women now exposed to GLP-1s before pregnancy, and easy access through online providers and medical spas, ACOG has released its long-awaited guidance on how to handle these medications around conception, pregnancy, and breastfeeding.
The core message is clear: discontinue GLP-1s 1–2 months before trying to conceive, avoid them during pregnancy, and use shared decision-making during the postpartum period. If a patient chooses to breastfeed while on a GLP-1, clinicians should monitor infant weight closely — and avoid use altogether for preterm infants and newborns. An international consensus statement published in The Lancet and two separate meta-analyses covering over 2 million pregnancies broadly align with ACOG's stance, finding no clear increase in congenital anomalies from inadvertent first-trimester exposure, though evidence quality remains low.
Key Takeaways
Why it matters: As GLP-1 prescriptions continue to climb, clinicians need a clear framework for the many reproductive-age patients using these drugs. This guidance fills a critical gap — even as the underlying evidence remains limited and more research is urgently needed.
