HN Summary
• Pharmacists in obstetrics and gynecology improve maternal and infant outcomes by optimizing medication use across pregnancy and postpartum care.
• They play a critical role in balancing medication safety and treatment needs, reducing risks from both untreated conditions and inappropriate therapies.
• Their expertise supports patient education, safety systems, and equitable care, strengthening outcomes in increasingly complex perinatal health.
Women’s health and perinatal care represent some of the most complex and high impact areas of health care, where medication decisions affect not one patient, but two. Across Canada, pharmacy professionals specializing in obstetrics and gynecology play a critical role in optimizing medication therapy, reducing preventable harm, and improving outcomes. Their work is increasingly important as health complexity rises, and medication use during pregnancy becomes more common.
Medication use and risk in pregnancy
Nearly three-quarters of pregnant people in Canada use at least one prescription or non-prescription medication during pregnancy, and many require treatment for chronic conditions such as diabetes, hypertension, asthma, or mental health disorders. According to national Perinatal Health Indicators from the Public Health Agency of Canada, rates of diabetes in pregnancy have nearly doubled over the past decade, highlighting the growing clinical complexity of care.
Medication decisions during pregnancy must balance maternal benefit with fetal safety. Canadian data demonstrate that untreated medical conditions can significantly increase risks of pre-term birth, neonatal intensive care admission, and morbidity of the pregnant parent. Pharmacists with expertise in pregnancy and lactation play a vital role in navigating these decisions—assessing evidence, counselling patients, and ensuring appropriate monitoring.
Improving Outcomes Through Pharmacist Expertise
Pharmacists working in obstetrics and gynecology contribute across the entire continuum of care, from pre-conception counselling to post-partum support. Evidence shows that pharmacist-led interventions improve medication adherence, clinical outcomes, and patient satisfaction among pregnant individuals, particularly in conditions such as gestational diabetes, asthma, and hypertensive disorders of pregnancy.
National public health data also underscores the impact of medication optimization. For example, only 53.7 per cent of patients in Canada report appropriate folic acid use during the periconceptional period, a modifiable risk factor for neural tube defects where pharmacist counselling has proven benefit. In the postpartum period, pharmacists are key resources for nursing-compatible medication selection—supporting the 38.2per cent of Canadian parents who exclusively nurse for six months while ensuring the birthing parent’s therapy is not unnecessarily interrupted.
Supporting equity and safety in maternal care
Medication safety remains a national priority. Medication incidents—including those related to prescribing, dispensing, and monitoring—are among the most frequently reported patient safety events in Canadian acute care settings. In perinatal care, such incidents can have lifelong consequences.
Pharmacists help mitigate these risks through system level interventions such as guideline development, staff education, and participation in incident reporting and quality improvement initiatives supported by CIHI and ISMP Canada. Their work also supports health equity, particularly for populations at higher risk of adverse perinatal outcomes, including individuals with complex medical, social, or medication needs.
Leadership in Practice: Sylvia Yazbeck, BSc Pharm, RPh, BCPS.
Sylvia Yazbeck is a national leader in obstetrics and gynecology pharmacy practice. A Clinical Pharmacist at IWK Health and Adjunct Professor at Dalhousie University’s College of Pharmacy, she brings nearly 20 years of experience supporting pregnant and postpartum patients with complex medication needs.
Recognizing gaps in evidence related to medication use in pregnancy and lactation, Sylvia has long emphasized the importance of collaboration and shared learning in this specialty. As Chair of CSHP’s Obstetrics and Gynecology Community of Practice, she fosters national connections among pharmacy professionals to support evidence informed care, advance education, and promote consistent, patient centred practice across diverse clinical settings.
Through CSHP, Sylvia notes, she was “introduced to members with similar practices and was able to collaborate with them on professional development initiatives and updates to medication policies.”
A Lasting Impact on Babies
As Canada continues to see increasing birthing parent age, rising chronic disease, and evolving medication therapies, pharmacists specializing in women’s and perinatal health are essential to delivering safe, high-quality care. Their expertise improves outcomes for mothers and infants, strengthens medication safety systems, and supports informed, patient-centred decision making.
By investing in these roles—and recognizing leaders such as Sylvia Yazbeck—health care organizations reaffirm their commitment to healthy pregnancies, thriving infants, and evidence-based obstetric and gynecological health care across Canada.