Australian and New Zealand Journal of Obstetrics and Gynaecology 2009; 49: 168– 172 DOI: 10.1111/j.1479-828X.2009.00976.x 168 © 2009 The Authors Journal compilation © 2009 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists Blackwell Publishing Asia Original Article MotherSafe: Review of three years of counselling by an Australian teratology Information Service Joy Marie LIM 1,2 , Elizabeth SULLIVAN 1 and Debra KENNEDY 1,3 1 MotherSafe Royal Hospital for Women, 2 AIHW National Perinatal Statistics Unit, School of Women’s and Children’s Health, University of New South Wales, and 3 School of Women’s and Children’s Health, University of New South Wales, Randwick, New South Wales, Australia Background: MotherSafe was established in January 2000 at the Royal Hospital for Women as Australia’s first ‘purpose-built’ Teratogen Information Service and since then has received over 75 000 calls regarding exposures during pregnancy and lactation. Aim: To describe the patterns of use of MotherSafe over a three-year period. Methods: Retrospective descriptive epidemiological study using data from the database established at MotherSafe. Records from all the calls logged at MotherSafe between January 2005 and December 2007 were analysed to determine total number of calls, demographic characteristics of callers, including age, caller category and postcode, reason for call, source of referral and type of exposure. Results: A total of 47 138 calls were recorded to the MotherSafe service from January 2005 to December 2007. The majority of calls were regarding exposures in pregnancy (55%) and breast-feeding (38%). Average age of patients was 32.3 years. Of the calls made, 81.9% (38 485 of 46 968) were by consumers (the pregnant or lactating woman herself or a relative). The most common primary exposure categories were: over-the-counter medications (11.3%), psychotropic medication (9.0%), herbal or vitamin products (8.2%), antibiotics (7.0%), gastrointestinal medications (6.8%) and topical products (6.6%). Forty per cent of callers enquired about multiple exposures. Conclusions: The utilisation of MotherSafe by consumers and general practitioners continues to increase, reflecting the strong demand for a teratogen counselling service that provides high-quality, evidence-based information on exposures during pregnancy and lactation. Key words: lactation, pregnancy, telephone service, teratology counselling. Introduction It is known that about 96% of women in Australia use some form of prescribed or non-prescribed medication during pregnancy. 1 This is consistent with what has been reported internationally. 2 As many as 50% of pregnancies are unplanned 3 so women are often inadvertently exposed to medications prior to realising they are pregnant. At the same time, there is a general perception in the community that any exposure, whether it is to a medication, chemical, drug, radiation or infection, may be harmful to the developing fetus. 4 A service that provides accurate, evidence-based, up-to-date information about the actual risks and benefits associated with exposures during pregnancy can help to reduce the level of misplaced anxiety by women and their health-care providers. It has been demonstrated that such information can prevent unnecessary pregnancy terminations and help to minimise occupational risks. 5 It also prevents women from being inadequately treated for medical illness during pregnancy. 6 Most conventional drug information resources used by medical practitioners and pharmacists are lacking in specific information regarding pregnancy and lactation or provide advice that drug use is contraindicated in these groups, thus causing either anxiety in women who have already taken the medication or reluctance in others to take a necessary medication for fear of causing harm. MotherSafe is a statewide teratogen counselling service that was established in New South Wales (NSW) in January 2000. Modelled on similar teratogen information services around the world, it is a free-of-charge telephone-based service staffed by trained health care professionals. Most of the counsellors are pharmacists, some with previous telephone drug information experience at the Poisons Information Centre and at other hospitals. One counsellor was a medical graduate with obstetrics experience. MotherSafe is a stand- alone, purpose-built service with a particular focus on counselling patients with regard to pregnancy and breast- feeding exposures. Comparable services in other states of Correspondence: Dr Debra Kennedy, MotherSafe, Royal Hospital for Women, Locked Bag 2000, Randwick, NSW 2031, Australia. Email debra.kennedy@sesiahs.health.nsw.gov.au Received 5 August 2008; accepted 24 November 2008.