Why My Doctor Pushed The Tiny Pill During My First Pregnancy

It was a Tuesday afternoon in 2018, and I was sitting in the driver's seat of my Honda CR-V in a CVS parking lot, wearing a mustard yellow maternity sweater that made me look like a severely bruised banana, absolutely sobbing over a tiny bottle of pills. I had a lukewarm decaf iced coffee sweating in the cup holder next to me. My OB-GYN, Dr. Evans, had just casually told me at my 12-week appointment that I needed to start taking a baby aspirin every single day.

Wait, what?

I thought aspirin was, like, the one universally agreed-upon thing you absolutely don't take when you're growing a human. Like sushi from a gas station, or unpasteurized cheese, or hot tubs. I was so sure of this that I had spent the last three months terrified to even look at a bottle of Advil when I had a headache, opting instead to just lie in a dark room with a cold washcloth over my eyes while my husband Mark awkwardly patted my shoulder and asked if I wanted toast.

So I didn't buy the pills that day. I drove home. I opened my laptop. And I did the one thing every doctor on the planet tells you never to do: I went deep into the internet forums.

I ended up on a message board from 2006 where a user named MamaBear44 told a horrifying, incredibly anecdotal story about how her cousin's neighbor took regular pain relievers and ruined her baby's kidneys, and I just absolutely spiraled. I decided right then and there that I knew better than my doctor, who literally went to medical school for over a decade, and I refused to take the medication for two solid weeks while Mark slowly lost his mind watching me take my own blood pressure at the kitchen counter four times a day.

Anyway, the point is, I was an idiot.

The giant horse pills versus the tiny one

Let's talk about prenatal vitamins for a second because it still pisses me off. I was already choking down this massive, chalky prenatal vitamin that tasted like straight-up fish and was roughly the size of a standard AAA battery. It made me gag every single morning. I had to psyche myself up just to swallow the damn thing, usually pacing around the kitchen and taking aggressive gulps of orange juice.

And then there was this new recommendation for a low-dose aspirin. An 81mg tablet.

Do you know how small 81 milligrams is? It's basically a speck of dust. It's so small that if you drop it on your bathroom floor, it belongs to the tile grout now. You will never find it. It's comical to me that the prenatal industry expects pregnant women, who are notoriously nauseous and sensitive to everything, to swallow giant boulders for their daily vitamins, but the actual medical intervention that could save your life is the size of a sesame seed.

I finally just started throwing the tiny pill to the back of my throat with my morning toast and barely even noticed it went down.

What Dr. Evans actually told me when I confessed

When I finally went back for my 16-week appointment, I had to admit to Dr. Evans that I hadn't been taking the baby aspirin because MamaBear44 on the internet told me not to. I thought she was going to yell at me. Instead, she just sighed, pulled up her stool, and explained what was actually happening in my body.

She told me that taking low-dose aspirin is completely different from taking regular adult pain relievers, which are usually like 325mg or more and definitely *can* cause weird heart and kidney issues for the baby later in pregnancy. The low-dose stuff acts like a mild blood thinner and helps with swelling.

She explained that preeclampsia—which was the scary word we were trying to avoid—happens when your blood pressure shoots up because the placenta isn't getting the right blood flow. It's like the plumbing to the baby is restricted, so your heart has to pump way harder to push the nutrients through, which stresses out all your organs. The tiny pill basically just greases the wheels. It keeps the microscopic blood vessels in the placenta open and happy so the baby gets oxygen and your kidneys don't freak out.

When she put it like that, suddenly the tiny little pill seemed like a really smart plumber, and I felt like a massive jerk for doubting her.

Why I was on the "high risk" list to begin with

Hearing the phrase "high risk" when you're pregnant is enough to make you want to throw up, even if you don't already have morning sickness.

But the criteria for getting prescribed this stuff is honestly pretty broad. I got slapped with the label because I was 35 years old—which the medical community lovingly calls "Advanced Maternal Age," a garbage term that makes you feel like your eggs are literally turning to dust—and it was my first pregnancy. I also had a BMI that was slightly elevated because, frankly, I had survived my entire twenties on bagels and sheer anxiety.

My doctor said that having even a couple of these moderate risk factors—being over 35, first baby, a bit of extra weight, or even just having a mom or sister who had high blood pressure during their pregnancies—was enough to warrant the daily 81mg dose. It's apparently super common now. It reduces the risk of early-onset preeclampsia by some crazy number, like over 60 percent, so doctors are handing the recommendation out to a lot of us.

Distracting myself with aggressive nesting

Once I finally started taking the pill, my anxiety didn't just magically vanish. I still worried about every little twinge and cramp. But instead of Googling medical studies I didn't understand, I channeled all that nervous energy into nesting. Like, psychotic levels of nesting. I was buying stuff we didn't even need yet just to feel like I had some control over the situation.

One of the absolute best things I bought during that manic phase was the Organic Cotton Baby Bodysuit from Kianao. I'm telling you, I initially bought a bunch of cheap, synthetic onesies from a big box store because I thought "clothes are clothes." Huge mistake. When Leo was born, it was the middle of July and he ran so hot. Every time I put him in the cheap stuff, he'd get this angry red heat rash on his neck and back that made me cry because I thought I was breaking my own baby.

I switched him to the organic cotton sleeveless bodysuit and it was like night and day. The fabric is stupidly soft—like, so soft I wish they made adult sweatpants out of it—and it actually let his skin breathe. It had these little envelope shoulders so when he had a massive diaper blowout (which happened constantly, oh god), I could pull the whole thing down over his body instead of dragging poop over his head. It was basically the only thing he wore for his first three months of life.

I also bought this Gentle Baby Building Block Set during my late-night stress-shopping sprees. I had this ridiculous fantasy that I was going to sit on a pristine white rug and teach my infant early mathematics. Honestly? They're just okay. They're soft rubber blocks. Leo barely looked at them, and my second kid, Maya, mostly just used the number 4 block as a chew toy for six straight months. They're totally fine and they don't hurt when you step on them barefoot at 3 AM in the dark, which is a major plus, but they eventually just ended up accumulating dog hair under the couch.

Anyway, if you're currently spiraling about blood pressure and need a distraction, I highly suggest browsing through the organic baby clothes collection instead of looking at medical forums. It's much better for your heart rate.

The heartburn situation

I do have to warn you about the heartburn. Oh my god.

Taking aspirin every day can make your stomach hate you. Around week 20, I started getting this fiery acid reflux that felt like a dragon had taken up residence in my esophagus. I'd wake up at 2 AM literally coughing up acid. Mark kept telling me that I needed to stop stressing out and just drink more water while propping myself up on pillows, which honestly just made me want to throw my water bottle at his head because he gets to sleep on his stomach in blissful ignorance.

Dr. Evans told me to switch to the "enteric-coated" version of the baby aspirin. It has a special coating that stops the pill from dissolving in your stomach and makes it wait until it hits your intestines, which saved my life. I also learned the hard way that I had to take it right in the middle of a meal with a massive glass of water, not just dry-swallowed while running out the door to work.

Please don't play pharmacist

The biggest takeaway from my entire dramatic saga is that you really, really shouldn't try to self-medicate or self-diagnose when you're pregnant.

Don't start taking baby aspirin just because your best friend took it, and definitely don't avoid it if your doctor tells you to take it just because you read a scary post on Facebook. There are certain people who absolutely shouldn't take it—like if you've bleeding disorders or weird allergies—so your OB needs to be the one making the call. They usually want you to start it right in that sweet spot between 12 and 16 weeks, which is exactly when I was busy arguing with Dr. Evans in my own head.

Once I accepted that the tiny pill was just part of my daily routine, I honestly felt better. It felt like I was actively doing something to protect Leo. By my third trimester, I had stopped checking my blood pressure obsessively and started focusing on the fun stuff, like putting together the Rainbow Play Gym Set I had bought.

I remember sitting on the nursery floor at 32 weeks pregnant, sweating profusely while Mark tried to screw the wooden A-frame together, just staring at the little hanging elephant and crying happy tears because it finally felt real. The play gym ended up being amazing, by the way. It's not plastic, it doesn't light up and make horrible electronic noises that haunt your dreams, and Leo seriously loved batting at the little wooden rings once he figured out how his hands worked.

Pregnancy is a weird, scary, beautiful mess. You're going to second-guess everything you put in your body. But sometimes, trusting your doctor and taking the tiny pill is exactly what you need to do to get to the finish line safely.

Before we get to the messy questions everyone asks, do yourself a favor and check out Kianao's nursery gear to take your mind off things. You deserve a break from worrying.

Questions I frantically asked my doctor (and the internet)

Can I just take a regular adult Advil or Bayer instead?

God no. Don't do this. Regular strength NSAIDs are a massive no-no, especially later in pregnancy, because they can mess with the baby's kidneys and close a really important blood vessel in their heart way too early. The 81mg low-dose version is completely different. Always check the milligrams on the bottle.

When do you honestly stop taking it?

My doctor had me stop taking it right around 36 or 37 weeks because she didn't want my blood to be too thin when I really went into labor (which makes total sense when you think about it). But I've friends who were told to take it right up until delivery, so this is definitely a "text your OB's nurse line" kind of question.

Does it genuinely guarantee I won't get preeclampsia?

I wish. It's not a magic shield. It just significantly lowers your chances. I still ended up with slightly elevated blood pressure at the very end of my pregnancy with Leo, but it never developed into the scary, full-blown preeclampsia, which Dr. Evans said was likely thanks to my daily aspirin habit.

Will it make my morning sickness worse?

It didn't make my nausea worse, but it definitely gave me raging heartburn. If your stomach is already super sensitive from the pregnancy hormones, make sure you buy the enteric-coated kind and never take it on an empty stomach. I learned that lesson the hard way.