ACOG’s New Guidance on GLP-1 Medications During Pregnancy and Breastfeeding: What to Know

What Are GLP-1 Medications?

GLP-1 medications have become increasingly common for managing type 2 diabetes and supporting weight management. You may recognize names such as Ozempic, Wegovy, Mounjaro, or Zepbound.

If you take one of these medications and are planning to become pregnant, are currently pregnant, or are breastfeeding, you may have questions about what to do next.

On October 23, 2026, the American College of Obstetricians and Gynecologists (ACOG) released new guidance to help healthcare professionals counsel patients about GLP-1 medications before, during, and after pregnancy. The guidance addresses an important challenge: while these medications are widely used, there is still limited evidence about their safety during pregnancy and lactation.

The key takeaway: GLP-1 medications should be avoided during pregnancy, and people planning to conceive should discuss when to stop their medication with their healthcare provider. Decisions about GLP-1 use while breastfeeding require a separate, individualized conversation because the available evidence remains limited.

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What Does ACOG Recommend About GLP-1 Medications and Pregnancy?

ACOG’s new guidance provides recommendations for three stages: before pregnancy, during pregnancy, and after birth.

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1. If You’re Planning to Get Pregnant

If you take a GLP-1 medication and are thinking about pregnancy, talk with your healthcare provider before trying to conceive.

ACOG recommends counseling patients to consider stopping GLP-1 medications one to two months before becoming pregnant. The appropriate timing can depend on the specific medication, so it’s important to confirm the recommended discontinuation period with your prescriber. 

Your care team can help you plan for the transition, including how to manage the condition the medication treats and what alternatives may be appropriate.

It’s also worth discussing contraception and pregnancy intentions while taking these medications. Changes in weight and metabolic health may increase ovulation and fertility, and some medications, particularly tirzepatide, may affect the reliability of oral contraceptives.

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2. If You’re Already Pregnant

GLP-1 medications are not recommended during pregnancy because their safety has not been established. There is not enough high-quality human evidence to determine their effects on pregnancy outcomes and fetal development. Your healthcare provider can review the medication you took, when you took it, and your individual circumstances to help determine appropriate follow-up care.

If you take a GLP-1 medication to manage diabetes, it is especially important to make a plan for blood sugar management during pregnancy. Do not leave diabetes untreated; your care team can help determine a safer treatment approach.

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3. If You’re Breastfeeding or Planning to Breastfeed

The conversation becomes more nuanced after birth.

ACOG recognizes that evidence about GLP-1 medications during lactation is limited and recommends shared decision-making between patients and their healthcare providers. That means considering the specific medication, the parent’s health needs, the baby’s age and health, and the potential benefits and uncertainties of treatment.

Additional caution is advised during the earliest weeks after birth and avoidance of GLP-1s is advised for those with babies born prematurely. If a GLP-1 medication is used while breastfeeding, baby’s growth and weight gain should be monitored closely in coordination with their pediatric healthcare professional. ACOG also recommends avoiding oral GLP-1 formulations while breastfeeding because there is not enough safety information about the ingredients used to increase medication absorption.