Is Botox During Pregnancy Safe?

Written & Reviewed by Dr David Chen

The first thing you should understand is that Botox is a cosmetic procedure which means that it is completely elective in nature. According to The American College of Obstetricians and Gynecologists (ACOG) guideline for non-obstetric surgery during pregnancy all elective procedures should be postponed until after giving birth.

That recommendation is to reduce the amount of risk that a pregnant woman has to go through. You don’t want to subject your unborn child to unnecessary risks and treatments. The best thing to do would be to wait until after the child arrives to do it. Of course, that recommendation doesn’t have anything to do with whether or not Botox is safe for an expecting mother.

pregnancy cartoon of mother

Our purpose here today is to go over the safety of using Botox during pregnancy. What does the research say and has any adverse effects ever occurred from doing it while you’re carrying a child? You may be surprised by what you learn!

I got Botox before I knew I was pregnant

It is not unusual to accidentally get Botox while you’re pregnant and not know it. In fact, there was a case study back in 2010 where a 17 year old female was treated with it. She didn’t find out until a week later that she was actually pregnant while she had the treatment done.

The patient was incredibly worried for the entire nine long months since she got it without knowing her fetal status. Fortunately she delivered the baby without any adverse effects. Both the mother and the baby made it through the entire process safely.

Apparently this isn’t an uncommon occurrence because there have been plenty of instances where pregnant women got it without knowing.

  • This woman got it and then found out she was 12 weeks pregnant.
  • Another woman got it and then found out she was 5 weeks pregnant.

Not everyone knows that they are pregnant and many don’t find out until many weeks later. Did you know that one of the earliest signs of a pregnancy is a missed period? That is of course according to the NHS.

Research studies about Botox safety during pregnancy

You may be surprised but Botox (Botulinum toxin A) is actually relatively safe to use during pregnancy. According to the Journal of Neurology, Neurosurgery & Psychiatry, they conducted a survey where they found 16 women were injected with it while they were expecting. The only adverse effect was one woman who had a miscarriage but she had a history of spontaneous abortions. The study concluded that it was relatively safe for the expectant mother and fetus.

There was a retrospective review of Allergan’s safety database which showed the rate of fetal defects from using Botox was about 2.7%. That rate is actually comparable to background rates in the general population. In other words, there was no difference in the rate of defects from using this medication. Of course, you also have to be aware that Allergan is the maker of Botulinum Toxin A. This is according to their data.

Last but not least, there was an interesting case by the International Parkinson and Movement Disorder society regarding the use of it. Apparently there was a patient who routinely received regular Botox treatments throughout not just one but four full term pregnancies. You read that correctly, she had four children while using Botox during all of the pregnancies. There were no adverse effects reported with any of her children.

Pregnancy risk category

As it turns out, Botulinum toxin A is actually a medication in the pregnancy risk category C. The risk cannot be ruled out due to no satisfactory studies having been done on expecting mothers. The recommendation for this category of medication is to only use it if the benefits outweigh the risks.

Pregnancy Risk Categories Chart

So, technically it isn’t dangerous to use it but you shouldn’t really use it due to insufficient studies. There may be a risk that we do not yet know of so the recommendation is to NOT do it despite many case studies reporting no ill effects. The safety of it has not been confirmed 100%.

So, should you get Botox while you’re carrying a child?

Despite a lot of research studies saying that there haven’t been many cases of adverse effects, you should still be cautious of it. Sure, some pregnant women may have gone through their pregnancy without effects but that doesn’t mean it can’t happen to you.

More studies are needed to determine whether it is truly safe or not. Once again, it is a category C drug so you should only use it if the benefits outweigh the risks. Due to that classification, it is also why the ACOG recommends that you abstain from this elective procedure.

You can do it but only if there is a very legitimate or valid reason for doing so. For that you would need to discuss with your doctor about why you need it in the first place. If it is medically necessary you may do it but if it is purely for cosmetic purpose, you may want to abide by the ACOG guideline and postpone it.


In our opinion, you should abide by the guidelines set by the ACOG since they are the authority on this topic. In addition to what they say, the ADA (American Dental Association) also says to postpone all elective procedures such as cosmetic ones. It has nothing to do with how safe Botox may be because you’re taking on an additional risk that is unneeded. We at afterva, fully follow all major organizational guidelines so you should wait until after you give birth. We can’t condone any other behaviors aside from that.

You don’t want to be the one who ends up being unlucky and have something happen to your baby because that would be a travesty. The pregnancy is only nine months anyway so it’s not a long wait if you really wanted the procedure.

In other words, please don’t get Botox while you’re pregnant! However, what you should still do is go in for your routine dental check ups and teeth cleanings. That much is at least safe to do and encouraged by both the ACOG and ADA.


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