GLP-1 and pregnancy, in short: if you take a GLP-1 drug for weight loss, the labels for Wegovy, Zepbound and Foundayo say to stop it when pregnancy is recognized.[1][2][6] If you are planning a pregnancy on semaglutide (Ozempic, Wegovy or semaglutide tablets), the labels say to stop at least 2 months before trying to conceive.[1][3][5] Breastfeeding advice differs by drug: semaglutide tablets and Foundayo are not recommended while nursing, and injected forms need a case-by-case decision.[5][6]
This guide covers what each label says, what studies of accidental exposure found, and what to ask your clinician. For fertility questions and “Ozempic babies,” see our separate Ozempic babies guide. More GLP-1 basics are in the GLP-1 basics hub.
Why weight-loss GLP-1s are stopped in pregnancy
The labels for weight-loss brands share the same reasoning. “Weight loss offers no benefit to a pregnant patient and may cause fetal harm,” and appropriate weight gain is recommended for all pregnant patients, including those with obesity.[1][2]
The concern comes mainly from animal studies. In rats and rabbits given tirzepatide during organ development, there was reduced fetal growth and some fetal abnormalities. These effects happened alongside drug-related drops in the mothers’ food intake and weight.[2] Semaglutide studies in rats, rabbits and monkeys showed similar patterns.[3] Human data are too limited to measure the risk directly.[2]
Diabetes is a different situation
For type 2 diabetes, poorly controlled blood sugar is itself a risk in pregnancy. It raises the chance of pre-eclampsia, miscarriage, preterm delivery, stillbirth and major birth defects.[3][4] The Ozempic, Mounjaro and semaglutide tablet labels say the drugs should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus.[3][4][5] In practice, the plan for blood sugar control during pregnancy is set with your diabetes and pregnancy care team.
Wegovy has a similar exception for MASH, a fatty liver disease with advanced scarring. The label says MASH itself may raise the risk of gestational diabetes, high blood pressure complications, preterm birth and heavy bleeding after delivery. For MASH, Wegovy should be used in pregnancy only if the potential benefit justifies the potential risk.[1]
What each label says
| Drug | Pregnancy | Planning a pregnancy | Breastfeeding |
|---|---|---|---|
| Wegovy injection or tablets | Stop when pregnancy is recognized (weight loss) | Stop at least 2 months before | Tablets: not recommended. Injection: weigh benefits and risks; no human data |
| Ozempic injection | Use only if benefit justifies risk | Stop at least 2 months before | No human data; weigh benefits and risks |
| Semaglutide tablets (Rybelsus, Ozempic tablets) | Use only if benefit justifies risk | Stop at least 2 months before | Not recommended |
| Zepbound | Stop when pregnancy is recognized | No set washout in label | Weigh benefits and risks; very low milk levels in one study |
| Mounjaro | Use only if benefit justifies risk | No set washout in label | Same as Zepbound |
| Foundayo (orforglipron) | Stop when pregnancy is recognized | Use effective contraception during treatment | Not recommended |
Sources: Wegovy,[1] Zepbound,[2] Ozempic,[3] Mounjaro,[4] semaglutide tablets[5] and Foundayo[6] prescribing information.
Birth control while on tirzepatide or Foundayo
Tirzepatide slows stomach emptying, which can make birth control pills less effective. The effect is strongest after the first dose and fades over time.[2][4]
- Zepbound and Mounjaro: switch to a non-oral method, or add a barrier method such as condoms, for 4 weeks after starting and for 4 weeks after each dose increase.[2][4]
- Foundayo: use effective contraception during treatment. If you take the pill, switch to a non-oral method or add a barrier method for 30 days after starting and after each dose increase.[6]
This matters because weight loss itself can improve fertility. People with PCOS on semaglutide sometimes ask about this too.
What studies of accidental early exposure found
Many pregnancies are exposed before the person knows they are pregnant. Three observational studies give the best current picture:
- Nordic, U.S. and Israeli data (2024): among infants of mothers with type 2 diabetes, major malformations occurred in 8.3% of 938 infants exposed to GLP-1s around conception, versus 7.8% with insulin. After adjustment, the relative risk was 0.95, which the authors called reassuring but needing confirmation.[7]
- Six teratology services (2024): in 168 pregnancies exposed in the first trimester, major birth defects occurred in 2.6%, compared with 2.3% in women with diabetes and 3.9% in women with overweight or obesity. Pregnancy loss was not increased.[8]
- U.S. claims data (2026): in 3,572 pregnancies, continuing a GLP-1 into the first trimester versus stopping showed no clear rise in pregnancy loss (adjusted risk ratio 1.09). Estimates for birth defects and small babies were too imprecise to rule out a meaningful difference.[9]
A 2026 systematic review of 36 studies reached a similar conclusion. Early exposure was not consistently linked to higher risk, but data on use later in pregnancy remain limited.[11] None of these studies support using GLP-1s on purpose during pregnancy.
Breastfeeding on a GLP-1
- Tirzepatide: in a label study of 11 breastfeeding women given one 5 mg dose, tirzepatide was undetectable in 164 of 171 milk samples. The total amount found over 28 days was less than 0.02% of the mother’s dose. There are no data on effects in babies or on milk supply.[2]
- Injected semaglutide: the labels report no human data.[1][3] In a small 2024 study of milk from 8 women, semaglutide was not detected in any sample. The authors estimated a worst-case infant dose of 1.26% of the maternal dose, well under the usual 10% threshold.[10]
- Semaglutide tablets: not recommended. Semaglutide in milk was too low to measure, but the absorption enhancer SNAC passes into milk and babies may clear it slowly.[5] The Wegovy label says the same for Wegovy tablets.[1]
- Foundayo: not recommended. Orforglipron passed into rat milk at levels 3 times higher than in blood, and human data are lacking.[6]
For the drugs without a firm “no,” labels ask you and your clinician to weigh the benefits of breastfeeding against your need for the medicine and any possible effect on the baby.[2][3]
Pregnancy registries
If you become pregnant while taking one of these drugs, registries collect outcomes to fill the data gap. The labels list:
- Zepbound: 1-844-524-0039 or pregnancyregistry.lilly.com/zepbound.[2]
- Wegovy: Novo Nordisk at 1-877-390-2760.[1]
- Foundayo: the label says a registry is planned; contact Lilly at 1-800-545-5979.[6]
Questions to ask your clinician
- When should I stop my GLP-1 before trying to conceive, and what will we use instead?
- What birth control works best with my GLP-1, and for how long after dose changes?
- If I have diabetes, what is my blood sugar plan during pregnancy?
- After birth, is my GLP-1 compatible with breastfeeding, or should I wait?
To understand how these drugs act on the stomach and appetite, see how GLP-1 drugs work. If you’re planning to come off treatment, read stopping GLP-1s and GLP-1 side effects.
