Livre d'Or

(That was me.)

So you've got:

Someone goes on a medication that it's not safe to become pregnant on; they should know this when going on it, and know what to do if they suspect they have become pregnant. This should likely be reviewed periodically; "you're a woman of a certain age so I won't give you that" should not be a reason to deny someone a medication they need. Reviewing their contraception plan (which could be anything from not having sex at all, with a plan to use X method if that changes, to being in an exclusive non-reproductive-capable relationship, to using a traditionally recognized contraceptive) is probably in order at this point.

The patient is on medication that they don't know whether is safe to be pregnant while on. This is where the doctor knowing the meds and doing/delegating the appropriate research is a valid life choice. If it's ambiguous, the patient should be given enough information to make an informed choice.

The patient is on medication and it's safe to be pregnant on it -- godspeed if they wish to become pregnant.

The patient is on medication and it is not safe to be pregnant on it -- the patient should be given enough information to make an informed choice between medication and pregnancy, with their quality of life given serious consideration, and any side effects of discontinuing the medication discussed, as well as a safe discontinuation schedule. Also extra/alternative support for the condition that requires the medication while temporarily off it.

The patient is on medication and it is not safe to be pregnant on it -- and the patient is already pregnant -- the above, plus sometimes abortion is in fact an option especially if there are significant problems.

Medication vs. breastfeeding.