Dr. Hilary Erin Rowe has made it her mission to find or conduct the research on medication safety in pregnancy and breastfeeding that new mothers with health conditions really need.
If Clinical Pharmacy Specialist Dr. Hilary Erin Rowe can’t find an answer to a complicated infant or maternity medication question, she creates it – by conducting her own research.
The Surrey Memorial Hospital expert in maternal fetal medicine is known for her cutting-edge research on safe drug treatments for mothers and babies in her care. Medication safety data for pregnant or breastfeeding women is scarce as these women are often not included in studies. So Dr. Rowe collaborates on research projects to try and fill these gaps in knowledge, with enthusiasm and creativity.
Her curiosity comes naturally. Raised in a family of health care professionals – her mother was a social worker and her father was an executive with Island Health – health care was routine dinner table conversation. When Dr. Rowe, who had always thought of working in pediatrics, discovered a love of chemistry in high school her path was set.
She began working at community pharmacies, completed pharmacy school at UBC and joined the Vancouver Island Health Authority. It was during her residency there, as she rotated through the NICU and maternity units at Victoria General Hospital, that she had a revelation.
“I saw there were a lot of women who were being given poor advice about their medications in pregnancy,” she recalled. “Some were stopping their drugs in pregnancy to reduce harm to their baby, not realizing that not controlling their disease might have consequences as well. I realized that the health of an infant really starts with the mom and her choices.”
In 2012, she joined Surrey’s Family Birthing Unit as the first clinical pharmacy specialist dedicated to maternity patients. Now, Dr. Rowe consults with nurses, physicians, midwives, lactation consultants and mothers to balance medication risks and benefits to provide the best outcomes possible for mothers and their children.
“Pregnancy and lactation are momentous social events that have lasting implications for the health of our population,” said Lynne Palmer, a clinical nurse specialist in the unit. “Hilary’s contribution to promote best medication practices for pregnant and lactating women advances the health of our future clients.”
Most of Dr. Rowe’s caseload involves mothers with high-risk conditions such as high blood pressure, serious infections, or mental health conditions who require significant drug therapy during pregnancy or while breastfeeding. She visits daily, monitors their conditions, adjusts their drug therapies and educates and advises them of the risks and benefits of drug therapy to health and that of their fetus
“Most of these mothers are worried about what drug exposure could do to their fetus,” Dr. Rowe explains. “It’s quite rewarding that you can help a patient through this difficult time.” It’s not uncommon for grateful patients to send her cards and baby pictures, and to ask for her when they return for subsequent pregnancies.
Employee education is also a passion. Dr. Rowe has co-authored two editions of the handbook “Medications and Mothers’ Milk,” has published a dozen papers in peer-reviewed journals, has delivered lectures at local universities and international conferences, and has worked with the Society of Obstetricians and Gynecologists to create clinical drug guidelines.
Within the hospital, she’s created medication safety sheets used throughout Fraser Health to support best practices and influence prescribing patterns. For her efforts, she’s been recognized with provincial and national awards, including a New Hospital Pharmacy Practitioner Award from the Canadian Society of Hospital Pharmacists.
“Hilary’s dedication, curiosity and perseverance often spill over into her personal time, as she goes above and beyond to find answers and share her expertise,” Palmer said. “Her creative approaches to knowledge translation inspire others to use the best evidence. This augments quality medication prescribing for all perinatal patients in Fraser Health.”
Despite these big accomplishments, her focus remains on the needs of her littlest patients. “I really have compassion for pregnant women,” Dr. Rowe said, “because they are making difficult drug decisions and only want to do the best for their fetus.”