I had a future mother come into the office recently. She was in her third trimester and had ingrown toenails in both great toes. Unfortunately, she had developed swelling and of course her shoes didn’t fit anymore. To top it off she was a “picker” and had attempted “bathroom” surgery on a previous occasion. She was understandably very concerned about her baby. We reasoned together that doing nothing wasn’t acceptable as any infection in the toe was a risk. She chose to have local anesthetic to the toes and to have the nails removed but to not use any opioid pain medication afterwards. The type of local anesthetic used would give her pain relief for up to 6-8 hours but she would then elevate her feet above her heart and if absolutely necessary use just Tylenol and soak the rest of the time. The good news – she did not need an oral antibiotic because of the absence of pus in the toes upon nail removal. Any oral medications can cross the placenta and affect the baby. Although, there are very few medications that have any studies of how medications affect the fetus (for obvious ethical reasons) it is still our preferred course to not give medications to pregnant mothers unless for the purpose of saving the mother’s life. Thankfully these toenails won’t kill her even though they felt like they would.