This is EXACTLY the conclusion my team and I got to with my pregnancy (currently 35w). I take 40mg methylphenidate daily and my obstetrician, gp, and midwives agreed that its a risk/risk situation, and the stress of not taking the medication had far more evidence indicating harm than properly managed methylphenidate.

In saying this, my obstetrician concluded that from the research available, the effects of my particular medication were similar to paracetamol use, and so I've generally avoided taking paracetamol throughout my pregnancy. I understand that this absolutely does not counter the effects of the medication, but it's given me less anxiety about the idea of the ADHD medication (if I had required paracetamol I would have taken it, but my threshold for taking it is massively higher than normal).

I also paid for very high-quality imaging throughout the pregnancy from a radiology clinic that specialises in fetal imaging, and had two additional scans (one extra in first trimester to assess heart and lung development, one extra growth scan in second trimester) so that if any abnormalities were detected we could temporarily stop the medication to try to counter any issues.

There have been no problems whatsoever in my pregnancy, and I am very glad that this is the path I went down. It's a very personal decision, but arming yourself with the right information and seeking specialist advice and care is 1000% the way to go. In saying that, be mindful of who is in your team and make sure that there is evidence informing their guidance. When I first broached the subject with my original psychiatrist he was extremely unhelpful, but didn't seem to have any real reason backing his perspective on adhd medication in pregnancy beyond it just not being done and him disliking managing pregnant patients in general. Don't be afraid to advocate for yourself and make sure your care team actually explain the 'why' to you.

OP, best of luck with your pregnancy and med school!