It’s flu season and if you’re expecting, maintaining good general health is crucial to keep those nasties at bay. Here, one of Australia’s most senior midwives shares advice for keeping you and your baby safe and well.
Beware the flu
It’s essential to be aware that the flu is serious and life threatening for pregnant women and their babies. Pregnancy compromises your immune system, leaving you more susceptible to the virus, and perinatal physiological changes can increase the severity of flu symptoms. Your risk of hospitalisation from the flu will have increased fivefold by your final trimester.
“Influenza is a significant problem for anyone immune-compromised,” says Professor Caroline Homer, President of the Australian College of Midwives as well as the Director of the Centre for Midwifery, Child and Family Health at UTS.
“This includes older people and pregnant women. “We had an influenza epidemic in 2009 and many [pregnant] women ended up in intensive care across NSW. Some sadly died. That’s the serious end of the spectrum, but the risks every year need to be taken very seriously.”
Sydney mother-of-two Camille Thiolouse had always been fit and healthy, but suffered from debilitating and dangerous flu during both her pregnancies. The first bout, at 16 weeks, left her bedridden for a week and developed into severe bronchitis, which lingered for more than a month. Flu during the later stages of her second pregnancy escalated into pneumonia, and Thiolouse needed oxygen immediately after the birth of her son Rapha to aid her breathing. Eleven months later, she’s still rebuilding her battered immune system. “I’d never been a sickly person,” she says. “But those spells of flu were really frightening. It was such a terrible experience, I’m relieved to have completed my family, as I don’t think I’d be able to face another pregnancy again.”
The flu vaccine protects you best
Professor Homer recommends the annual flu shot for all expectant mothers. “In maternity care we are strong advocates of women having the influenza vaccine to protect them and their baby,” she says.
The flu shot can be given at the same time as the whooping cough vaccine (ideally at 28 weeks) but should not be put off if winter has begun or is close (the earlier in the season, the better).
Professor Homer stresses that the vaccine’s safety throughout pregnancy is endorsed by doctors and midwives. “We would not advocate it if we had any concerns at all around risk,” says Professor Homer. “And pregnancy is the time when health professionals are most acutely attuned to risk. We emphasise that women should feel confident that this is a good thing for them and their baby.”
It’s important to have the most current version of the vaccine, as it’s adjusted each year to best protect against recent strains of the virus. The flu vaccine takes two weeks to provide protection, also worth remembering, says Professor Homer, if you’re travelling during pregnancy. “So if you’re planning to spend time in another country in its flu season, plan to get vaccinated here at least two weeks before you travel.”
Along with the flu vaccination, maximising your physical and mental wellbeing throughout pregnancy is your best defence against illness. Exercise, says Professor Homer, is a great place to start – but it’s sometimes overlooked in winter.
“When it’s colder we don’t tend to go outside and exercise,” she says. “We stay home and keep ourselves cosy. But when you’re pregnant you need to be exercising. I advise women to keep doing what they normally do; whether it’s yoga, running, swimming, walking, keep it up.”
She adds: “If you’ve never exercised we say that this is a perfect time to start – maybe buy a pedometer and start taking walks, or check out aqua-aerobic classes.”
Overeating is another concern during winter, she says. “The old adage of eating for two has well and truly gone. We now know that too much gestational weight gain carries significant risks for both mother and baby.”
How much weight you can safely gain during pregnancy will depend upon your weight at the start, but be guided by your midwife or doctor, and nourish yourself and your unborn baby with a healthy, balanced diet including plenty of vegetables and fruit.
Certain foods are more likely to carry harmful bacteria like listeria, which can cause serious infections during pregnancy. Listeria-risk foods that expectant mothers should avoid include soft and semi-soft cheeses, cold meats, pre-prepared vegetables and salads, and paté. You should also avoid foods that contain raw egg to reduce your risk of gastro bugs like Salmonella, and always cook meat, chicken and eggs thoroughly.
Water your baby body
A well-hydrated body is best equipped to ward off illness and support a healthy pregnancy, says Professor Homer, so be sure to drink plenty of water.
“When you’re pregnant, your blood volume goes up about 30 per cent,” she says. “Your kidney and cardiac function change and your body is working at a different level; it’s under quite a lot of physiological stress, growing a new baby. Plenty of hydration ensures your kidneys are functioning.”
In winter, she says, we can forget to drink as much water as in summer, when we sip to stay cool. “Also sometimes we overheat our houses during winter and we lose fluids because we are hot inside, huddled around the heater.”
Aim for healthy habits
Midwives advocate an alcohol-free mum and a smoke-free environment for a growing baby at every stage in the pregnancy.
“We advise pregnant mums not to drink alcohol at all, and I know for some women that’s not easy, but it’s the safest option,” says Professor Homer.
“Another risk in winter is that instead of sending smokers out on to the veranda to have a cigarette, you let them stay indoors because it’s cold,” she says. “But we know that second-hand smoke has similar effects on mother and baby as firsthand. Having a smoke free house and car is very important.”
Flu can hit smokers harder, she adds. “If you get the flu and you’re a smoker and you’re pregnant you’ve got three things against you, so try and remove the first two!”
Beat the blues
Winter blues can strike anyone, but pregnant women are particularly susceptible. Colder, darker weather combined with worries about impending life changes plus hormonal swings can be a recipe for perinatal depression or anxiety.
“Anxiety can be a particular problem,” says Professor Homer. “There is so much to think about that pregnant women can feel paralysed and scared.”
In most NSW hospitals, every woman is screened for perinatal mental health. “Midwives and doctors are also very attuned all the way through the pregnancy to try to identify women who might be feeling low,” says Professor Homer. If this is true for you, she recommends asking your health professional to identify support networks and resources to help you cope.
The same applies to your safety, she says. Every pregnant woman, regardless of background, can expect to be asked questions by their healthcare team about their domestic safety. “This might seem confronting,” says Professor Homer, “but we ask everyone, so you are not being singled out for any reason.” Again, she says, it’s an opportunity to have helpful conversations about accessing support.
The vitamin myth
It seems tempting – especially in winter – to pop vitamin pills to ward off illnesses. Save your dollars, says Professor Homer. “There is no good evidence that taking multivitamins improves pregnant women’s health, unless you are severely malnourished or have a well-diagnosed vitamin deficiency. The official antenatal guidelines that I co-chair recommend that vitamin A, C and E supplements are not of benefit, and could even cause harm. Just stick to a nutritious, balanced diet.”
When you’re pregnant, catching the flu is far more serious. A flu shot is the best way to protect you and your baby during your pregnancy, and in the first critical months after birth. That’s important because babies under six months can’t be given the flu vaccination. Protection is only achieved by vaccinating the mum during pregnancy. Vaccination is free and safe at any stage of your pregnancy and available from your doctor, specialist or nurse. For more info, visit: http://www.health.nsw.gov.au/flu/pregnancy