During pregnancy some women find their asthma improves, some have no change in their asthma at all and some, mostly those women who already have severe asthma, find their asthma gets worse.
Nasal congestion and hay fever can get worse for some women when they’re pregnant – ask your GP, asthma nurse or pharmacist what hay fever medicines are safe for you to take during your pregnancy.
When you first find out you’re pregnant make sure you review your asthma medicines and your asthma action plan with your GP/asthma nurse. Talk to your midwife about your asthma too at your first antenatal appointment.
See your GP or asthma nurse regularly throughout your pregnancy to make sure your asthma is under control and talk to your midwife about keeping your asthma symptoms under control while you’re pregnant and during labour.
If you’ve had a baby before, your asthma is likely to be similar during this pregnancy to how it was during your other pregnancies. As long as your asthma is well controlled the risk of complications to you or your baby is very small.
Will my baby develop asthma?
We don’t know the exact cause of asthma, but we do know that asthma often runs in families. Your baby is more at risk of developing asthma or breathing problems if:
- you smoke while pregnant
- both parents have asthma. If only one parent has asthma, the baby has a greater chance of developing asthma if it’s the mother who has asthma rather than the father.
There’s no proof that avoiding certain foods during pregnancy stops your baby from developing asthma.
Will my asthma medicine harm my baby?
No. The medicines used to treat asthma are safe in pregnancy and won’t harm your baby. This includes reliever inhalers (usually blue); preventer inhalers; long-acting and combined relievers; theophyllines; and steroid (prednisolone) tablets. There are more risks to both you and your baby if you don’t take your medicines and your asthma gets worse.
There’s one group of medicines that wouldn’t normally be started while you’re pregnant called leukotriene receptor antagonists (Montelukast/Zafirlukast). If you were taking these before you got pregnant and it was working well for your asthma, your GP or asthma nurse will probably advise you to continue with this medicine to make sure your asthma stays stable. This is one of the ways your GP or asthma nurse weighs up what’s best for you, balancing your asthma care and your care while you’re pregnant.
You can talk about your concerns about medicines and side effects at your asthma review.
Is it safe to have the flu vaccine?
The flu vaccine is recommended for pregnant women as well as for anyone with a long-term respiratory condition such as asthma, because of the higher risk of developing complications from flu. It’s safe to have the flu vaccine at any stage of your pregnancy with no risk to you or your baby. Having the flu vaccine while you’re pregnant will also protect your baby from flu in the first few months of its life.
How can I look after my asthma while I’m pregnant?
It’s important for you, and your baby, that your asthma stays stable during your pregnancy. You can do this by:
- taking your asthma medicines regularly as prescribed even if you have no symptoms
- downloading an asthma action plan to fill in with your GP or asthma nurse
- reviewing your asthma regularly with your GP or asthma nurse
- making sure you’re using your inhalers in the best way by asking your GP, asthma nurse or pharmacist to check your inhaler technique.
If you have difficult or severe asthma you should have a consultant respiratory physician as well as an obstetrician caring for you.
What should I do if my asthma gets worse while I’m pregnant?
Make an appointment to see your GP or asthma nurse as soon as possible so they can make changes to your usual asthma medicines if necessary. Sometimes a short course of steroid tablets may be prescribed. These are safe to use during pregnancy. To reduce your risk of your asthma symptoms getting worse continue to take your preventer inhaler regularly and use your reliever inhaler when you need it to relieve symptoms.
If you find that you’re using your reliever inhaler more than three times a week speak to your GP or asthma nurse as this can be a sign that your asthma isn’t under control.
What should I do if I have an asthma attack while I’m pregnant?
Having an asthma attack is always an emergency whether you’re pregnant or not. When you’re pregnant it’s more important than ever to keep your risk of an asthma attack low to avoid the risk of complications for you, and for your baby.
Make sure you, and the people around you, know what to do in an asthma attack. Download our asthma attack card here.
Women who smoke while they’re pregnant are more likely to have babies who have breathing problems, including asthma. Smoking while pregnant also increases your risk of miscarriage or going into premature labour.
Smoking isn’t good for your asthma, for your baby or for your health generally. You can find support to stop smoking at www.smokefree.nhs.uk. You can also talk to your GP, practice nurse or pharmacist to see if they run a Stop Smoking Clinic. Remember to ask friends and family to avoid smoking around you.
A healthy diet while you’re pregnant
There’s no proof that avoiding certain foods during pregnancy reduces the risk of your baby getting asthma. In the past the UK Government advised pregnant women to avoid eating peanuts. However, following a major review of the scientific evidence in 2009, this guidance was revised and the advice now is that it’s safe to eat peanuts while you’re pregnant, unless you’re allergic to them or your health professional advises you not to. Further advice about eating peanuts during pregnancy, breastfeeding, and in your child’s early years can be found on the Food Standards Agency website:http://food.gov.uk/science/research/allergy-research/allergy-labelling/t07061/#.U9-KZuNdXTo
Some women develop new sensitivities to certain foods when they’re pregnant, but others find their pregnancy reduces food sensitivities they already have.
The best advice for all pregnant women is to eat a healthy balanced diet with plenty of fresh fruit and vegetables. This will give your baby all the nutrition it needs to grow to a healthy weight.
What if I have an asthma attack when I’m in labour?
Asthma attacks during labour are very rare because your body produces hormones (cortisone and adrenaline) that help with labour. These natural steroid hormones also help prevent asthma attacks. Even if your asthma did get worse during your pregnancy these symptoms are usually less by the time you reach the later stages of your pregnancy.
If you do have asthma symptoms during labour it’s safe to use your reliever inhaler as normal. It won’t harm your baby in any way. If you’re on high doses of steroids, and have been for more than two weeks before you go into labour, make sure you tell your doctor or midwife, as they’ll need to make sure you continue to take these medicines while you’re in labour. If you have a latex allergy make sure staff at the hospital know so that they can take necessary precautions.
Talk to your GP, asthma nurse or midwife beforehand about a birth plan. This will make sure your asthma is also thought about and can help reduce any fears you may have about having asthma and giving birth.
What about pain relief during labour?
There are a number of different ways to control pain during labour, including Pethidine and epidurals, all of which are safe for women with asthma.
If you need to have a caesarean (a C-Section) it’s recommended that women with asthma have a local anaesthetic rather than a general one wherever possible.