During pregnancy your body goes through many changes and this can affect your asthma in different ways. Some people may find their asthma improves, some experience no change in their asthma and some find their asthma gets worse.
You'll probably have lots of questions about your asthma if you are pregnant, and we'll try to answer some of these here. We also recommend having a chat with your doctor, asthma nurse or midwife about how you can keep your asthma symptoms under control during pregnancy and labour.
Can my asthma medicine harm my baby?
No. In general, the medicines used to treat asthma are safe in pregnancy. This includes reliever inhalers, preventer inhalers, long-acting relievers, theophyllines and steroid tablets. There are more risks to both you and your baby if you don't take your medicines and your asthma gets worse.
There is one group of asthma medicines that wouldn't normally be started during pregnancy called leukotriene receptor antagonists (Montelukast or Zafirlukast). However, if you were taking Montelukast/Zafirlukast before you became pregnant, and it's working well for your asthma, you will probably be advised by your GP to continue taking it.
What should I do if my asthma gets worse while I'm pregnant?
Take your preventer regularly and your reliever inhaler as needed to relieve your symptoms and make an appointment to see you GP or asthma nurse as soon as possible. Your GP or asthma nurse may make some changes to your normal medicines or prescribe you a short course of steroid tablets. These are safe to use during pregnancy.
What should I do if I have an asthma attack while I'm pregnant?
Having an asthma attack when you're pregnant is an emergency. Here are the steps of what to do if you have an asthma attack:
- Take one to two puffs of your reliever inhaler (usually blue), immediately.
- Sit down and try to take slow, steady breaths.
- If you don't start to feel better, take two puffs of your reliever inhaler (one puff at a time) every two minutes. You can take up to ten puffs.
- If you don't feel better after taking your inhaler as above, or if you are worried at any time, call 999.
- If an ambulance doesn't arrive within 10 minutes and you are still feeling unwell, repeat step 3.
If your symptoms improve and you do not need to call 999, you still need to see a doctor or asthma nurse within 24 hours.
Please note - our asthma attack advice is not relevant for people on the Symbicort SMART regime who should speak to their doctor or asthma nurse for asthma attack advice.
How often should I be seeing my doctor or nurse about my asthma while I'm pregnant?
People with asthma usually have their asthma reviewed by a doctor or asthma nurse every year, however we know that during pregnancy asthma may get better, get worse or stay the same. This can vary at different times of your pregnancy so it's a good idea to go and see your doctor or asthma nurse to have your asthma reviewed early on in your pregnancy and then to have regular reviews during your pregnancy.
Can I smoke during pregnancy?
If you are pregnant it's best for you and your baby if you stop smoking and ask people to avoid smoking around you. Women who smoke during pregnancy are more likely to have babies who have breathing problems, including asthma. Children whose parents smoke are 1.5 times more likely to have asthma.
Smoking while pregnant also has other harmful effects, eg you're more likely to have a miscarriage and go into premature labour. We know that quitting smoking is difficult, so if you're thinking of trying to quit, visit the NHS Smokefree website smokefree.nhs.uk or call the NHS Smoking Helpline for some support: England - 0800 022 4332, Wales - 0800 169 0169, Scotland - 0800 84 84 84, Northern Ireland - 0800 85 85 85 . You can also talk to your GP, practice nurse or pharmacist to see if they run a Stop Smoking Clinic.
Should I change my diet?
During pregnancy it's important to have a healthy, balanced diet with plenty of fruit and vegetables. This will help make sure that your baby gets all the nutrition it needs.
- There is no convincing evidence that avoiding any foods during pregnancy will help prevent your baby from developing 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 you can eat peanuts if you wish during pregnancy as part of a healthy balanced diet, unless you are allergic to them or your health professional advises you not to. Further advice can be found on the Food Standards Agency website: food.gov.uk/safereating/allergyintol/peanutspregnancy
What if I have an asthma attack when I'm in labour?
Asthma attacks during labour are very rare because your body produces extra natural steroid hormones (cortisone and adrenaline), which help to prevent asthma attacks.
If you do find yourself getting asthma symptoms during labour (eg coughing, wheezing, shortness of breath, tightness in the chest), use your reliever inhaler as normal. It will not harm the baby in any way.
Talk to your doctor or midwife beforehand about drawing up a birth plan. This will take your asthma into account and can help to reduce any fears you may have about giving birth.
What about other complications 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 an operation, it won't cause problems provided your asthma is well controlled and the anaesthetist knows that you have asthma.
Will my baby develop asthma?
We don't know the exact cause of asthma, but we do know that the tendency to develop asthma often runs in families. Research has shown:
- If both parents have asthma, the chances of the baby developing asthma are increased.
- 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.
Where else can I go for information?
- Asthma UK Adviceline - you can call our Asthma UK Nurse Specialists for free on 0800 121 62 44
- NHS Choices website
- NHS 24 - Health, information and self care advice for Scotland