Swine flu (H1N1) - Pregnancy 

Swine flu advice for pregnant women 

Pregnant women are at greater risk from swine flu because their immune system is suppressed during pregnancy.

This means that pregnant women are more likely to catch flu and, if they do, they are at greater risk of developing complications (see below).

However, during pregnancy, the immune system still functions and the risk of complications is very small. Most pregnant women will only have mild symptoms.

Symptoms and risks

If you are pregnant and you catch swine flu, the symptoms are likely to be similar to those of normal flu. You will usually have a fever (a high temperature of or above 38C/100.4F), plus two or more of the following symptoms:

  • unusual tiredness
  • headache
  • runny nose
  • sore throat
  • shortness of breath or cough
  • loss of appetite
  • aching muscles 
  • diarrhoea or vomiting

Most pregnant women will have only mild symptoms and recover within a week. However, there is evidence from previous flu pandemics that pregnant women are more likely to develop complications.

Possible complications include:

In pregnant women, these are more likely to happen in the second and third trimester.

If a pregnant woman develops a complication of swine flu, such as pneumonia, there is a small chance this will lead to premature labour or miscarriage. There is not yet enough information to know precisely how likely these birth risks are.

It is therefore important to be well prepared and to take precautions against swine flu.

Vaccination and pregnancy

Pregnant women are advised to take the seasonal flu jab, whatever the stage of pregnancy. This includes pregnant women not in high-risk groups.

This year's seasonal flu jab offers protection against the swine flu virus, as well as other strains of flu virus.

There is no evidence that inactivated vaccines, such as the seasonal flu vaccine, will cause any harm to pregnant women or their unborn baby. Every year, the seasonal flu vaccine is given to pregnant women who are at risk of flu.

The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency has given a clear recommendation that the GlaxoSmithKline vaccine Pandemrix can be given safely to all pregnant women.

Special precautions

If you are pregnant, you can reduce your risk of infection by avoiding unnecessary travel and avoiding crowds where possible.

Pregnant women should also follow general measures to prevent swine flu, as described below. Good hygiene is essential.

You can reduce, but not eliminate, the risk of catching or spreading swine flu by:

  • always covering your nose and mouth with a tissue when coughing or sneezing
  • throwing away dirty tissues promptly and carefully
  • maintaining good basic hygiene, for example
  • washing hands frequently with soap and warm water to reduce the spread of the virus from your hands to your face, or to other people
  • cleaning hard surfaces, such as door handles, frequently using a normal cleaning product

If you think you may have swine flu, call your doctor for an assessment. Your doctor will advise you what to do if they think you have flu.

Unless you have swine flu symptoms, carry on attending your antenatal appointments to monitor the progress of your pregnancy.

Antivirals

If you are pregnant and diagnosed with swine flu, you may be given a course of antiviral medication.

If you have an uncomplicated illness due to influenza and do not have an underlying disease, you can take either Relenza or Tamiflu. Relenza is recommended as a first choice.

Relenza is inhaled using a disk-shaped inhaler. It is recommended for pregnant women because it easily reaches the throat and lungs, where it is needed, and does not reach significant levels in the blood or placenta. Relenza should not affect your pregnancy or your growing baby.

However, Tamiflu should be offered instead of Relenza if you:

  • have a condition such as asthma or chronic obstructive pulmonary disease
  • have difficulty taking an inhaled antiviral
  • develop a severe or complicated disease due to influenza (where you will probably be treated in hospital)

An expert group reviewed the risk of antiviral treatment in pregnancy. It is much smaller than the risk posed by the symptoms of swine flu.

Some people have had wheezing or serious breathing problems when they have used Relenza. Relenza is therefore not recommended for people with asthma or chronic obstructive pulmonary disease (COPD). Other possible side effects of Relenza include headaches, diarrhoea, nausea and vomiting.

In a small number of cases, nausea is a side effect of Tamiflu.

If you take an antiviral and have side effects, see your healthcare professional to check that you are OK.

Painkillers

You can also take paracetamol to reduce fever and other symptoms. This is safe to take in pregnancy.

However, pregnant women should not take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Nurofen).

Page last reviewed: 12/10/2012

Next review due: 12/10/2014

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Comments

The 21 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Carley9621 said on 04 March 2011

I am currently 14 weeks pregnant but only found out i was pregnant at 11 weeks, i went to see my GP who did not mention to me about having the swine flu jab. The next day i called up my Dr's surgery to request the swine flu jab as it has been clearly published pregnant women should have it to be told they no longer have it in stock and to go to my local Boots or Supermarket pharmacist! After visiting Boots i was told that they are not able to give me the jab as my GP or hospital can only do this. I then went back to my Dr's surgery who have now put me on the waiting list for it but they do not know when they will be receiving it!
The last couple of days i have had a headache and runny nose and feel slightly achy. Now im slightly paranoid that i may be getting ill and worried it could harm my baby....

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Joshine said on 30 January 2011

Stil no available jabs it was supposed to say obviously...

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Joshine said on 30 January 2011

No point in all this warning and warning letters to us pregnant women, when in fact there isn't any flu vaccine available, huh? To me this just seems like scaremongering. I have been waiting for more than a month now and still available jabs at my GP. That didnt prevent them from sendindg me strong letters of warning of all the horrible things that could happen to me if I didnt get it. Thanks a lot!

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Cubbysmum said on 25 January 2011

After a long and tough deliberation process my husband and I decided to go ahead with the jab last year when I was pregnant, because the risks of not having it far outweighed the alleged risks of having it. At the time it was so new that there weren't any mums around to speak to who had had it while they were pregnant. It was a really tough decision to make and I know how hard it can be.
Our baby girl is now 9 months old and is a very healthy, happy, busy, beautiful and bright little girl. I would have no hesitation getting the jab again. The only side effect I experienced was a slightly sore arm at the sight (like I'd been doing press-ups). Gave me the peace of mind I needed.
Ultimately you have to make the decision that is right for you and your partner.

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Reisha barr said on 15 January 2011

hi i advise all pregnant women to get the jab, i have swine flu and im 18 weeks pregnant! iv been having contracting pains the doc at the hosp didnt want me there nd told me to go home and call my midwife who of course cant come and see me no one has checked to see if my baby is ok, iv just gotta sit nd wait for my symptoms to go before i can see my midwife! it is the scariest thing ever nd i really wish i now had my jab! so please take my advise nd get the jab i wouldnt want anyone else to have to go through what iv been through!

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Skydust said on 13 January 2011

I am 15 weeks pregnant and had been feeling unwell for a couple of days; headachy and generally run down. I became a little concerned and on seeing my GP today he gave me my swine flu jab. I agreed to have it, but I am worried about side effects as I MC back in June 2010 and I guess I don't want to put my baby at risk, but I am also aware that pregnant women are dying from Swine flu.. it is a hard decision to make and I am now anxious as to whether I have done the right thing. Anyone had the swine flu vaccine when pregnant and had no serious side effects that affect the baby/pregnancy? Is quite worrying, but I also have been feeling poorly..

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den123 said on 08 January 2011

I had the Swine Flu Vaccine in January last year when I was about 16 weeks pregnant. Having had 3 previous miscarriages, at the time it was a big decision to make. However, I felt that being pregnant and asthmatic put me at higher risk than many others and decided to go ahead with it. I had no ill effects from the jab apart from a sore arm for a couple of days. I now have a beautiful healthy baby girl following a very normal pregnancy. Having the swine flu vaccine gave me peace of mind throughout my pregancy and I would urge anyone who is unsure, to have it done, as from my experience it did not affect my pregnancy or the health of my daughter.

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OMGMUMMYTOBE said on 08 January 2011

I just found out I am pregnant and now have to make the descion whether to get this flu and swine flu jab or not. This is my first pregnancy so I am learning alot and need advice on what to do. I am prone to catching the cold if anyone around me has it but only twice in the past 2 years have i been really ill with flu. I am really confused whether to get the jab or not?????????????????

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samscam said on 07 January 2011

Hi, I am currently 21+4 weeks pregnant after 2 miscarriages i am really concerned about having the vaccine i dont want to put my baby at any risk as its taken 2 years to get this far. I am very rarely ill, i can only remember one time in 4 years. I have always had a high immune system (apparently its because my mum let me eat worms!) everywhere says no it wont harm your baby but surely as the vaccine for swine flu has only been out 1 year they havent had enough time to properly check. Am I the only one to be thinking like this??
Sam

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Kym79 said on 07 January 2011

I am currently 18 weeks pregnant with my second child. I am unable to have the flu vaccine as I had an extremely bad reaction to it a few years ago which took me nearly 8 months to recover from (this is very rare and only occurred as I was suffering from a post viral illness at the time so please don't be put off having the vaccine - get it if you can!!). I was advised by both my GP & a microbiologist not to have the vaccine. I have received no advice as to what symptoms to look out for, what to do if I think I have flu, or how best to protect myself. I actually work in a Pathology department in a hospital and know that we have already had deaths in our area due to flu and have over 10 people in ICU due to flu including a pregnant woman. To be honest, I am really quite scared! My two year old is at nursery, which are well known for being germ factories - good for her immune system but not so good when you are trying to avoid flu! Though this page states that the risks are relatively low with all the media coverage impressing the importance of vaccinating pregnant women I feel less than reassured.

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Dr M said on 06 January 2011

I'm a GP and pregnant - on here checking out the page prior to recommending it to my patients so I thought I'd answer the questions posed.
Cathy - we have been advised by the department of health that people should have this year's flu vaccination regardless of whether they had it or the swine flu jab last year as you should have a booster to ensure you are still covered. This year's flu jab contains the swine flu vaccine so will boost last year's jab. For this reason I've had my vaccination in pregnancy despite having had it last year to ensure I'm covered.
-Marie, I'm sorry to hear about your daughter. Most people with flu, including swine flu do get over it well and although there are very sad cases in the news when this was not the case, this is thankfully rare. The most likely outcome is that your daughter will get well over the next 2 weeks. Poor thing. It's more likely she picked it up before hospital as it has an incubation period after infection with the virus before you get symptoms if that makes you feel any better about the safety of the delivery unit.

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Marie Hudson said on 05 January 2011

My Daughter has just given birth to her Son yesterday and now has suspected swine Flu, she was never contacted to be given the vaccination and her midwife never advised her to get the jab. If she does have it she has caught it since going into hospital as she was healthy before being admitted on Saturday. I am incredibly concerned for her and the baby, can anyone advise me on the risks both of them are facing?

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cathyearmstrong said on 04 January 2011

Hi, am seeking advice if possible.

I was vacinated against swine flue approx 16 months ago and am currently 37 weeks pregnant. 3 weeks ago at an ante natal meeting I was advised by the midwife that I was still covered by the vaccine. However with the recent increase in cases of swine flu in pregnancies locally and media coveeage I vistsed an nhs website which advise that the vaccine should be boosted on a yearly basis. Can anyone advise is this the case o was the advice of the midwife correct?

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Miss S said on 22 December 2010

I work for the NHS & have been informed that some patients have been admitted with symptoms of swine flu. I asked my occupational health dept about the flu jab & she told me I couldn't have it becuase i am pregnant, i am confused as everything else i have read says i should have the jab.

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dthacker said on 19 November 2009

Had a letter home from my eldest childs school 3 weeks ago stating a child has swine flu. So I went straight to my gp surgery to find out about the vaccine and I told them what was happening. They said they have the vaccine in and was sending out appointments for priorty groups, they took my name to make sure I was forgotten. Which concerned me straight away. And as of yet I still haven't heard a thing. This is stupid and concerning to me. Why is there such a hold up I'm 29 weeks pregnant and ill all the time and I have to take iron tablets to. But they can't be bothered. I think the nhs should buck up there ideas and start helping people before there is a huge problem. They keep on about it but seem to be doing nothing. I will put a post on here when I have the vaccine, I'm going down the gps to nag tomorrow, hopefully that will speed it up. Doubtful though

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dthacker said on 19 November 2009

I'm very concerned with the local gps in regards to giving out the vaccines for pregnant people. About 3 weeks ago I had a letter home from my eldest childs school stating there has been a case of swine flu, so I spoke to my gp surgery and they said that they have the vaccines in and will be giving me my appointment soon, they took my name but I haven't heard a thing. They are being incompetent. Will they not act until there is a serious problem. I will add a post on here when I have the injection. I am also going to nag the gp. Maybe they might be a tad quicker.

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SJS1026 said on 04 November 2009

I agree with 'cao' I called my GP surgery last week (as I am 10 weeks) and they had no idea whether they would be receieving supply of the vaccine and when. I find it quite troubling that the NHS and all the health authorities like the WHO are saying it's critical for pregnant women to get the vaccine, but then GP surgeries seem to be very much behind the ball in contacting high risk patients or even having any info on timelines. Surely there must be a plan for this and GPs have been properly informed of process and timings before the NHS makes sweeping statements to the public about the need to be vaccinated?

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cao said on 02 November 2009

My GP surgery does not yet have supplies of vaccine, nor does it know when the vaccine will arrive. Surely there is a rollout schedule for supplying surgeries, which could then be used for priority patients to book appointments. The current dearth of information does not engender any confidence in the system. I am 35 weeks pregnant and have not been able to ascertain when I might be able to get the vaccine, or if there is an alternate route to the GP surgery.

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cao said on 02 November 2009

My GP surgery does not yet have supplies of vaccine, nor does it know when the vaccine will arrive. Surely there is a rollout schedule for supplying surgeries, which could then be used for priority patients to book appointments. The current dearth of information does not engender any confidence in the system. I am 35 weeks pregnant and have not been able to ascertain when I might be able to get the vaccine, or if there is an alternate route to the GP surgery.

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sherbear09 said on 14 September 2009

Sheribump... I agree with you.. I am 36 weeks pregnant, due Oct. 13. Will I also miss the high risk group for the swine flu vaccine? Myself and both my kids have had the seasonal flu shot about 2 weeks ago, but what about the H1N1 vaccine? I also think that prenant women that gave birth winthin 2-3 mos should still be high risk... how can we care for our newborn if we are sick or how do we tell if our newborn is sick? My son, who is sick today, has swine flu symptoms..... now I 'm concered for my 3 yr old? Should I start taking tamiflu even though i do not have symptoms?? I agree with you and know where you are coming from...

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sheribump said on 18 August 2009

im concerned that i wil miss being high risk group as my baby is due the 26th of october are the vaccines avalible before then ?? surely if u have just givin birth within the last 2 months your still high risk as your immune system is still gettin back to normal also not getting a lot of sleep which is also not good for fighting infection and how do they expect a mum to care for a new born if they are ill with flu and they can also pass it on to a newborn baby ?? also i have no idea what to look out for in a new born as they cant exactly tell me if they have aches or are shivery can they what should we do to help protect and diganose our new borns ????

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