Respiratory Medicine
Tips for staying well with your asthma through your pregnancy
Here’s how you can lower the risk of asthma symptoms and asthma attacks:
Keep taking your asthma medicines as prescribed
They are safe to take when you’re pregnant. In fact, your baby is more at risk if you stop taking your medications and as result have symptoms and asthma attacks.
Attend asthma clinic appointments
Your GP or asthma nurse can check your asthma medications, your inhaler technique and update your written asthma action plan. Book further appointments if you notice worsening symptoms during your pregnancy.
Tell your midwife you have asthma
Make sure the diagnosis of asthma is in your notes and included in your birth plan. Your midwife can book you into a high dependency clinic under a consultant obstetrician who can make an individualised care plan for your pregnancy and labour. Looking after your asthma needs to be part of your overall antenatal care plan.
Stop smoking
Smoking while you’re pregnant means your baby is more likely to have breathing problems, including asthma. It also puts you more at risk of both miscarriage and premature labour. Avoid breathing in second hand smoke too. There’s lots of support to help you quit. Speak to your asthma nurse and midwife. Asthma is a long-term condition and cannot be cured but the effects are reversible. Changes in lifestyle, age and health can affect how well controlled asthma symptoms are. Asthma can be controlled through medication and support.
Have the flu-jab
Pregnant women, and people with asthma, are more at risk of complications from flu, like chest infections and pneumonia. The flu jab is safe in pregnancy. It will also help protect your baby from flu in their first few months. Please speak to your GP to arrange this.
Asthma and pregnancy – what to expect
Because every pregnancy is unique and everyone’s asthma is different, it’s hard to predict what will happen with your asthma whilst you are pregnant.
Some pregnant women find their asthma improves. Some don’t notice any changes in their symptoms at all. And some women – especially those with severe asthma – may find their symptoms get worse.
If you do notice changes in your asthma during pregnancy, these may not persist once your baby is born. In most cases asthma goes back to how it was before you became pregnant.
If you have difficult or severe asthma, you will be booked under a consultant obstetrician who can liaise with an asthma specialist to support you during your pregnancy. It is important to keep an eye on your symptoms, and make sure the medicines you’re taking are working well.
Some women notice asthma symptoms for the first-time during pregnancy, if this happens to you, it probably means that you had mild asthma without realising it and pregnancy hormones during pregnancy have triggered your symptoms.
Take action if your asthma symptoms get worse during pregnancy
The sooner you get help the quicker you can lower the risks to you and your baby. Talk to your GP, asthma nurse, obstetrician, or pharmacist if you notice any of the following:
- You’re coughing or wheezing especially at night
- Your chest feels tight
- You’re taking your reliever inhaler more often
If you are taking your reliever more than three times in a week you may be at risk of an asthma attack and should contact your GP for an urgent appointment - Your nose feels stuffy
This is a common pregnancy symptom. But it could also affect your asthma. If your nose is stuffy, you’re more likely to breathe through your mouth instead. This means the air doesn’t get warmed up before it hits your airways and allergens can’t be filtered out properly - You feel more breathless
Getting a bit breathless more than usual is another common pregnancy symptom but don’t ignore it, it’s also a sign that your asthma may be getting worse. - Your hay fever gets worse
Hay fever or pollen allergy can make your asthma symptoms worse so it’s important to treat it. Ask your GP, obstetrician, or pharmacist about which hay fever treatments are safe for you to use during pregnancy. It is likely that you will be recommended eye drops or nasal sprays first. You can also try other ways to relieve hay fever symptoms. - You have acid reflux
This is common in pregnancy and can make your asthma worse. What to do if you’re having an asthma attack
Having an asthma attack is always an emergency, whether you’re pregnant or not. Make sure you, and the people around you know what to do in the event of an asthma attack.
Taking asthma medicines whilst you are pregnant
The medicines used to treat asthma are safe in pregnancy. They won’t harm your baby. This includes reliever inhalers, preventer inhalers, long acting and combined relievers, theophylline, and steroid tablets.
If you are already taking a leukotriene receptor agonist (LTRA) such as Montelukast, it’s safe to continue taking it during pregnancy.
And if you are still taking steroid tablets when you go into labour, your birth team will need to make sure you continue to take these medicines during labour. It’s important that these medicines are not stopped suddenly.
If you are worried about taking your medicines whilst you are pregnant talk to your GP, asthma nurse or midwife or obstetrician. You can also talk about medicines and any potential side effects during your asthma review.
Asthma and giving birth
Talk to your GP, asthma nurse, midwife or obstetrician during the weeks and months before your due date and make sure your asthma is included in your birth plan.
Please remember that each health professional supporting you with the birth knows that you have asthma and is aware of what to do if you have symptoms.
What if I have an asthma attack during labour?
Asthma attacks during labour are very rare. It is thought this is because steroids, your body produces naturally to help with labour, also helps reduce inflammation in your airways.
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 anyway.
Make sure you tell your midwife and the hospital staff about any allergies you have. For example, some people with asthma have a latex allergy and staff should use latex free gloves.
Pain relief during labour for women with asthma
There are several ways to relieve pain during labour and they are all safe for women with asthma. These include:
- Gas and air (Entonox)
- Pain relief injections (usually pethidine)
- Epidurals
If you have severe asthma, your GP, asthma specialist, midwife and obstetrician will talk to you about which pain relief is suitable for you. You can add this to your birth plan.
Different types of birth when you have asthma
Vaginal birth
Most women with asthma can have vaginal birth. But if you are anxious about whether your asthma will affect you giving birth vaginally, discuss this with your midwife or consultant. If, after discussion and support, you still feel you would prefer a planned caesarean, it is your right to ask for one.
Home birth or midwife led unit
If your asthma has been well managed during your pregnancy, it will be safe for you to have your baby at home or in a midwife-led unit. However, if you have needed to increase your asthma medications during pregnancy or have needed hospital treatment for your asthma, you will be advised that it is safer to give birth in hospital.
If labour needs to be induced or accelerated
If your labour must be induced (started medically) make sure you remind your doctor or midwife that you have asthma so they can use the safest medications suitable for you.
You also need to do this if your birth needs moving along (accelerating). Ask your midwife to include details about your asthma in the birth plan and notes.
Having a C-section (caesarean)
Having asthma doesn’t mean you need to have a c-section but if you do have one the anaesthetist will aim to use a spinal block or epidural rather than a general anaesthetic.
A C-section is considered a safer option for women with asthma, it is also safer to use your reliever medication before, during and after the operation if you need to.
If you need to have a c-section under general anaesthetic, please be reassured that the anaesthetist will choose the correct anaesthetic medicines if you have asthma.
Asthma and breastfeeding
Very small amounts of asthma medications pass into breast milk, and these are not harmful to your baby.
Breastfeeding has lots of health benefits for both you and your baby. There is some evidence that even suggests breastfed babies may be less likely to develop asthma later in life.
If you decide to bottle-feed, for whatever reason, it does not mean your baby will necessarily go on to develop asthma. If they do, it may not be because you didn’t breastfeed. There are lots of different reasons why some babies are more likely to develop asthma.
Contact us
If you require any advice about your asthma symptoms during your pregnancy, please contact our respiratory nurse team:
Telephone: 01642 854241
Email: [email protected]
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