Influenza (flu) and pregnancy

Influenza is a serious disease. It’s more than just a runny nose and sore throat. Instead, it can cause a person to be very sick. 

Influenza is commonly called the “flu.” Many people say they have the flu when they really have just a cold or a cough. If you do get the flu, it can cause serious illness. And for some people, it can be life-threatening. It can be especially harmful to pregnant women. Pregnant women are at high risk of having serious health problems from the flu.

The flu is easily spread from person to person. When someone with the flu coughs, sneezes or speaks, the virus spreads through the air. You can get infected with the flu if you breathe it in. You also can get infected if you touch something (like a door handle or a phone) that has the flu virus on it and then you touch your nose, eyes or mouth.

The best way to protect yourself from the flu is to get the flu vaccine each year before flu season starts in October. You can get the vaccine from your health care provider. Many pharmacies and work places also offer it each fall. Even though you’re more likely to get the flu during flu season (October through May), you can get it any time of year. 

How do you know if you have the flu?

You may have the flu if you have any of these signs and symptoms:

  • Fever
  • Chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches 
  • Headaches
  • Feel very tired
  • Vomiting and diarrhea (more common in children)

For most people, symptoms last a few days. But some people, including children, people older than 65 and pregnant women, can be sick from the flu for a longer time. 

How can the flu harm your pregnancy?

Health complications from the flu, such as pneumonia, can be serious and even deadly, especially if you’re pregnant. Pregnant women who get the flu are more likely than women who don’t get it to have preterm labor and premature birth. These are labor and birth that happen too early, before 37 completed weeks of pregnancy. Premature birth can cause serious health problems for your baby

The flu can be harmful during pregnancy because pregnancy affects your immune system. Your immune system is your body’s way of protecting itself from illnesses and diseases. When your body senses something like a virus that can harm your health, your immune system works hard to fight the virus.

When you’re pregnant, your immune system isn’t as quick to respond to illnesses as it was before pregnancy. Your body knows that pregnancy is OK and that it shouldn’t reject your baby. So, your body naturally lowers the immune system’s ability to protect you and respond to illnesses so that it can welcome your growing baby. But a lowered immune system means you’re more likely to catch illnesses like the flu.

Another reason the flu can be harmful during pregnancy is that your lungs need more oxygen, especially in the second and third trimesters, for you and your baby. Your growing belly puts pressure on your lungs, making them work harder in a smaller space. You may even find yourself feeling shortness of breath at times. Your heart is working hard, too. It’s busy supplying blood to you and your baby. All of this means your body is stressed during pregnancy. This stress on your body can make you more likely to get an illness like the flu.

Is it safe to get the flu vaccine during pregnancy? 

Yes. The flu vaccine is safe at any time during pregnancy. 

All women who are pregnant or planning to be pregnant during flu season can get the flu vaccine.  It can help protect you from getting the flu and spreading it to others. It also can help protect your baby during pregnancy and in the first few months of life until he’s old enough to get the vaccine himself.. Babies born to women who get the vaccine during pregnancy are less likely to get sick with the flu.

The 2013-2014 influenza vaccine protects you against seasonal flu and the H1N1 flu that spread around the world in 2009. It’s important to get the vaccine every year because the viruses are always changing, so protection from the vaccine only lasts about a year. You can get the vaccine from your health care provider or at places like local health clinics, health departments and pharmacies.

Pregnant women should get the flu shot. Although a flu mist (spray in the nose) is available, it’s not recommended for pregnant women.

In the past, the flu vaccine wasn’t recommended for people who are allergic to eggs. But new egg-free vaccines make it safe for people with egg allergies. If you have an egg allergy, talk to your provider to make sure you get the egg-free vaccine.  

How is the flu treated?

If you think you have the flu, call your health care provider right away. He can give you medicines to help protect you and your baby from the infection. Some medicines can help fight the flu, but you need a prescription for them from your health care provider. It’s important to start these medicines right away.

The Centers for Disease Control and Prevention (CDC) recommends two medicines for flu. Talk to your provider about which medicine is right for you: 

  1. Oseltamivir (Tamiflu)
  2. Zanamivir (Relenza) 

Fever and most other symptoms can last a week or longer. If you’re uncomfortable from fever, ask your health care provider if you can take acetaminophen (Tylenol®). 

If you have the flu, get lots of rest and drink plenty of fluids. You may not want to eat much. Try eating small meals to help your body get better.

When should you call your health care provider?

Call your provider right away if you have any of these signs and symptoms:

  • Trouble breathing or shortness of breath 
  • Pain or pressure in the chest or belly
  • Sudden dizziness
  • Confusion
  • Severe or persistent vomiting 
  • Symptoms that get better but then come back with fever and worse cough
  • High fever that doesn’t go down after taking acetaminophen
  • Feeling your baby move less or not at all

How can you stop the flu from spreading?

When you have the flu, you can spread it to others. Here’s what you can do to help prevent it from spreading:

  • Stay home when you’re sick.
  • Limit your contact with others.
  • Don’t kiss anyone.
  • Cough or sneeze into a tissue or your arm. Throw used tissues in the trash.
  • Try not to touch your eyes, nose and mouth.
  • Wash your hands with soap and water before touching anyone.  You also can use alcohol-based hand rubs (sanitizers).
  • Use hot, soapy water or a dishwasher to wash your dishes and utensils.
  • Don’t share your dishes, glasses, utensils or toothbrush. 

For more information

Last reviewed September 2013

See also: Flu and your babyVaccinations during pregnancy

Most common questions

What is mononucleosis?

Mononucleosis (also called mono) is an infection usually caused by the Epstein-Barr virus (EBV). It’s sometimes caused by another virus called cytomegalovirus (CMV). EBV and CMV are part of the herpes virus family. Mono is most common in teenagers and young adults, but anyone can get it. Mono is called the “kissing disease” because it’s usually passed from one person to another through saliva. In addition to kissing, it can also be passed through sneezing, coughing or sharing pillows, drinks, straws, and toothbrushes.

You can have mono without having any symptoms. But even if you don’t get sick, you can still pass it to others. Symptoms can include:

  • Achy muscles
  • Belly pain
  • Fatigue (feeling tired all the time)
  • Fever
  • Sore throat
  • Swollen glands in your neck

If your symptoms don’t go away or get worse, tell your health care provider. He’ll most likely do a physical exam and test your blood to find out for sure if you have mono.

There’s no vaccine to prevent mono. There’s also no specific treatment. The best care is to take it easy and get as much rest as you can. It may take a few weeks before you fully recover.

Can Rh factor affect my baby?

The Rh factor may be a problem if mom is Rh-negative but dad is Rh-positive. If dad is Rh-negative, there is no risk.

If your baby gets her Rh-positive factor from dad, your body may believe that your baby's red blood cells are foreign elements attacking you. Your body may make antibodies to fight them. This is called sensitization.

If you're Rh-negative, you can get shots of Rh immune globulin (RhIg) to stop your body from attacking your baby. It's best to get these shots at 28 weeks of pregnancy and again within 72 hours of giving birth if a blood test shows that your baby is Rh-positive. You won't need anymore shots after giving birth if your baby is Rh-negative. You should also get a shot after certain pregnancy exams like an amniocentesis, a chorionic villus sampling or an external cephalic version (when your provider tries to turn a breech-position baby head down before labor). You'll also want to get the shot if you have a miscarriage, an ectopic pregnancy or suffer abdominal trauma.

I had a miscarriage. How long should I wait to try again?

Before getting pregnant again, it's important that you are ready both physically and emotionally. If you don't need tests or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant after one normal menstrual cycle. However, it may take longer for you to feel emotionally ready to be pregnant again. Everyone responds differently to a miscarriage. Only you will know when you are ready to try to get pregnant again.

Are gallstones common during pregnancy?

Not common, but they do happen. Elevated hormones during pregnancy can cause the gallbladder to function more slowly, less efficiently. The gallbladder stores and releases bile, a substance produced in the liver. Bile helps digest fat. When bile sits in the gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow of bile, causing indigestion and sometimes serious pain. Staying at a healthy weight during pregnancy can help lower your risk of gallstones. Exercise and eating foods that are low in fat and high in fiber, like veggies, fruits and whole grains, can help, too. Symptoms of gallstones include nausea, vomiting and intense, continuous abdominal pain. Treatment during pregnancy may include surgery to remove the gallbladder. Gallstones in the third trimester can be managed with a strict meal plan and pain medication, followed by surgery several weeks after delivery.

©2013 March of Dimes Foundation. The March of Dimes is a non-profit organization recognized as tax-exempt under Internal Revenue Code section 501(c)(3).