For What to Expect's "What I Wish I’d Known" series, moms and dads share the wisdom they’ve gained since first becoming parents.
As a soon-to-be mom, I've been somewhat surprised how smoothly my first pregnancy has gone — I've been running 15 miles a week, measuring right on target and (thankfully) have avoided major complications so far. That is, until a few weeks ago. Lying in bed surrounded with tissues and a humidifier running on full blast, I couldn't help but break down crying — partially because I was 26 weeks along and somewhat hormonal, but mostly because I had come down with a miserable, no-good case of the flu.
To put it mildly, getting the flu when you're pregnant is terrible, but now that both my baby and I are healthy, I have some tips for other moms who find themselves in the same sniffly and snotty situation. There are things you can do to both prevent the flu and make recovery easier on yourself in case you get it, the most important of which is getting vaccinated, like I did. While immunization can't guarantee you won't catch the flu (case in point: me), it can keep you from getting super sick.[1]
"The antibodies generated by the flu vaccine do not entirely prevent infection, but they can help fight the flu and lessen the severity of symptoms," confirms Jennifer Wu, M.D., an OB/GYN in New York City and a member of the What to Expect Medical Review Board.
- The flu shot is safe and recommended for pregnant women, and it can reduce symptoms if you do get sick.
- Tamiflu, Tylenol and Mucinex are all safe treatment options if you're sick with the flu during pregnancy.
- Call your doctor ASAP if you experience a high fever, decreased fetal movement, severe pain, sudden dizziness or shortness of breath.
Here's what else I wish all pregnant moms knew about getting sick that can make it so much easier.
There are record number of flu cases right now
In the event you've somehow avoided all of the viruses floating around right now, you might not know that the flu has hit especially hard this year. The Centers for Disease Control and Prevention (CDC) reports at least 37 million cases, 480,000 hospitalizations and 21,000 deaths so far.[2] These numbers exceed any flu season in the past 15 years.[3]
What I Wish I'd Known
That's not great for anyone, but pregnant women especially need to take caution because they're more susceptible to the flu and can come down with worse cases than other adults.
"In pregnancy, the fetus is half 'not you' so your immune system essentially goes on vacation to protect the developing baby," says Laura Baecher-Lind, M.D., M.P.H., an OB/GYN at Tufts Medical Center in Boston. "That makes pregnant people more prone to getting sick after an exposure to a virus like the flu. Because of these immune system changes and also because lung volume decreases as pregnancy progresses, pregnant people can have more severe symptoms from the flu and complications like pneumonia, hospitalization, needing a breathing tube or even death. Thankfully, most pregnant people with the flu don’t have these complications, but the likelihood is higher."
What I wish other moms knew about the flu
Avoiding the flu may seem impossible, and you might assume there's not much you can do. However, as someone who's gone through it recently, I really want other moms to know that it's still important to get immunized — and that if you do get sick, it's totally safe to take any medications your doctor recommends. Here's what else I wish all moms knew:
Getting your flu shot offers some protection — and can make you less sick
It is true that the flu shot isn't 100% effective at preventing the flu. Each year, infectious disease specialists try to predict the predominant flu strains that will circulate and design a vaccine that will offer the most protection.[4] This year's flu shot is about 36% to 54% effective in helping adults avoid the flu, experts estimate, which might not sound that high. It's why I still got sick even though I had gotten the vaccine early on in flu season, back in the fall at my OB's office.[5]
The great thing about the shot, though, is that it's pretty effective at keeping you out of the hospital if you do get sick. Anecdotally, I never ran a fever, and I never had to go to the hospital. Getting the vaccine also probably made my symptoms more mild, explains Shannon Smith, M.D., an OB/GYN at Brigham Faulkner OB/GYN Associates in Boston and a member of the What to Expect Medical Review Board.
"While the yearly flu vaccine is a 'guess' as to the most likely strains to dominate in the population that flu season, there's still great benefit even if the formulation is wrong," Dr. Smith says. "There is cross immunity and protection between strains. It's clearly shown that for people vaccinated, the severity and complications of the virus are greatly diminished."
As a new mom who's also just trying to do her best, I also really appreciated knowing that by getting the vaccine, I had done what I could to protect myself and my baby. That thought alone offered some peace of mind at a time when I felt really stressed.
Call your doctor right away if you start feeling sick
I first noticed something was off when I woke up on a Tuesday morning feeling achy and tired. Looking back, the first thing I should have done was call my OB's office and get advice on next steps, but I just chalked it up to a bad night's sleep — pregnancy will do that to you! — or the common cold. But a couple days later, I heard from the group of friends I'd hung out with the previous weekend. Out of our group of 10, eight of us felt sick — increasingly sick.
All of a sudden, I panicked. Did I need to get flu and COVID tests from the pharmacy? What was I going to do? When I called my OB's office and talked with one of the nurses on staff, she confirmed that a wicked wave of influenza A was hitting Boston, where I live, and that all of my symptoms (aches, coughing, congestion, fatigue …) sounded like a textbook case.
The good news: I didn't have a high fever, decreased fetal movement, or shortness of breath — concerning symptoms that I'd need to come in for — and at that point, I didn't need to take a test. The bad news: I had missed the boat on taking prescription antiviral medication (e.g., Tamiflu), which needs to happen within 48 hours of symptoms first appearing and can reduce the illness severity and length.
Take Tamiflu, if you can
At that moment, I burst into tears — if only I had called earlier, I could have had a treatment that would make me feel better! It's true that Tamiflu can help, Dr. Smith says, and it's safe to take during pregnancy.
"I encourage many of my patients to take it in order to decrease the severity of illness and reduce the risk of complications," she says. "If you have a known flu exposure, you can get prophylactic dosing as well to help prevent infection — but this should not be used as a substitute for vaccination."
That's another reason to call right away if you're feeling flu-y or worried you might feel that way soon: Your doctor can do a quick test for the flu. Results come back in minutes, Dr. Wu says.
You can safely take Tylenol and Mucinex when you're pregnant
Prior to that phone call with the nurse, I had avoided taking any over-the-counter medication for my symptoms. I think part of me was in denial about how sick I was, and the irrational part of my brain was worried about whether acetaminophen would impact my pregnancy.
When I did talk to the nurse, she confirmed what I (rationally) knew: It's safe to take acetaminophen (e.g., Tylenol) when you're pregnant, and it won't hurt your baby. It can help with that all-over body pain and reduce a mild fever if you have one.
The other thing she told me: I could take guaifenesin (e.g., Mucinex) to alleviate the extreme congestion I felt at that point. (I was so stuffed up she could hear it over the phone.) I didn't know that Mucinex got the green light during pregnancy, and it was so helpful once I started taking it and could breathe through my nose again.
Invest in some things to make yourself more comfortable
The last time I had the flu was in 2008. (Remember the swine flu?) I had totally forgotten how long and how rough this sickness can be. This time around, it took me a few days to figure out the key things that made a difference, at least in my case. Here are the home remedies I wish I had used from day one:
Plug in that humidifier. It can reduce stuffiness and break up mucus.[6] If you don't own a humidifier already, you'll probably want one for your nursery, regardless!
Have soup on hand. Luckily for me, I happened to have frozen Italian wedding soup ready to go. The warm broth and mini meatballs were the perfect comfort food when I was too sick to cook. It can't hurt to store a few extra cans in your pantry or containers in your freezer during sick season. And if you do get caught soup-less, it's the perfect time to get delivery from a ramen shop or another neighborhood favorite.
Stock up on the good tissues with lotion. I think I went through two boxes in 10 days, but at least my nose wasn't raw.
Try saline spray or rinse. All of that mucus can make you feel pretty yucky. These can help clear it out so you can breathe easier.[7]
Invest in cozy pajamas. If you've put off buying maternity jammies, now's the time to get yourself a pair. It's harder to feel comfy when your shirt is constantly riding up on your belly.
You will get better
At the time, it felt pretty scary to be so sick and pregnant. Reminding myself that I would feel better in seven to 10 days and that I had a good health care team a phone call away helped calm my nerves.
Make sure you check in with your care team as soon you feel flu symptoms so you know when to seek help. Concerning symptoms that warrant a call include:[8]
Decreased fetal movement
High fever
Severe muscle pain or weakness
Pain or pressure in the chest or belly
Sudden dizziness or confusion
Shortness of breath
Flu symptoms that get better but then come back
After about 10 days of couch time and rest, my baby and I are totally healthy — and my husband and I got to enjoy our babymoon the next weekend tissue- and Tylenol-free.
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