During pregnancy the body's natural defenses are compromised - the immune system undergoes significant changes to allow a woman's body to tolerate the foetus, which would otherwise be considered a foreign object.
This is partly why pregnant women who catch COVID-19 may be at increased risk of becoming severely unwell compared to non-pregnant women, particularly in the third trimester, according to the Royal College of Obstetricians and Gynaecologists – and why pregnant women must be careful to take extra precautions against COVID-19.
But it also means that succumbing to everyday colds, coughs and other complaints is often commonplace for those who are expecting. But with many medications considered unsafe, working out what you can and cannot take to aid recovery is a bit of a challenge. Here we look at the best routes to avoiding and treating common illnesses (that aren’t COVID-19) during pregnancy…
Read more about what happens to a pregnant woman who catches COVID-19 in the UAE
Please note: Before taking any medicine when you're pregnant, including painkillers, check with your doctor that it's suitable for you.
HEADACHES AND MIGRAINES
During pregnancy, headaches and migraines have actually been shown to decrease in people who usually suffer from them regularly, especially after the first trimester. However, it’s still common to suffer from headaches during pregnancy, and the reason for them can be anything from hormone and blood volume fluctuations, to dehydration or low blood sugar, caffeine withdrawal for those who’ve given up their morning coffee, or even plain old sinus congestion and tension. However, headaches can sometimes be linked to blood pressure issues in pregnancy, so if you suffer from them often, or if you experience severe migraine headaches while pregnant, do mention it to your doctor. And, if you have a headache that won’t go away, or you experience dizziness or vision problems along with them, contact your healthcare provider.
What to do:
Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are not recommended during pregnancy as they have been linked to complications in labour and aspirin can also increase the risk of bleeding in the mother and baby, particularly if taken in the third trimester (although low-dose aspirin is sometimes prescribed to prevent pre-eclampsia, this should only be done with a doctor’s input). For mild to moderate headaches, only paracetamol is considered safe in pregnancy and can be taken to treat both headaches and mild fever, although it is recommended to only take the lowest dose of paracetamol that works, only for as long as necessary. "Each dose of paracetamol (one to two 500mg tablets) lasts about four hours, and a maximum of 4g (eight 500mg tablets) can be taken in 24 hours," says GP Dr Morag Martindale.
A gentle head massage can sometimes help. For migraine sufferers, the advice from the UK's Migraine Trust is "to take as few drugs as you can and at the lowest effective dose." Some migraine tablets contain ergotamine which has been shown in trials to stimulate the muscles of the uterus, raising the risk of a miscarriage. The Trust also says that the use of triptan drugs should be avoided and, while paracetamol is safest, your doctor will be able to prescribe a migraine medication suitable for use in the second and third trimesters of your pregnancy.
COUGHS AND COLDS
With lower immunity during pregnancy, many women find they suffer a constant stream of niggling coughs and colds. Remedies often contain a combination of several ingredients, including painkillers, antihistamines and decongestants, many of which it is recommended to avoid during pregnancy. Cough medicines containing iodine as an expectorant should be avoided, as the iodine might impair the functioning of a baby's thyroid gland.
What to do:
Drinking lots of water or warm drinks can help to relieve a chesty and inhaling steam can help to loosen mucus. "Although there is no confirmed evidence that vitamin C reduces the duration or intensity of a cold, there is no harm in taking the recommended daily allowance of 40mg if you think it helps," says dietician Louise Sutton. "However, more than this is inadvisable as it can cause diarrhoea and tummy ache." Some soothing cough mixtures are safe to take, but check with your doctort. Honey is also a well-known cough suppressant and throat soother, and its antimicrobial properties mean it can also boost your immune system – it is considered by the UK’s National Health Service to be safe in pregnancy, although it’s worth noting you should not feed it to your baby until he or she is one year old. Try mixing some in warm water with lemon juice and fresh ginger for a stimulating and soothing drink.
Because of their compromised immune systems, pregnant women are statistically more likely to catch the influenza virus than other women, and the later they catch it in their pregnancy, the worse it can be. Studies show that women who get flu during pregnancy are not only at greater risk of dying in childbirth, but that their babies are more likely to have brain damage that causes emotional and development problems, including ADHD.
A 2019 review of 20 studies concluded that maternal infection during pregnancy may be associated with a higher risk of childhood leukemia, while one study suggested that flu in pregnancy doubles the risk of childhood leukemia because the virus triggers changes in a baby's immune system that can increase the likelihood of the blood cancer later in their life. Fever - a symptom of flu - in pregnancy has also been linked to behavioural and psychological disorders in young children by some researchers.
What to do:
Unlike vaccines for some other illnesses, the flu vaccination is considered safe to take during pregnancy and it is thought that the vaccine also protects the baby against catching the virus in the first months of life. Vaccination has been shown to reduce the risk of flu-associated acute respiratory infection in pregnant women by up to 50%. A 2018 study showed that getting a flu shot reduced a pregnant woman’s risk of being hospitalized with flu by an average of 40%.
If you do get flu, doctors recommend you drink plenty of water, take paracetamol to treat a high temperature, headache and muscle pain, but only take over-the-counter medications after consulting a pharmacist or doctor. Generally, aspirin and non-steroidal anti-inflammatories (such as ibuprofen) should be avoided, particularly in the third trimester.
TONSILITIS AND BACTERIAL INFECTIONS
Although bacterial infections, like tonsillitis, are generally treatable with antibiotics, doctors are now being warned not to prescribe the medication to women at risk of premature labour as it may increase the chance of their babies getting cerebral palsy, following a study designed to look into their effect on premature births. Children of mothers prescribed macrolide antibiotics during early pregnancy were also found to be at an increased risk of major birth defects, particularly heart defects, compared with children of mothers prescribed penicillin, according to a study published by The British Medical Journal in February 2020.
What to do:
Despite this study, the Royal College of Obstetricians and Gynaecologists insists most pregnant women showing signs of infection can be treated promptly and safely with antibiotics. It is though that where there is an obvious infection, antibiotics should be prescribed because they could be lifesaving for mother and baby.
With tonsillitis, drugs containing paracetamol can also be taken to bring down temperature, while warm drinks, soft food can help to ease swallowing.
About 40 per cent of women experience constipation during pregnancy, mostly during the early stages. It is thought be a result of raised levels of the female hormone progesterone acting as a relaxant to the intestinal muscles combined with the pressure of the expanding uterus on the intestines. Relaxation of the intestinal muscle causes food and waste to move slower through your system. Iron tablets prescribed for anaemia - common during pregnancy - may also contribute to constipation.
What to do:
Always try drinking more fluids and eating more high fibre foods, including dried and fresh fruit and wholegrain cereals, before resorting to other measures.
If that doesn't work, there are some laxatives that are considered safe for pregnant women - including the bulking agents like lactulose and macrogols - which can help soften your bowel movements and reduce constipation. However no studies have been carried out to examine whether using these during pregnancy can be linked to problems in the unborn baby, but no issues have been reported. You should always remember to ask your pharmacist or doctor before taking laxatives, however, as others are not suitable, and no laxative should be taken long-term.