Swine flu pregnancy tips reissued

A suppressed immune system makes pregnant women more vulnerable

The Department of Health has attempted to clarify its guidelines to expectant mothers and parents with children under five on how best to avoid swine flu.

Its advice to practise good hygiene by washing hands and surfaces regularly has been re-issued after a woman with the virus died soon after giving birth.

The Royal College of Midwives (RCM) says all expectant mothers should avoid crowded places and unnecessary travel.

But the DoH says only the “particularly concerned” should consider the advice.

Concern over the effects of swine flu on new and expectant mothers has heightened since the death of Ruptara Miah, 39, in London’s Whipps Cross Hospital on 13 July. Her baby is said to be very ill in intensive care.

Good hygiene

Another child under six months old, who died in London, is also among the latest victims of the virus.

The refreshed DoH advice has been given greater prominence on its website.

Health experts say expectant mothers could suffer possible complications if they contract swine flu, such as pneumonia, breathing difficulties and dehydration, because they have suppressed immune systems. Young children are also vulnerable.

Most mothers-to-be with swine flu are being prescribed Relenza, an inhaled antiviral drug which treats the virus without reaching the foetus. However, where it is particularly severe, doctors can offer Tamiflu instead.

The NHS website stresses that most expectant mothers who contract swine flu will only have mild symptoms and recover within a week.

Belinda Phipps, chief executive of the National Childbirth Trust (NCT), said that while the risks for expectant mothers were low, women needed information to make an informed decision.

“If you are pregnant, you are slightly more susceptible to all infections. One of them is swine flu.

“It is important that pregnant women know that – and particularly other members of the population know that – so that they behave responsibly and if they are sick they don’t go and put themselves close to a pregnant woman.”

If you are pregnant, you are slightly more susceptible to all infections. One of them is swine flu Belinda Phipps, NCT

The Department of Health said it advised women to plan their pregnancy carefully, but was not advising against trying to conceive.

“Mums-to-be are more vulnerable to any type of flu. It is particularly important that anyone who has existing health problems and is thinking about starting a family should talk to their GP first, as they normally would,” a DoH spokesman said.

Louise Silverton, deputy general secretary of the RCM, said women could not be expected to wait for the first wave of the pandemic to end before trying for a baby.

Speaking on BBC One’s Andrew Marr Show, Alan Johnson, the new home secretary, said an unexpected aspect of the virus was that it was attacking the young, not the elderly as with seasonal flu.

He called on parents to keep using their common sense, saying the “vast majority” had been following public health advice.

Twenty-nine people have now died in the UK after contracting swine flu – 26 in England and three in Scotland.

The government has warned that the number of deaths from the virus this winter in the UK could reach between 19,000 and 65,000.

However, during the 1999 to 2000 winter, seasonal flu deaths reached 21,000 and even during average winters there are normally anywhere between 6,000 to 8,000 deaths.

The National Flu Service will go live at the end of next week

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We asked you whether you were concerned about the effects swine flu might have on expectant mothers. Here is a selection of your comments.

I am in the third trimester of pregnancy, and I am asthmatic. I am concerned that neither Tamiflu or Relenza will be suitable for me if I contract swine flu.
Louise, Nottingham

This is such stupid advice. I am pregnant and travel to work every day on a packed Tube. How am I supposed to avoid crowded places and unnecessary travel? It’s impossible. I can’t just stop going to work can I?
Laura, Hertfordshire

My daughter has a 4yr old son who has swine flu, she is 4 months pregnant and worried in case she catches it and it harms the baby, we are also worried about the treatments used in pregnant women. There is to much contradiction going around to know what to believe.
Tina, Essex

I am currently 24 weeks pregnant and have been ill and at home for 5 days now with bad cold symptoms. After consulting the doctor by phone I was told it could possibly be swine flu but how am I to know? I am usually very level headed in these situations but not sure that not swabbing pregnant women with symptoms is wise – at least if we know if we have it we can be better informed!
Anonymous, Wales

I am 36 weeks pregnant and came into contact with Swine flu last week. I experienced a slight sore throat spoke with a nurse at NHS direct and my GP and was completely reassured that I was fine and not displaying any symptoms. There is definitely some scaremongering going on but if you seek appropriate medical advice your fears can be eased.
Jo, Romford, Essex

I have got a 14 month old child and am currently pregnant. I’m very worried we could all catch the virus as a lot of people where we live are getting it. Also it is going round schools where my niece goes. I believe there should be vaccinations soon as possible for young children and those who it could endanger more than others
Nikki, Chelmsford, Essex

Mums ‘accept natural birth risks’

About a quarter of UK births are carried out by Caesarean section

First-time mothers-to-be will accept greater risks than clinicians for a natural birth, research suggests.

A Sydney, Australia study also found the women prepared to accept higher pain levels, reports the British Journal of Obstetrics and Gynaecology.

Researchers asked 102 pregnant women and 341 midwives, obstetricians and other doctors what complications would make them choose a Caesarean section.

The journal editor said doctors were “biased”, having seen things go wrong.

This indicates that experiencing labour and attempting a normal birth are two very important priorities in women’s decision-making Professor Philip Steer Editor in chief, BJOG

Approximately one in four pregnancies in the UK ends in a Caesarean section, and most are offered in the face of potential complications such as the baby lying in the wrong position for natural birth.

But the Royal Prince Alfred Hospital study suggested that women, given an informed choice, were less likely than the professionals treating them to take a more cautious approach.

A total of 102 women, 84 midwives, 166 obstetricians, 12 urogynaecologists and 79 colorectal surgeons were interviewed to find out whether different complications would prompt them to choose a Caesarean.

Researchers asked them about mild complications such as a prolonged birth and superficial tears to severe problems such as anal and urinary incontinence, vaginal prolapse and severe tearing.

In all categories, the pregnant women were far more likely to be prepared to put up with complications in order to have a natural birth than their midwives or doctors.

Priorities

Study author Catherine Turner said: “Our study found that pregnant women were more likely to aim for a vaginal delivery, and they accept a higher threshold of risks from vaginal delivery when compared with clinicians.”

Professor Philip Steer, the journal’s editor in chief, said: “This indicates that experiencing labor and attempting a normal birth are two very important priorities in women’s decision-making.

“It may also indicate that doctors are biased by their inevitable involvement in complex cases, or labours where things have gone wrong.”

Belinda Phipps, chief executive of the National Childbirth Trust, agreed that health professionals could let their own negative experiences influence the recommendations they gave to women.

“If they’ve seen a traumatic birth, or been involved in a tragedy, there is no debriefing for them.

“It can mean they are more judgemental about the risks involved.”

She added: “I recognise that this is very difficult to avoid, but they need to realise that for most women, this is something that they feel it is important to do for themselves.”