Emily called MotherToBaby and confided, “My husband and I are thinking about getting pregnant…I am so excited but scared, too. I am wondering what I can do to make it more likely we will have a healthy pregnancy and baby.”   

I assured Emily that we love it when people call ahead of their pregnancy and ask these questions. Preconception health is a topic that does not receive as much attention as it deserves, and it is important for both Emily and her husband. Good preconception health care can impact fertility and make it easier to conceive, and also helps to improve pregnancy outcomes and the health of the baby.   

Here is a preconception prep guide– because if you are ready to have a baby, you want to take steps now to keep you and your baby as healthy as possible:

• Make a pre-conception checkup appointment: Begin by making an appointment about three months in advance with your obstetrical care provider. At that appointment you can confirm you are in good health. If you have any chronic conditions such as high blood pressure, thyroid disease, depression or diabetes you and your provider can make sure the condition is being managed effectively and confirm that any prescription or over-the-counter medications you are taking can be continued in the pregnancy. If you have a question about medications during pregnancy, MotherToBaby can help by providing you with information to bring to your appointment.
• Begin taking a prenatal vitamin: If you are not already taking a vitamin with folic acid this is a great time to start. The Centers for Disease Control and Prevention (CDC) recommend that all women who can become pregnant take a vitamin containing 400 micrograms of folic acid; this helps reduce the chances for certain birth defects such as spina bifida (when the spinal cord does not form properly).
• Review your vaccine status: During your preconception checkup, make sure that you are up to date on vaccinations such as the MMR (measles, mumps, rubella), Tdap (tetanus, diphtheria, whooping cough), influenza, and COVID. Planning ahead makes it more likely you will not get ill during pregnancy and helps protect the baby from getting infections from parents after birth.
• Get your body fit for pregnancy: Get regular exercise and consider whether you and your partner are at your preferred weight. If not, make plans to remedy that prior to attempting to get pregnant. You can also learn more about a healthy diet and nutrition. This is something that may improve fertility in both parents and lay the groundwork for a healthy pregnancy.
• Eliminate harmful exposures: It goes without saying that this is a great time to make lifestyle changes such as reducing use of alcohol, tobacco, and recreational drugs.  Addressing stress and mental health concerns up front can improve fertility, make the whole pregnancy experience better, and prepare you for the excitement and hard work of parenthood.
• Evaluate your home and work environment: If you and your partner are exposed to toxic substances like lead in your work or home environment, working to reduce those exposures is very effective when done ahead of the pregnancy.

MotherToBaby has many resources for Emily and her husband – and you!  We have fact sheets on medications, herbal agents and supplements, diabetes and other health conditions, illnesses and vaccinations, occupations such as veterinarian and dental, exercise, paternal exposures, and cosmetics (sunscreen, skin creams, nail polish, hair dye). There are also useful blogs and podcasts, and whole web pages on various conditions, and if you have questions, our information specialists are here to help.

Last year I was pregnant with my first child. At the same time, I was going through the immigration process to apply for permanent residency in the United States. I wasn’t aware of the many things that you must do to get your health records cleared by immigration and how that process can be a great source of anxiety during pregnancy. If you are an immigrant, you may not have health insurance or cannot understand the language, which can be another challenge. In order to have sound and scientifically true advice during that critical period, I always consulted with my doctor and then MotherToBaby.

First, I was told that I needed to get revaccinated for certain diseases, even though I may have had them or may have been previously vaccinated in the past. Those vaccinations included measles, mumps and rubella (MMR), varicella, polio, tetanus diphtheria pertussis (Tdap), hepatitis B, and COVID-19. As soon as I heard this long list, I went online and checked the MotherToBaby facts sheets about those vaccines one by one to see what was known about their use in pregnancy. It turns out the Hepatitis B and COVID-19 vaccines are not associated with risk during pregnancy. Even more, it is recommended to get a Tdap vaccine during pregnancy to provide protective antibodies to your baby against pertussis (whopping cough). Live vaccines like MMR and varicella (chickenpox) are not recommended during pregnancy. Thankfully I was able to get bloodwork done to check antibody levels (protective proteins) showing prior protection. If you can show full protection, you no longer need to get vaccinated for these diseases after pregnancy. 

One other thing I had to find out was my tuberculosis (TB) status. This is done by blood work, but if the results don’t rule out the disease, you would need a lung x-ray. In general, X-rays are not recommended during pregnancy. However, if needed, studies show that a single chest x-ray is not associated with an increased risk for birth defects or pregnancy complications for the developing baby. It is important to know your tuberculosis status before pregnancy since active infection can be associated with preterm labor (early birth before 37 weeks), low birth weight of the baby, or even maternal death. Getting TB treated as soon as possible, even when you are pregnant, is so important. Tuberculosis is a slow-growing, pesky disease that is common in certain countries, including my home country, Turkey, but not common in the United States. That is why it is important to get it checked during the immigration process to prevent spread.

In addition to making sure I was getting my immigration to-do list sorted out, I also had to contend with new feelings brought on by pregnancy, both happy and stressful ones. This included all day nausea, aka the morning sickness, I had lots and lots of morning sickness. My first instinct was to call my mom and ask for help. She gave me a recipe for a concoction that included turmeric, sage, ginger, and mistletoe. I made it and drank it a couple of times without thinking whether that might be safe during pregnancy since it was all natural and herbal. A few days later, I was talking with one of my best friends, who was pregnant as well, complaining about morning sickness and asking for suggestions that have helped her. She said she would not drink any herbal tea without checking with her doctor. Ding ding, after talking with her, I was terrified to research the topic, and when I did, it confirmed my worst fears. The mistletoe in my nausea drink might cause miscarriage if consumed in large amounts. Many of the other herbs hadn’t been studied in pregnancy at all. I didn’t consume any more of the morning sickness drink and am fortunate that I had a healthy term baby. Lesson learned!

As immigrants, we bring our full heritage with us and try to combine the best of both worlds. Those herbal remedies and recipes are our culture; however, pregnancy is a special and very vulnerable time period. Everybody should be cautious about what we put into our bodies, especially herbal remedies since they are mostly not well studied during pregnancy to show whether they are associated with risks to the baby or not. Even if they are studied, the production and harvesting are not regulated or controlled by the Food and Drug Administration (FDA), or other governmental agencies, and contaminations might happen. Better safe than sorry, right?

Carrying my baby through the immigration process and following my dreams along the way was challenging, but I learned on that road that it is important to question my customs and traditional medications when pregnant. Not everything my mother or grandmother did is safe and effective. Also, I was glad that MotherToBaby was there for me when I was going through the immigration process while pregnant to ask my burning questions about vaccinations and x-rays.

Anyone with questions about herbals, vaccines, TB testing, or any other exposure in pregnancy should know that MotherToBaby is a great resource. Call or chat today to get your individual questions answered by a teratogen information specialist so you can rest assured that you and your baby can have a healthy and well-informed entry into America.

“I just found out I am pregnant.  I’ve heard that it is really important to get the flu shot this fall, but is it still OK now that I am pregnant?”  The woman on the other end of the phone line sounded cautious and concerned.  I told her, “I’m so glad you called to ask about this.  The influenza vaccination may be even more important for pregnant women.  The coronavirus pandemic has given us a lot to worry about without adding influenza infections to the mix.  Let me tell you more about this….”

Influenza and Pregnancy

Once we are into influenza season (October to March), pregnant women are strongly recommended to get immunized, regardless of where they are in their pregnancy. Yet, many women delay, and in the end only about 50% of pregnant women get their flu shot.

An influenza infection itself can cause severe illness and even death in pregnant and post-partum women.  It is important to remember that a healthy mother is more likely to have a healthy baby!  The injectable version of the influenza immunization (“flu shot“) contains an inactivated (dead) virus and is not going to make you or your baby sick.  It is the most effective way to prevent influenza or have less severe symptoms if you do get the flu.  Currently, the nasal-spray flu vaccination is not recommended for pregnant women because it contains live attenuated virus.   

Will the vaccine harm my baby?

Some pregnant women are worried about whether immunizations will harm their baby.  The scares about vaccines being associated with problems like autism have been shown not to be true.   In fact, just last month a large study was published in the journal Pediatrics, “Early Childhood Health Outcomes Following In-Utero Exposure to Influenza Vaccines: A Systemic Review.”  This study compiled results from 9 earlier studies and found no association between exposure to the flu vaccine during pregnancy and adverse outcomes in children.  One of the authors was later quoted as saying, “This should be reassuring for pregnant women who may be considering the vaccination…”    

Are you interested in learning more about vaccinations in pregnancy or while breastfeeding?  Visit the MotherToBaby website and read all of our vaccine-related fact sheets.  There is a general fact sheet on all vaccines, and then specific fact sheets on the seasonal influenza vaccine and also many others like the Tetanus, Diphtheria, and Pertussis (Tdap), Measles, Mumps, and Rubella (MMR), HPV (human papillomavirus), hepatitis A, and varicella (chicken pox) vaccinations. 

References

Early Childhood Health Outcomes Following In Utero Exposure to Influenza Vaccines: A Systematic Review Damien Y.P. Foo, Mohinder Sarna, Gavin Pereira, Hannah C. Moore, Deshayne B. Fell, Annette K. Regan, Pediatrics Aug 2020, 146 (2) e20200375; DOI: 10.1542/peds.2020-0375

Tanya called in on a Monday morning. “I’m getting married in a few months and we want to start trying to get pregnant right away. What should I be doing now to have the best chance of a healthy baby?”

Preconception health and pregnancy planning present a terrific opportunity to assess a wide range of factors that can give your baby the best start. This blog will outline the things to consider, as I relayed to Tanya:

Your Personal Health

Are you generally healthy? If you already get headaches or have acid reflux, know that pregnancy can make these more frequent. Ask your doctor if the way you treat these common conditions should change once you are pregnant. Ask about your current exercise routine and if you need to alter it during pregnancy. Get checked for sexually transmitted infections because some may not show symptoms. Also discuss your medications – some should be stopped before you start trying to conceive, such as Valproic acid, leflunomide (e.g. Arava®), teriflunomide (Aubagio®), methotrexate, and isotretinoin (e.g. Accutane®) to name just a few. For others, you’ll want to weigh the risks vs. the benefits with your health provider before you conceive. Talk with your doctors now to make a plan.

Caffeine

Do you drink caffeinated coffee, tea, or soda? What about energy drinks, protein powders, or Kombucha? MotherToBaby’s fact sheet on caffeine may put your mind at ease and encourage you to think about all your beverage options.

Body Weight

Is your weight a concern? One of the best things you can do before conception is to get to a healthy weight. Women who are overweight or obese have increased risks for miscarriage, birth defects, gestational diabetes, high blood pressure and preeclampsia, and unplanned cesarean birth. Now is a good time to meet with a nutritionist or go on a sensible diet to get to a healthy weight in anticipation of pregnancy. Once you are pregnant, continue to watch what you eat but don’t try to lose weight. Weight gain is inevitable during pregnancy but guidelines from the American College of Obstetricians and Gynecologists (or ACOG, the leading professional society for OB/GYNs) advise women to gain anywhere from 11-40 pounds, depending on your pre-pregnancy weight. It’s a myth that you need to “eat for two,” so don’t set yourself up for postpartum weight gain by eating more than you should. After delivery of an average 7-8 lb. baby, you may lose 2 lbs. in amniotic fluid, 1.5 lbs. of placenta, 5-7 lbs. in blood volume, and 2 lbs. as the uterus returns to its normal size. That could still leave you with 10 pounds of excess weight, or more if you gained more weight during the pregnancy. Some women never take off those extra pounds, and their weight creeps up with successive pregnancies and age, which can lead to pregnancy complications and chronic health problems later on. See our exercise fact sheet for more information.

Chronic Health Conditions

Do you have chronic health conditions like diabetes, high blood pressure, migraines, asthma, high cholesterol, heart conditions, varicose veins, or anemia? Do you have an autoimmune disease like Crohn’s or ulcerative colitis, lupus, rheumatoid arthritis, ankylosing spondylitis, multiple sclerosis, psoriasis or psoriatic arthritis? Meet with your obstetrician for a “preconception” appointment to discuss how a pregnancy might impact your health, and how your health might affect a future pregnancy. Your specialist can provide an important opinion too. A maternal-fetal medicine specialist (MFM) is a doctor who specializes in high-risk pregnancies, and consulting with a MFM once you are pregnant could help you learn how to optimize your and your baby’s health.

Mental Health

What about your mental health? If you have a history of anxiety or depression, ADHD or other conditions, ask your psychiatrist and OB about treatment, and don’t make changes before you do. Many medications can be continued during pregnancy and while breastfeeding. In fact, mental health is incredibly important – for example, when a woman doesn’t treat her mood disorder or inadequately treats it, some studies suggest risks for miscarriage, premature birth, low birth weight, and preeclampsia. Talk therapy is vitally important too. And if you struggle with mental health concerns during the pregnancy, you are at risk for postpartum depression. Let’s face it – pregnancy and caring for a new baby is stressful, so now is the time to marshal your helpers – friends, relatives, therapists and doctors – to ensure you have enough support. Your obstetrician should ask about mental health but if not, speak up. Your doctor can be your ally here, helping you get treatment and addressing concerns related to pregnancy and postpartum mental health. And MotherToBaby can give you an overview of the research related to any prescriptions you might choose to take.

Dental Health

Have you seen a dentist lately? Oral health can impact a pregnancy, meaning that if you have swollen or bleeding gums, a toothache or an infection, it can increase risks to the pregnancy. If you need to have a dental x-ray, take antibiotics, or have local anesthesia for a dental procedure, these are generally acceptable during pregnancy, but best to complete before you get pregnant. Contact MotherToBaby for more details.

Your Workplace

Where do you work? MotherToBaby can give you information to minimize exposures in a veterinarian office, dry cleaners, salon, laboratory/hospital, imaging center, pest control service, or other business. Your occupational safety department can recommend personal protective equipment (PPE) and tell you about ventilation that may be in place to ensure workplace safety. Safety data sheets (SDS) give an overview of chemicals used in industry and are available online or at work.

Food Safety

Read up on food safety and learn how to minimize your exposure to foods that have commonly been associated with foodborne illness such as E. coli or listeria. Get in the habit of washing your fresh fruits and vegetables well. Check out other blogs on our website too.

Vitamins and Supplements

Have you started taking a prenatal vitamin? Are you getting enough folic acid? ACOG recommends that women take at least 400 mcg of folic acid before getting pregnant and at least 600-800 mcg/day once they are pregnant. This can help prevent birth defects of the brain and spinal cord. Call MotherToBaby if you want to learn the recommended daily intake for specific vitamins or minerals. In general, taking more than what is recommended is not advisable – we haven’t studied how mega-doses of vitamins may impact a pregnancy. Other supplements beyond taking a prenatal vitamin are not advisable either – the Food & Drug Administration (FDA) doesn’t supervise their manufacturing plants and past surveys have shown some supplements actually contain contaminants. Furthermore, we’ve seen instances where the label didn’t match the contents of the bottle and could cause ill effects. Pregnant and breastfeeding women should avoid herbal supplements unless specifically recommended by your doctor.

Alcohol, Cannabis, and Tobacco

Do you smoke cigarettes? Do you use cannabis for medicinal or recreational purposes? Do you drink alcohol? Recent research has demonstrated that marijuana use very early in pregnancy causes changes in brain development, which could result in behavioral or learning challenges we see later in the child’s life. Cigarettes increase risks for pregnancy loss, among other things. And alcohol is known to cause a variety of birth defects known as fetal alcohol spectrum disorder (FASD). We don’t believe that there is a “safe” amount of alcohol which when consumed doesn’t cause issues for a developing child. Now is the time to quit smoking, drinking, and using cannabis – your baby will be heathier for it. MotherToBaby can provide resources, or check with your doctor.

Vaccinations

Are you up to date on all your vaccines? Did you get a flu shot this past season? You don’t want a vaccine-preventable illness to have an impact on your pregnancy. Flu infection can increase risks for more severe symptoms, longer-lasting illness, pregnancy loss and premature delivery, which can have a lifelong impact on your baby. Flu vaccine helps prevent infection. Another benefit to vaccinating during pregnancy? Studies show the protection extends to your baby, and gives them a little extra immunity from birth until they can receive vaccines. Also good to know: some vaccines can be given and are recommended during pregnancy, like a flu shot or TDAP, but others are best given before you conceive to avoid a small risk of spreading the illness to the fetus (e.g. the measles, mumps, and rubella (MMR) vaccine, as well as the Varicella (chicken pox) vaccine) – so try to get these done at least a month before trying to conceive. Check your medical records to see the last time you received any of these vaccinations. If you don’t know if you were previously vaccinated, your doctor can draw blood to check if you have immunity.

Your Pets

Do you have a cat? There is some concern in pregnancy about an infection called toxoplasmosis, which is caused by a parasite that can be found in cat feces. Read our blog for more info on what you can do to prevent this infection if you have a fur baby at home.

Other Illnesses

Do your upcoming travel plans involve travel to a warm tropical place? Check out our Zika fact sheet to learn more before you book nonrefundable tickets. In general, women will want to wait to try to conceive for eight weeks from the time of your return home; the wait time is three months if your male partner travels with you. COVID-19 is also spreading around the globe and our fact sheet can give you the latest information on whether and how it could affect a pregnancy.

Finally, your obstetrician or primary care doctor would be glad to see you for a Preconception consultation. Make an appointment to discuss your personal history and health. It’s a great way to get you and your baby off to the best start.

Dana Howe, a communications director for a non-profit called Vaccinate Your Family and soon-to-be mom, joins host Chris Stallman to discuss some common questions and fears surrounding vaccination during pregnancy. She helps debunk common myths to set the record straight. Howe holds a degree in biology and community health and a master’s degree in health communication.

Resources mentioned in this episode:

Vaccinate Your Family

www.VaccinateYourFamily.org

Ep. 79 Transcript

  You’re listening to the Mother 2 Baby podcast, medications and more during pregnancy and breastfeeding. Ask the experts with your host, genetic counselor and mom of four, Chris Stallman.

This episode contains evidence based information that’s current as of the day recorded and may change as more data becomes available. To get the very latest information about this topic or other topics in pregnancy and breastfeeding, please contact a mother to baby specialist at 866 626 6847 by text at 855 999 3525 or through our website at mothertobaby.

org.

Welcome to another episode of the mother to baby podcast. My name is Chris Stallman, and I’m a genetic counselor, a mom of four, and a teratogen information specialist. So what that means is that I talk to people, so healthcare providers, patients, family members, and the general public, about exposures that can happen before pregnancy, during pregnancy, while breastfeeding, and in cases of adoption.

And an exposure can be anything, so it could be a medication you’re taking, a chemical at your workplace, Or a vaccine. And that’s what we’re going to be talking about today. Not just vaccines, but how and why they are so important. Our guest today is Dana Howe, communications director for a nonprofit called Vaccinate Your Family.

She holds a degree in biology and community health and a master’s in health communication. She is also a very soon to be mom. Hi, Dana. Welcome to the show. Hi, Chris. Thank you so much for having me. I’m really happy to be here. Our pleasure. So first and foremost, how are you feeling and how is your pregnancy going?

I am feeling pretty good. It is, um, this is going to be my first baby, so I have, um, I’m going through this, you know, journey for the first time, learning a lot along the way. It’s been really interesting how it’s intersected with my professional work with Vaccinate Your Family a little bit. Um, but overall feeling Good.

I’m in my third trimester and due next month. So things are getting real around here. That’s amazing. Congratulations, and I hope that the remainder of your pregnancy and delivery is smooth and safe. Thank you. So can you tell us a little bit about the organization you work for called vaccinate your family?

Yes, absolutely. So I am the communication director at vaccinate your family. Um, we are a nonprofit organization that was originally founded in 1991, formerly called every child by two, started by former first ladies, Rosalynn Carter and Betty bumpers of Arkansas. Um, In response to measles epidemics that were happening at the time, and the need to vaccinate our nation’s children against the vaccine, preventable diseases of the time our mission today remains to protect people of all ages from vaccine, preventable diseases.

Um, and we do that through a mix of communication work, um, trying to educate and arm trusted messengers with good information about vaccines as we serve as the subject matter experts and try to work with trusted messengers, community based organizations, um, leaders. Parents often really health decision makers, um, to spread good evidence based information about vaccines.

We also work in vaccine policy and then we follow the science basically to stay on top of the latest vaccine recommendations that are coming through and all the, there are new vaccines. There’s a lot of really exciting work being done. Um, and I actually joined during the coded pandemic. So it’s been a really interesting time as a health communicator to watch how the experience of going through the pandemic has.

impacted the way that we all think about the vaccines that we need, not just against covid, but against all vaccine preventable diseases. I would agree. Um, as someone who was part of the efforts when mother to baby was answering a lot of the questions about the new vaccines during the pandemic, it really, it really did change our perspective.

And of course, you know, I’m a mom. I have my own perspective. And, you know, really soon you’re going to be a mom too. And so can you share a little bit about your personal experiences with vaccination and pregnancy? Yeah, absolutely. So, um, you know, I work in vaccines. I work in public health. I have always had a high level of vaccine acceptance in my family growing up myself.

I’m generally happy to get the recommended vaccines at the recommended times, um, but pregnancy has been a really sort of interesting time where there are now a few recommended vaccines during pregnancy. Um, The vaccine, which is important for protection against whooping cough or pertussis that you can pass antibodies onto your baby when you get it.

When you’re pregnant, flu and cobit are more important than ever to get while you’re pregnant. There are extra benefits to getting it. Um, to getting them while you’re pregnant, you can pass some immunity onto your baby, but also getting sick with flu or COVID during pregnancy is something you really want to avoid.

It’s more dangerous because your immune system doesn’t work the same way while you’re pregnant. So if you were to get sick, you are at higher risk because you’re less able to fight off those infections. So that extra boost is really important. Um, and then we now have a maternal RSD vaccine as well that can pass antibodies on to babies.

I’m concerned about RSD certainly as someone who’s about to have a newborn in the middle of RSD season. And the ability to pass some antibodies on and get that vaccine during pregnancy is something that I don’t want to miss out on and I’m actually really excited about. But, I will say. So far, I’ve gotten three out of those four vaccines, and in making my own health decisions during this pregnancy, um, I’m very aware of all the things that we weigh when we’re pregnant, um, it does feel in some ways like a lot of vaccines, and I feel that way even as someone who is, for the most part, Excited to get them.

Of course, I’m not excited for if I feel a little since the next day, like, that’s not great, but I’m happy that I have the opportunity to get them. But still, I thought about, you know, the timing of those vaccines. What is available at my doctor’s office? What information am I getting from my doctors? So, you know, personally.

My doctor, my doctor’s office had Tdap available a little bit sooner. So I just said, sure, did that at like 28 week appointment. And then at my 32 week appointment, I actually proactively asked about the RSV vaccine because I, you know, work in vaccines. I was curious, like, so do you have it here? Are you giving the RSV vaccine?

And they did, and they said we also have flu available. So I did RSV and flu at the same time at that appointment, and then I’m scheduling my COVID vaccine separately at a pharmacy. So, you know, I’m very aware of, as I navigate this time, like, what’s available to me in which places, how do I feel after each vaccine?

I know that’s definitely a concern. Um, and. You know, recently I got a little head cold and it was a good gentle reminder of how much Being sick stinks, especially while pregnant and how much I, how much I have been weighing this thing of like, okay, I’m like many people who, um, when I’ve gotten my COVID vaccine, the next day I feel a little under the weather in, in past vaccines like that.

Immune response. And so I’ve been like, oh, when is going to be a good time to do that? I’m putting it off. I’m noticing myself being a little like, well, it’s already hard to feel good. In your third trimester of pregnancy, do I really want to like, you know, take a sick day? Am I going to be like, how’s it going to feel?

Um, but then I actually got sick with just a head cold and I was like, no, we got to go get that vaccine because this is even just this head cold is much worse than that day after the vaccine feeling. So it was a good little reminder for me that those. transient, mild, you know, for me, it’s like 24 hours of fatigue, soreness, um, after a vaccine that sometimes we see is still worth it, but it can be, it can be tough to convince yourself that.

Um, so that’s just a little bit of what I’ve been experiencing as I kind of navigate this from a personal perspective. So what are some common myths you hear about regarding vaccines and pregnancy or breastfeeding? Yeah, so I am lucky. Something that’s been really interesting is I have quite a few friends who are navigating pregnancy at the same time as me, so it’s kind of been a topic of conversation.

I’m also in some, um, like Facebook groups, mostly out of curiosity as a first time mom navigating this. I’m in like a due date group, which is a real interesting slice of people from all over the world who are Do at the same time or the same month that I am, um, sometimes vaccines come up in there that can be interesting and then, you know, I work in vaccines professionally and we kind of keep tabs on what some myths are.

About vaccines and pregnancy and breastfeeding. I think the big thing that sticks with me is during pregnancy. There are so many things that we’re told to watch out for, or to not put in our bodies. Yes, and I think that it can put people in a very defensive frame of mind as far as. like exposures. And I know this is the work that mother to baby is doing all the time.

Then we’re so grateful for. Um, but I think it makes pregnant people wary of vaccines and susceptible to myths, especially about vaccine safety. So I think some things that I’ve heard Are that certainly about the concerns about specific vaccine ingredients, and I think that that comes down to that anxiety and hyper vigilance and, you know.

In our work at vaccinate your family, we have done a lot of breaking down to a really sort of digestible level. The reason why the ingredients and vaccines are. Not something that we need to be concerned about. Right? Like you’re exposed to more aluminum when you drink a can of soda or seltzer than when you take a vaccine and just kind of right sizing that those exposures on those fears, um, and kind of, you know, Reinforcing that these are things where we have more safety data, more evidence to support that the benefits outweigh any potential risks, then like anything else we put in our bodies, then the prenatal vitamins that we’re taking, then, you know, really like any eating out at any restaurant, you know, the list goes on.

This is something that we actually do have a lot of evidence to support the use of, um, another thing that I hear sometimes. Definitely. I want to talk about the new R. S. V. vaccines because they are newer and I think people feel like it’s not viewed as safe by some folks because the R. S. V. vaccines. Are a new vaccine, um, and, you know, for me, I think, yeah, it’s relatively new, but it’s a type of vaccine that’s been around for a long time.

It’s undergone that extensive testing. And I think that people, it’s easy to consider again, because we’re in this reactive, like, fear based, uh, wanting to avoid exposures place. We forget to weigh the benefits of the thing. Um, the benefits of getting vaccinated. And we forget about the risks of not vaccinating.

And I think that’s something that, um, especially with RSV, I’m thinking about, like I said, the risk of not vaccinating is having a newborn during RSV season. That’s a really, that’s a significant risk that you have much less control over. Um, and I think that, um, you know, weighing all of those things and kind of being aware of my own.

Yeah. Cognitive bias toward I think we’re really biased toward inaction for like I can stay safe by avoiding Something during pregnancy because there’s so many things like that right that we’re told to avoid So I think that it’s easy to have a bias towards saying I’m gonna make sure I don’t do anything that could On my baby, the action being get a vaccine when actually the choice to not vaccinate is not a risk free choice, but our brains don’t like that.

They kind of go, wait, wait, wait. Um, I think we’re more afraid of. Um, potential outcomes for things that we do choose to do versus choose to not do. Um, but of course, when we take a step back, thinking about the risks associated with. Not vaccinating and the benefits that come when we do choose to vaccinate.

On top of all the safety data that we have. Um, I think it’s actually, like, a really exciting opportunity to get to using the example of the vaccine for some people who are concerned about the number of shots that infants get. Getting the maternal vaccine now is actually a way to get 1 less. Shot for a newborn baby, because there are options right now for either a maternal RSV vaccine or an antibody that’s given to newborns to ways to protect baby against RSV.

But it’s exciting as a expecting mom to be like, okay, this is 1 thing I can do to do 1 last shot for my baby. Which I would get if that was the only option, but. Um, it’s like, you know, just, just reframing it as a positive thing to kind of be able to, without any risk to myself, like the risk that would come from getting sick, be able to pass antibodies onto my baby during this time window is actually really exciting.

Um, so kind of taking those myths and trying to get to a positive place of like, well, we have the opportunity to pass some protection on. Um, and we don’t want to miss that window of opportunity. Wow. We’re pregnant. When you mentioned, you know, thinking about myths specifically, you also mentioned something that unfortunately is not a myth, but does contribute to the myths.

And that whole thing is what you can and cannot do during pregnancy. And I’m so glad you mentioned it and we’re not going to go too far, but I’m so appreciative of it because I don’t think that we, and by we, I mean society in general, mention this enough. My goodness. There is so many different things that were all, there’s so much conflicting information.

There’s so much fear around doing the very simple things. It’s like, is my bath water too hot? Did I wait too long to get the vaccine? You know, what if, you know, I missed the window because of the season or it wasn’t available where I am. And now, you know, it would be a better idea for my baby to get the RSV.

You know, there’s so many different things. And I just want to say, I know we’ve said it a couple of times before, and I know that folks in our business say it all the time to the people we’re with, especially, but you’re doing a good job. If you’re out there and you’re pregnant or you’re trying to get pregnant or you were just pregnant and or maybe you’re breastfeeding or maybe not, but you might have a newborn or a newly adopted child on your hands, I’m, I’m here to tell you, you’re doing a good job.

You are, and it’s hard out there. And I just so much Dana appreciate not only what you do and everything you’ve said, but I just appreciate so much that you’ve mentioned. That there is a lot out there for a person who is pregnant to navigate and a lot of it Is the am I doing it right? And how can you not?

At some point, even for a second, make that question with everything you see. Don’t eat that lunch meat unless it’s cooked. Make sure you’re doing X, Y, or Z. Make sure you’re not doing X, Y, or Z. And again, you, Dana, are doing it right. And everyone out there making that effort, which I know you are. We know you, we see you, and we know that you’re doing a good job.

So keep up the good work. Yeah, I so appreciate that. And I think It just, if you’re anxious about vaccines during pregnancy, of course you are, because we’re anxious about everything that we’re putting in our bodies, and I think there are so many messages that we receive from our communities, from healthcare providers sometimes, from our family sometimes, about, yeah, to be in a place of, you know, vigilance, and fear, and to do it right, and So, you know, I have friends who have never worried about it before, but are having trouble with anxiety just around food decisions because they’re pregnant.

Um, and it’s, I think, been a really interesting eye opening experience. And, you know, if we’re suddenly really anxious about our dietary choices, of course we’re going to be anxious about a vaccine that we know less about or that, you know, has the power to, you know, Be interacting with our immune systems like it makes sense.

So I definitely want to say like this isn’t to say. Oh, just don’t worry about it. Right? Right. We’re conditioned to feel. worried and it means we care. Um, but it, there’s a lot of stress that comes with it too. So I appreciate that. And yeah, that’s, that’s a big thing. And then what we hear about is how you’re supposed to reduce stress in pregnancy.

But again, I mean, we could honestly, we could have, and we, we very well may actually this entire, body of work and your experience is so inspirational, we might end up doing a, Hey, you know, we should just talk about some of the silly things we hear in pregnancy, but what I would also love to get to. So aside from the myths, right, what are some of the other frequently asked questions do you get about vaccines in the pregnancy breastfeeding space?

Yeah. So I actually recently was kind of scrolling through the due date group that I was telling you because I think such an interesting Like, Slice of Life, different from other Facebook groups I’m in, where it’s like people from all over and, um, you know, the thing that we have in common is that we’re due the same month, so I was like, this is, you know, the comment section, it’s not for everyone, but it is really interesting, just from a, like, what’s on people’s mind, um, kind of perspective, and something that I came across Several times that I worry about from a health communication perspective is that people really feel like vaccines during pregnancy are pushed on them by their care providers and that I thought was an interesting trend.

It’s not everybody, right? But it came up more than once that I think it comes down to, like, a communication and a trust and information issue where, um, You know, care providers are strapped for time. They’re doing their best. Obviously want to give them the benefit of the doubt, but the way that we’re presenting information about vaccines to pregnant people is making people go like, Whoa, I don’t, I feel like I’m being that it’s assumed that I have to do this.

And people are coming to groups and saying, like, can I say, no, can’t like, do I have to do this? Mm hmm. And You know, it sets up kind of an adversarial relationship that I think, you know, as a communicator, I’m like, Ooh, I wonder how we can do a better job coming into those conversations with information and feeling like we’re making an informed decision so that when our care provider says, Oh, you know, you can do the Tdap today.

Do you want to do it? It doesn’t feel like we don’t interpret that as. Get your Tdap and that being the first time that we’ve thought about it, but you know, in my experience, my, my care providers, who I really like, didn’t bring up the Tdap vaccine to me until it was the week that we were going to do it.

And they just said, Oh, you know, it is time for the Tdap vaccine. Here’s the, you know, information sheet about it. Do you have any questions? And. If I didn’t know a lot already, which I do because it’s my job, about the Tdap vaccine, if I didn’t see it coming and I hadn’t anticipated it, it might feel, and I think for many people does feel, just this, like this thing that’s really blase, casual, and doctors who give vaccines all the time, I think do treat vaccines casually sometimes.

Because they are an amazing public health tool that are safe and they work well and we love them because they prevent illness and are extremely safe and have very few side effects. So, as a care provider, you’re like, vaccine time. Woo. But as someone who’s in a place of vigilance and worry about what’s coming into their body, especially at the doctor’s office, potentially, I think I would love for everyone to.

Be able to anticipate that vaccine conversation coming in a positive way, like, oh, I know what that is. I know how I’m going to benefit from it. I already, like, if I have some questions, I know what to ask because you probably don’t. I mean, I’ve had that experience. You’re in a conversation with a care provider.

You are hearing about something for the 1st time. You don’t have your questions ready to go. Like, they come later, and then you end up on Google, and that’s not what we want, so. Yeah, that’s, that’s definitely true. I mean, you know, Google and other search engines, you know, have their place certainly. Um, but I, you had mentioned earlier, um, I believe what you had said was a trusted messenger, meaning a place of information that is based on available, um, evidence and, um, While there’s certainly other forms of information, I think knowing where and how to get that trusted information is really important, just sort of generally speaking, and then to your point, when you go into your provider, right, you want, and we hope, and that’s the goal, is that the person or the group that you’re speaking with is a trusted source of information, and as a provider, also, not necessarily in this space, I do understand that feeling when I go in as, well, Of course, I know what I’m talking about.

I’m a provider. I’ve been doing this for a while. So the two sides of it are completely different and coming from completely different places. And I think it’s, it’s wonderful when we can come together. As long as you realize, you know, it helps if you have some information going in. And it helps if your provider also knows how to address, explain, and fill in the gaps for the information either that you may not have or that you may not fully understand or that you may have.

So, again, I do love that it ends up being a two sided piece, right? We say all the time, you know, you have to advocate for yourself as a patient, which is absolutely true. But from the provider piece, you know, we do like to say, hey, you know, you have to make sure that your patient has this information. In that magical place when all of those things can happen in a way that everyone’s comfortable with, that’s where we are.

Until then, we need to keep looking for information and looking for the best way to give and support that information as well. Yeah, absolutely. You know, going back to your previous question, the other thing that one, the other thing that comes to mind for me about just frequently asked questions, things that come up about pregnancy and vaccines, I do think there are a lot of concerns about vaccine reactions during pregnancy and by that I do just mean sort of the side effects that can happen when you get a vaccine.

That, like, feeling a little bit sick. Um, everybody’s different, so I don’t want to claim to know what someone else’s, you know, vaccine reaction looks like. I think they’ve gotten, um, it’s something that’s been talked about more because I do think, anecdotally, The COVID 19 vaccines, people are experiencing that, um, you know, some vaccine side effects.

Many people get them from seasonal flu shots to many people, you know, children get them after their routine vaccines. You might feel a little gross for a day or two. It is normal and it is expected. It doesn’t happen to everyone, but I think it really throws people off. And when you’re pregnant and you already feel bad, and it is hard to get through the day at work.

And Honestly, I really get this. My friends, like, we are already pregnant, probably working during pregnancy, probably worried about the amount of sick time that we have, if we’re lucky enough to have it, um, you know, thinking about our schedules, maybe you have other kids, and the weekend’s not a good time to get a vaccine and be down and out.

We feel like there is not a lot of buffer for feeling unwell and it’s hard to choose something like getting a vaccine that you have a guest might make you feel kind of not well for 24 hours. It’s hard to choose to do that. Yeah. Um, and people are definitely asking like, Oh, how did you feel and worried that during pregnancy, you might actually feel worse.

I will say that hasn’t been my experience. I think there’s probably a few different reasons for that. I’m like, well, I’m already taking it easy, so I haven’t noticed it as much. Or, you know, like, maybe my immune system’s working a little differently. So it hasn’t been, like, it hasn’t been worse for me, I’ll say, after I’ve gotten vaccines during pregnancy.

Uh, to just put that out there, but I was concerned on a personal note concerned like, well, it’s already a lot. How am I going to feel for the day after I get these vaccines? Am I going to have to call in sick? And I think, you know, we can’t dismiss those are real like decision making kind of things that we’re weighing in our day to day lives.

Yes. 100%. And I, I, again, I appreciate that because not everybody has a sick day. Not everybody can take a sick day. And again, it’s, it’s sort of how things are presented. You know, there’s lots of, of other issues, but you know, I can tell you from the, how you feel piece. that during my pregnancies, especially my last two, if there was anything I even thought was going to make me feel even more fatigued, I was like, I don’t even know what more fatigue looks like.

More, more fatigue probably looks like me just not being awake at all. Right. Um, and, and that’s real. Now, I do want to say that I did choose to, and had vaccines available to me during all my pregnancies. And that’s something that our family had decided was a personal choice. But I do want to, you know, say that even though I work in the field, I’ve had those thoughts.

These aren’t, these are typical thoughts. It’s okay to have these thoughts. You know, however that weighs into your decision is completely up to you and maybe a conversation with your healthcare provider. But I, I did want to say, you know, yeah, I, I’ve definitely thought about that. And then I was like, well, you know what, I really am more worried about this.

And then I weighed it, but it is absolutely typical to have those thoughts. Like I don’t want to have to go to Walgreens. What if I have to miss a day at work? I don’t want to feel sick. I definitely don’t want to feel tired. And then again, you know, if it’s all part of your decision making. then that is something that a lot of people have typically experienced.

So, Dana, before we let you go today, is there a final thought you would like to leave our audience with? Well, I would just say, you know, I mentioned a lot of vaccines by name, um, and I would encourage anybody who is thinking about, is pregnant, um, knows somebody who is, if you’re looking for more information about the vaccines that are recommended during pregnancy, what they are, why they’re recommended, what the benefits are.

Um, we have some great information at vaccinateyourfamily. org. Um, there is some pregnancy specific resources as well as information about accessing vaccines during pregnancy. So I would just say, please check it out. Um, come with an open mind. I, we say do your own research and I support that. Do your own research.

We have, you know, all our sources come to vaccinateyourfamily. org and, um, I hope you’ll take the time to kind of learn more about the vaccines that are recommended during pregnancy so that when it comes time to talk to your provider about them, you can go in feeling informed and ready to have that conversation and make the vaccine decision for your family.

Because that’s the goal. The goal is making sure that you have the information that you can use to make the decision. That is best for yourself and your family and you know, wonderful organizations like vaccinate your family do have evidence based information that can help you with your decision making and we will be happy to put information on how to find vaccinate your family in our show notes.

Dana. Yes. Well, thank you so much. Oh, thank you. I thank you. Doesn’t even cover it. So happy to have you here today. So happy to talk about this. And as you know, you know, vaccines are more and more a part of some of the recommendations that we have at all points in the life cycle. So we would love to have you back on the show in the future if you’re ever ready to do so.

Yeah. Absolutely. It’s been a pleasure. Great. Dana. Thank you so much. And that’s going to do it for this episode of the mother to baby podcast. Be sure to hit that subscribe button. So that way you never miss a new episode and you can go back and listen or relisten to some of those older episodes as well.

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