This sheet is about exercise in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare providers.  

Can I exercise during pregnancy? 

The U.S. Department of Health and Human Services Physical Activity Guidelines for Americans and The American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women without medical or pregnancy complications aim to do at least 150 minutes (2 hours and 30 minutes) of moderate intensity exercise each week.  

Moderate intensity means you move enough to raise your heart rate and start to sweat. It also means that you can still talk normally, but you cannot sing.  

150 minutes of exercise can be spread over the days of the week. For example, you can divide the 150 minutes into 30-minute workouts on 5 days of the week or into smaller 10-minute workouts throughout each day. Women who are new to exercise can start out slowly and work up to 150 minutes a week.  

You may not be able to exercise while pregnant if you have had a preterm delivery (birth before week 37), or currently have ongoing vaginal bleeding, anemia (blood has a hard time carrying oxygen), uterine contractions, or other pregnancy-related complications. Please check with your healthcare provider to see if you should exercise during pregnancy. You should also check with your healthcare provider before starting or continuing an exercise program if you have a history of medical concerns such as heart or lung problems or high blood pressure. 

I exercise. Can it make it harder for me to become pregnant? 

Light to moderate exercise is not expected to make it harder to become pregnant. Vigorous exercise, defined as causing shortness of breath and only being able to say 1 or 2 words, might reduce the number of times a woman has a menstrual cycle (period); which would affect fertility. On the other hand, exercise might improve fertility in women with polycystic ovary syndrome and obesity.  

Does exercise harm my pregnancy in any way?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like exercise, might increase the chance of birth defects in a pregnancy. Also, miscarriage is common and can occur in any pregnancy for many different reasons.  

When done in moderation and under the guidance of your healthcare provider, exercise is not expected to increase the chance of miscarriage, birth defects, or preterm delivery (birth before week 37). Studies show no relationship between exercise and distress or heart rate changes in a fetus. One study found that moderate to high intensity exercise in the later stages of pregnancy can lead to smaller, leaner babies that are still within the normal size range for newborns.  

Will exercise be harder during pregnancy?  

The body goes through many changes throughout pregnancy that could change your ability and tolerance to exercise. As pregnancy goes on, the amount of blood in your body and your heart rate increases. This means your body works harder to give enough nutrients and oxygen to both you and your pregnancy, so there is less oxygen available for exercise. This change in blood flow could also make you feel light-headed.  

As your pregnancy grows larger, your sense of balance changes, which means you may need to adjust your posture. This shift in posture can make certain types of exercise (such as running, yoga, and free weights) more challenging. Joints also become looser due to hormonal changes. Looser joints mean there is a higher chance of strains or sprains during otherwise routine movements and exercise.   

What are the benefits of exercising during pregnancy?  

Exercise is important for your physical and mental health. It may improve mood and sleep patterns and might help prevent or treat gestational diabetes. Exercise may also ease some of the common discomforts of pregnancy such as constipation, backache, fatigue, leg swelling, and varicose veins.  

What are some basic guidelines for exercising during pregnancy? 

If your pregnancy is not high risk, and you have checked with your healthcare provider, some basic guidelines to keep in mind include:  

• Exercise most days of the week. 
• During the second and third trimesters, avoid exercise that involves lying flat on your back because this causes less blood flow for both you andyour pregnancy. 
• Avoid exercising to the pointwhere you are exhausted or out of breath. 
• Be aware that your sense of balance will change throughout pregnancy, which could lead to falls. 
• Drink plenty offluidsbefore and during exercise. 
• Avoid overheating your body, especially in the first trimester.

What types of exercises are good choices during pregnancy? 

Most women can continue their pre-pregnancy exercise routine during pregnancy, but you may need to modify some activities. Listen to your body and stop when you feel too tired or if you feel dizziness, headaches, muscle weakness, nausea, chest pain, fewer fetal movements, or have contractions. Do not get discouraged: even mild to moderate exercise can help your fitness level and mood.  

Most women can participate in a wide range of recreational activities. Non-weight bearing exercises such as stationary cycling, swimming, or water aerobics are the easiest on your body throughout your entire pregnancy. Check with your healthcare provider if you are wondering if you should try a certain type of exercise or activity. 

What types of exercise should I try to avoid during pregnancy? 

ACOG does not recommend contact sports or activities that can increase the risk of injury or falls during pregnancy. Contact sports such as ice hockey, soccer, and basketball could cause trauma to both you and your pregnancy. In addition, the chance of falling during activities such as gymnastics, horseback riding, jet skiing, water skiing, surfing, and downhill skiing may be higher during pregnancy from changes in balance. Scuba diving, skydiving, or any exercise at or above altitudes of 6,000 feet are not recommended since they are all associated with lower oxygen levels. Hot yoga (also known as Bikram yoga) and hot Pilates are done in rooms that are usually between 95ºF and 104ºF (35ºC to 40ºC). These activities are not recommended during pregnancy due to the very high temperatures and the lack of information in pregnancy. Check with your healthcare provider if you are wondering if you should try a certain type of exercise or activity. 

If I am doing intense training, is there anything I should consider while pregnant?  

Talk with your healthcare provider about your training and goals. As an athlete, you may need to change your training program at each stage of pregnancy. While there may be risk involved in physical activity for some women, most healthcare providers believe that the benefits of being active far outweigh the risks, even for those who wish to continue participation at an elite level. Your pre-pregnancy levels of fitness, as well as your particular sport, must be considered when planning how intensely, how long, and how often you exercise. When done under the care and guidance of your healthcare provider, it is unlikely that your exercise program or sport will cause problems.  

Studies have found that some athletes use supplementation to enhance performance. However, information on the use of supplements in pregnancy is often very limited. Be sure to talk to your healthcare provider if you are thinking about taking any supplements while pregnant or breastfeeding. MotherToBaby has a fact sheet on herbal products at: https://mothertobaby.org/fact-sheets/herbal-products-pregnancy/.  

When can I begin to exercise after giving birth? 

Talk to your healthcare provider to find out how soon you can begin to exercise after giving birth. Your body will continue to go through changes from your pregnancy for many weeks after your baby is born. How long you should wait will depend on a few factors, including how active you were able to be during pregnancy, any health problems you have, and what type of delivery you had. 

Breastfeeding while exercising:  

When done in moderation and under the guidance of your healthcare provider, exercise is not expected to affect breastfeeding. Most women will make the same amount of milk whether they exercise or not. However, it is extremely important to drink plenty of water while breastfeeding, especially if you exercise. Be sure to talk to your healthcare provider about all of your breastfeeding questions. 

If a man exercises, could it affect his fertility or increase the chance of birth defects? 

Exercise is not expected to affect male fertility (ability to make healthy sperm). Studies have not been done to see if exercise in men could increase the chance of birth defects in a partner’s pregnancy. In general, exposures that men have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures and Pregnancy at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/. 

Please click here for references. 

This sheet is about having inflammatory bowel disease in pregnancy or while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.  

What is Inflammatory Bowel Disease?  

Inflammatory bowel disease (IBD) is a chronic intestine illness with symptoms such as abdominal pain, vomiting, diarrhea, and weight loss. IBD includes Crohn’s disease (CD) and ulcerative colitis (UC). CD and UC involve serious inflammation of the intestines.  

I have IBD. What should I talk about with my healthcare team before I get pregnant? 

It is important to talk to your healthcare team about plans for treating your condition before and during pregnancy, during delivery, and after delivery. If possible, talk with your healthcare team before getting pregnant. If your pregnancy is unplanned, contact your healthcare providers as soon as you find out you are pregnant.  

Things to talk about with your healthcare team include: 

• Ways to monitor your pregnancy and your IBD symptoms. 

• Ways to avoid triggering flare ups. 

• Any medications or vitamins you should take during pregnancy. Women with IBD might not have enough of certain vitamins and nutrients, such as vitamins D and K.  

• Getting any necessary vaccines before and during pregnancy. Many vaccines can be given in pregnancy. For more information, please see the MotherToBaby fact sheet on vaccines at https://mothertobaby.org/fact-sheets/vaccines-pregnancy/. 

• Any other questions or concerns you have. 

I have IBD. Can it make it harder for me to become pregnant?  

In general, women with UC and inactive CD are as likely to get pregnant as women without IBD.  

Active CD might lower the ability to get pregnant by increasing inflammation in the pelvic organs. Achieving remission might improve the chances of becoming pregnant.  

It might also be harder to get pregnant if a woman has had surgery for IBD, as the surgery might have caused scar tissue to form in the pelvic region and/or around the fallopian tubes.  

How will pregnancy affect my symptoms?  

Women who are in remission from their CD at the start of pregnancy might have no change in symptoms, or they might have an improvement of symptoms, or a worsening of symptoms. Women with active symptoms at the time of conception, are likely to continue to have active disease throughout pregnancy. Women who had symptoms in a previous pregnancy might be at an increased risk for experiencing symptoms again in their next pregnancy. 

UC might become more active in the 1st or 2nd trimester. However, some women will see their symptoms improve early in pregnancy. Among women with active UC at conception, approximately half (1 out of 2, or 50%) have worsening symptoms during pregnancy.  

Does having IBD increase the chance for miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. In women whose IBD is inactive, the chance for miscarriage is not expected to be greatly increased. The risk might be higher with active IBD depending on the severity of the symptoms.  

Does having IBD increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like IBD, might increase the chance of birth defects in a pregnancy. Most studies suggest that the chance for birth defects is not increased in women with inactive IBD. It is not clear if there is an increased chance of birth defects with active IBD. If there is an increased chance, it is expected to be low.  

Does having IBD increase the chance of other pregnancy-related problems? 

There are some studies that suggest that women with active disease have an increased chance for pregnancy complications, such as preterm delivery (birth before week 37), stillbirth, or having a baby with low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). There have also been higher rates of delivery by C-section reported in women with IBD. The chance of experiencing these pregnancy-related problems might be related to the severity of the woman’s illness during pregnancy. 

Women with CD might be at an increased chance for having vitamin deficiencies, including vitamins K and D. Vitamin K is important in the blood clotting process. Vitamin D is important in lowering the chance of pregnancy complications such as preeclampsia (high blood pressure and problems with organs, such as the kidneys) that can lead to seizures (called eclampsia), preterm delivery, and babies that are small for gestational age. For these reasons, it is important that women with IBD talk with their healthcare provider about their condition and their nutrition. 

Does having IBD in pregnancy affect future behavior or learning for the child?   

Based on most studies, IBD is not expected to increase the chance for developmental delays. However, having an active IBD disease can increase the chance for preterm delivery. Preterm delivery has been associated with an increased chance for children to have intellectual disabilities. 

What medications can be used to treat my IBD during pregnancy?  

It is important to talk with your healthcare providers as soon as possible about the best way to treat your condition during pregnancy. There are different types of medications used to treat IBD. In some cases, women will need to take more than one medication during pregnancy. For information on a specific medication, see our fact sheets at https://mothertobaby.org/fact-sheets-parent/ or contact MotherToBaby to discuss your specific exposures. 

IBD itself can be associated with risks during pregnancy, and it is important that IBD remain as inactive as possible. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

Breastfeeding while I have IBD:  

Studies have not shown breastfeeding to affect disease activity or symptoms in women with IBD. There is some data to suggest that breastfeeding might protect against flare ups in the first year after having a baby. 

There are medications that have been used to treat IBD that are considered acceptable for use while breastfeeding. For information on specific medications, see our medication fact sheets or contact a MotherToBaby specialist. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man has IBD, can it make it affect his fertility or increase the chance of birth defects? 

Available information suggests that active disease or experiencing a recent flare-up can impact a man’s ability to conceive a pregnancy. Factors such as swelling, anxiety, depression, and effects of medication used might impact fertility. Men who have had surgery for IBD might have problems related to ejaculation. Men affected with IBD should discuss their condition and treatment options with their healthcare provider. In general, exposures that males have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references. 

 

MotherToBaby is currently conducting a study looking at Inflammatory Bowel Disease and the medications used to treat this condition in pregnancy. If you are interested in taking part in this study, please call 1-877-311-8972 or sign up at https://mothertobaby.org/join-a-study-form/.  

This sheet is about having asthma in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is asthma? 

Asthma is a condition that causes inflammation (swelling and tightening) in the airways of the lungs. When an asthma attack happens, it is hard for air to pass through the lungs. This can lead to symptoms like wheezing, coughing, and trouble breathing. Asthma is often managed with medication in inhalers for fast symptom relief (when an attack happens) and/or with daily medication to help lower inflammation (to prevent attacks).  

Asthma is one of the most common chronic diseases among people of reproductive age. For some people, asthma attacks might be triggered by things like breathing in cold air, cold/flu viruses, heavy exercise, chemicals, smoke, and allergies. Avoiding triggers and having a good medical plan in place can lower the number of asthma attacks you have. Asthma that is not well controlled can increase the chance of problems in pregnancy, so it is important to talk with your healthcare provider about the best way to treat your asthma.  

I have asthma. What should I talk about with my healthcare team before I get pregnant? 

It is important to talk to your healthcare team about plans for treating your condition before and during pregnancy, during delivery, and after delivery. If possible, talk with your healthcare team before getting pregnant. If your pregnancy is unplanned, contact your healthcare providers as soon as you find out you are pregnant.  

Things to talk about with your healthcare team include: 

• Ways to monitor your pregnancy and your asthma symptoms, and ways to avoid triggers.  
• Any medications or vitamins you should take during pregnancy.  
• Getting any necessary vaccines before and during pregnancy. Many vaccines can be given in pregnancy. For more information, please see the MotherToBaby fact sheet on vaccines at https://mothertobaby.org/fact-sheets/vaccines-pregnancy/. 
• Any other questions or concerns you have.

Can having asthma make it harder for me to get pregnant? 

It is not known if having asthma can make it harder to get pregnant. Some studies have suggested that it might take longer for people with asthma to get pregnant, especially when asthma is not well controlled. Other studies have not shown that it is harder for people with asthma to get pregnant.      

Will pregnancy affect my asthma? 

It is hard to know how a person’s asthma will act during pregnancy. About one-third of people with asthma who are pregnant will have improvement in their symptoms, about one-third will stay the same, and about one-third will get worse. It appears that the more severe asthma is at the time of conception, the more likely it is that the symptoms will get worse during pregnancy. It is important that a person’s asthma is well controlled before getting pregnant or as soon as possible. 

Does having asthma increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. A few studies have suggested a small increased chance of miscarriage; however, these studies did not look at other factors that can cause miscarriage. Most studies have not shown an increased chance of miscarriage in people with asthma.

Does having asthma increase the chance of birth defects? 

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like asthma, might increase the chance of birth defects in a pregnancy.  

Some studies have suggested an increased chance of birth defects in people with asthma, while others have not. In these studies, it is hard to know if the birth defects found were due to asthma, the medications needed to control asthma, or other factors. Most people who are pregnant and have asthma have babies without birth defects. If there is an increased chance of birth defects from asthma itself, it is expected to be low. 

If a person who is pregnant has trouble breathing, they will take in less oxygen. This could lead to a lower amount of oxygen getting to the pregnancy, which could cause problems in organ development and other complications.  

Does having asthma increase the chance of other pregnancy-related problems?

Asthma that is not well controlled during pregnancy is linked to higher rates of pregnancy complications, such as preterm delivery (birth before week 37), low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth), higher rates of C-section, problems with the placenta, hemorrhage (blood loss), high blood pressure, and preeclampsia (high blood pressure and problems with organs, such as the kidneys). People with well-controlled asthma during pregnancy are not expected to have a greater chance for pregnancy-related problems than people without asthma.  

Does having asthma affect future behavior or learning for the child? 

It is not known if having asthma in pregnancy can increase the chance of behavior or learning issues for the child.  

Can taking medication for asthma during pregnancy increase the chance of birth defects or other pregnancy-related problems? 

Most asthma medications have not been shown to increase the chance of birth defects or other pregnancy-related problems. It is important that your asthma be as well controlled as possible before, during, and after pregnancy. Talk with your healthcare provider before making any changes to how you take your medication(s) and contact MotherToBaby with questions about your specific medications. For a list of MotherToBaby fact sheets related to asthma please see: https://mothertobaby.org/pregnancy-breastfeeding-exposures/asthma/.    

Breastfeeding while I have asthma:

Having asthma is not expected to affect a person’s ability to breastfeed.  

Can I breastfeed while taking my medications for asthma?

Most asthma medications can be taken while breastfeeding. Contact MotherToBaby with questions about your specific medications. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man has asthma, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if asthma could affect men’s fertility (ability to get a partner pregnant). Asthma in males is not expected to increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/. 

MotherToBaby is currently conducting a study looking at asthma and the medications used to treat asthma in pregnancy. If you would like to learn more, please call 1-877-311-8972 or visit https://mothertobaby.org/join-study/. 

Please click here for references.  

This sheet is about having anxiety in a pregnancy or while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare providers. 

What is anxiety? 

Anxiety is an excessive and uncontrollable worry. It is common to worry about your pregnancy or your baby’s health. Worrying becomes an anxiety disorder when the thoughts are frequent, time-consuming, intrusive, and irrational. Intrusive thoughts are unwelcome thoughts or images that are upsetting. Irrational worry means worrying about things that are unlikely to happen.  

Almost everyone can experience anxiety at some point in their life. It can be hard to tell the difference between what the usual pregnancy-related worry is and what excessive worry or anxiety disorder is. However, when anxiety interferes with everyday activities, it might be Generalized Anxiety Disorder (GAD), one type of anxiety disorder. GAD occurs in about 9 to 11 out of 100 (9% to 11%) women who are pregnant.  

What are the symptoms of anxiety? 

Anxiety can lead to difficulty sleeping, feeling tired, feeling irritated, and/or lacking focus. People with anxiety might also feel like their heart is pounding or beating fast. Some might start to sweat, tremble or shake, or feel short of breath. Anxiety might also cause diarrhea or constipation. During anxiety attacks (also known as panic attacks), people might have fears of passing out, dying, or of losing control or “going crazy.” 

I think I just worry too much. I don’t want to tell anyone. Should I tell my healthcare provider?  

Yes. If you think that you worry too much, or your partner, friends or family have told you that you are worrying too much, the best thing to do is to tell one of your healthcare providers. Many women with anxiety spend a lot of time worrying about seeking help which can delay treatment. Finding ways to lower your levels of anxiety can help you have a healthy pregnancy. Around half (50%) of individuals with anxiety disorder also have some symptoms of depression. Having anxiety during your pregnancy increases the chance of depression during pregnancy as well as having a mood disorder after the baby is born (postpartum mood disorder). Discussing anxiety with your healthcare providers can help during and after a pregnancy. For information on depression, please see that fact sheet at: https://mothertobaby.org/fact-sheets/depression-pregnancy/. 

I have been taking medication for anxiety, and I am trying to get pregnant. Should I stop my medication? 

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Stopping a medication that is working to treat your anxiety might cause symptoms to restart or to get worse. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

I have anxiety. Can it make it harder for me to become pregnant?  

It is not known if anxiety could make it harder to get pregnant.   

Does having anxiety increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Some studies have reported that anxiety might increase the chance of miscarriage. 

Does having anxiety increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like anxiety, might increase the chance of birth defects in a pregnancy.  

Anxiety alone is unlikely to increase the chance of birth defects. However, since it is difficult to measure anxiety and people respond differently to stress, it is difficult to study the effects of anxiety on pregnancy. For information on stress, please see this fact sheet at: https://mothertobaby.org/fact-sheets/stress-pregnancy/.     

Does having anxiety in pregnancy increase the chance of other pregnancy related problems? 

Untreated anxiety might contribute to pregnancy related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). There have also been some studies that reported untreated anxiety in pregnancy might increase the chance for admission to the neonatal intensive care unit (NICU), poor physical growth, delayed gross-motor (large muscle) development, and asthma in early childhood.  

Does having anxiety in pregnancy affect future behavior or learning for the child? 

A few studies have found that poorly treated anxiety in pregnancy might affect early childhood development, including weakened social, emotional, and communication skills.  

Untreated anxiety can make it difficult to feel connected (bonded) with the baby both during pregnancy and after delivery. Having a mental health disorder can increase the chance of postpartum mood disorders, which can also interfere with bonding with the baby. Having frequent negative thoughts can lead to less involvement with your baby. Talk with your healthcare providers so that they can determine if you have an anxiety disorder (with or without depression) and can then discuss ways to manage it. 

What types of treatment are available for anxiety? 

Specific types of talk therapy or counseling, relaxation techniques and mindfulness therapy can be effective for treating or managing mild to moderate symptoms of anxiety. Some people benefit from exercising. Some people benefit from medication. There may be other treatments available, as well. Talk to your healthcare provider to plan out the best treatment for your anxiety.  

If I take medication for anxiety during my pregnancy, will it harm the baby? 

There are many different medication options for treating anxiety in pregnancy. Generally, studies have not found an increased chance for birth defects for many of these medications. For more information about specific medications, please see our medication fact sheets at https://mothertobaby.org/fact-sheets-parent/ or contact MotherToBaby to speak with an information specialist about your specific medications. MotherToBaby also has a general information page on anxiety in pregnancy and breastfeeding, including links to fact sheets and other resources:  https://mothertobaby.org/pregnancy-breastfeeding-exposures/anxiety/.  

Breastfeeding if I have anxiety or need to take medication: 

Having anxiety does not need to keep you from breastfeeding. For some women, breastfeeding can feel overwhelming. Find supportive friends or family members who can help you. You can also talk to your healthcare provider about different treatment options, including therapy and medications. If you and your healthcare provider decide that medication is the best treatment for you, there are medications that can be used while breastfeeding. For more information about medications, please see our medication fact sheets at https://mothertobaby.org/fact-sheets-parent/ or contact MotherToBaby to speak with an information specialist about specific medications. Be sure to talk to your healthcare provider about all of your breastfeeding questions.  

If a man has anxiety, can it affect his fertility or increase the chance of birth defects? 

Some reports have found that men with anxiety might have lower fertility (ability to make healthy sperm). Anxiety (and depression) have been shown to lower semen volume and sperm density. A man’s emotional well-being is important, not only for their personal health, but also for the health and support of their partner and children. Men who have symptoms of anxiety should talk to their healthcare provider to plan out the best treatment for their anxiety. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here to view references. 

This sheet is about exposure to antiviral medications in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What are antiviral medications?  

Antiviral medications treat viral illnesses, such as influenza (the “flu”). Symptoms of the flu may include fever, headache, chills, muscle aches, coughing, congestion, runny nose, and sore throat. There can also be stomach upset with vomiting and diarrhea. For more information, see the MotherToBaby fact sheet on Seasonal Influenza (the Flu) at https://mothertobaby.org/fact-sheets/seasonal-influenza-the-flu-pregnancy/.   

What do antiviral medications do? 

Antiviral medications can lessen the symptoms of the flu and lower the risk of serious illness. Some may be used to help prevent a person from catching the flu. There are 4 antiviral medications approved by the U.S. Food and Drug Administration (FDA) to treat the flu: oseltamivir (Tamiflu®), peramivir (Rapivab®), zanamivir (Relenza®), and baloxavir (Xofluza®).  You need a prescription from your healthcare provider to get these medications.  

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

According to the Centers for Disease Control and Prevention (CDC), oral oseltamivir is the preferred treatment during pregnancy. Also, baloxavir is not recommended for the treatment of the flu during pregnancy or while breastfeeding, due to a lack of information. Your healthcare provider can discuss what treatment is best for you. 

Can I skip getting the flu vaccine and just take one of these medications if I get sick?  

Antiviral medications are not a substitute for the flu vaccine. Women who are pregnant have a higher chance of complications from the flu. Women who are pregnant or planning to get pregnant should get the injected form of the flu vaccine (flu shot). The nasal-spray form of the influenza vaccine has not been recommended during pregnancy. For more information, see the MotherToBaby fact sheet on the Seasonal Influenza Vaccine (Flu Shot) at https://mothertobaby.org/fact-sheets/seasonal-influenza-vaccine-flu-shot-pregnancy/.   

I take an antiviral medication. Can it make it harder for me to get pregnant? 

There are no human studies on the use of oseltamivir, peramivir, zanamivir, or baloxavir and female fertility (ability to get pregnant).  

Does taking an antiviral medication increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Researchers have not found a higher chance of miscarriage after the use of oseltamivir. Limited information on zanamivir does not suggest an increased chance of miscarriage. Studies have not been done to see if exposure to baloxavir or peramivir in human pregnancy could increase the chance of miscarriage. 

Does taking antiviral medication increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like antiviral medications, might increase the chance of birth defects in a pregnancy. 

Several studies that looked at the use of oseltamivir and zanamivir during pregnancy did not find an increased chance of birth defects. Studies have not been done in humans to see if exposure to baloxavir or peramivir could increase the chance of birth defects. 

Does taking an antiviral medication in pregnancy increase the chance of other-pregnancy related problems?  

Several studies have not found a higher chance of pregnancy complications with oseltamivir or zanamivir use during pregnancy. Studies have not been done in humans to see if exposure to baloxavir or peramivir could increase the chance of preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2,500 grams] at birth). 

Does taking an antiviral medication in pregnancy affect future behavior or learning for the child?   

Studies have not been done to see if oseltamivir, peramivir, zanamivir, or baloxavir can increase the chance of behavior or learning issues in a child.   

I am pregnant and think I may have the flu. What should I do?   

Talk to your healthcare provider as soon as possible. Women who are pregnant have a greater chance of complications from the flu. Taking an antiviral medication within 48 hours (the earlier the better) of your first symptoms can lower the chance of severe complications from the flu. The medications may still be helpful when they are started later than this, so talk to your healthcare provider even if you have already been sick for more than 2 days.  

I am pregnant and my partner has the flu. Should I take an antiviral medication so that I don’t get sick?  

Talk with your healthcare provider if you have been in close contact with someone who has the flu. Because women who are pregnant are at an increased risk of complications from the flu, some may benefit from taking antiviral medications. Your healthcare provider can help you decide whether taking an antiviral medication for flu prevention is best for you.  

Be sure that you and others around you are doing the following to help prevent spread of the flu:  

• Wash your hands with soap and water frequently 
• Avoid touching your eyes, nose, or mouth 
• Try to avoid close contact with sick people 
• Cover your nose and mouth when you cough or sneeze 
• Stay home and avoid close contact with others if you are sick 
• Get your flu shot every year

Breastfeeding while taking antiviral medication: 

Oseltamivir passes into breast milk in small amounts and has not been shown to cause side effects in nursing babies. Zanamivir is given by inhalation, which limits the amount of medication that gets into the bloodstream. For this reason, zanamivir is unlikely to enter breast milk in high amounts. Studies have not been done on the use of peramivir during breastfeeding. Because peramivir does not get absorbed well from the gut, it is unlikely that any medication that passes into the breast milk would enter the baby’s system. Studies have not been done on the use of baloxavir during breastfeeding. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man takes an antiviral medication, could it affect his fertility or increase the chance of birth defects?  

Studies have not been done in humans to see if oseltamivir, peramivir, zanamivir, or baloxavir could affect male fertility (ability to make healthy sperm) or increase the chance of birth defects. Illnesses that cause fever, such as the flu, might cause a temporary reduction in the movement or number of sperm which could make it harder to conceive a pregnancy during that time. Close contact may not be recommended when you have the flu to try to avoid passing the flu to your partner. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet on Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/. 

Please click here for references.