Being pregnant is hard. Getting sick stinks. But being pregnant and coming down with an illness is a special kind of misery.
It’s tough to get through 40 weeks of pregnancy without picking up a cold, the flu, a stomach bug or another everyday ailment, especially if you have older children bringing germs home. But these illnesses are likely to feel worse when your body is already hard at work, says UNC Health OB-GYN Tiffany M. Flanagan, MD.
“You’re going to feel like death warmed over,” she says. “It’s how much energy your body is taking to develop this baby, and now on top of that you’ve got a cold or another illness.”
Making matters worse, not all medications are safe for pregnancy, and pregnant women sometimes err on the side of avoiding drugs altogether out of an abundance of caution.
But if you’re pregnant and sick, you don’t need to suffer unnecessarily. Here’s what to know to feel better.
Pregnancy and the Immune System
A pregnant woman’s immune system and its response to pregnancy are very complex. The common belief used to be that the entire system must be weakened by pregnancy—that the immune response is “turned down” universally so the mother’s body doesn’t reject the fetus as a foreign invader.
But research has shown that some features of the immune system get stronger during pregnancy. For example, pregnant women’s bodies have more active neutrophils and “natural killer” cells, types of white blood cells that fight infection.
“Most women make extra antibodies during pregnancy,” Dr. Flanagan says. “Autoimmune diseases, such as asthma, arthritis and irritable bowel syndrome, can even get better.”
What changes is your experience of common illnesses. In the first trimester, fatigue and nausea are common. Add the exhaustion and discomfort of an infection, and it’s no wonder that you feel especially terrible. In the late second trimester and third trimester, as your uterus expands, a respiratory virus can be challenging because your diaphragm is already crowded.
“You can’t take as big of a breath because you’ve got a living being under there,” making it harder to clear mucus from the lungs, Dr. Flanagan says.
Likewise, gastroenteritis or foodborne illness that sends you running to the bathroom is painful and depleting no matter when it happens. But when your body is also taxed by pregnancy, it’s likely to be especially uncomfortable.
How to Feel Better When You’re Pregnant and Sick
If you are pregnant and get sick, Dr. Flanagan has two main pieces of advice: Take care of yourself and know when to call your doctor.
Make sure you stay hydrated and drink lots of water, she says. Add in sports drinks or Pedialyte to replace salts and sugar. Eat foods with high water content, including soups, broths and fresh fruits.
While most women have responsibilities with family and work, avoid the impulse to power through your illness as if it’s a regular day. Rest and sleep are paramount.
“Just like Grandma would tell you, go get in bed if you can,” Dr. Flanagan says.
If you feel extra warm or you’re having chills, take your temperature. If it’s above 100.4 degrees, call your doctor, Dr. Flanagan says.
Most minor illnesses will have no impact on your baby, so try not to worry, Dr. Flanagan says. But take steps to minimize risk. That means taking acetaminophen (Tylenol) for a fever, because an elevated temperature has been linked to neural tube defects, miscarriage and preterm labor. (But be assured that most of the time, a fever will not cause problems.)
If you have vomiting or diarrhea for more than 24 hours, call your doctor so they can monitor you for dehydration, Dr. Flanagan says.
And if you have a persistent and painful sore throat, get tested for strep throat, which may require antibiotics. If you think you might have the flu or COVID-19, a nasal swab can tell you for sure, and then your doctor may prescribe an antiviral drug to reduce your risk of complications.
“We are women, we are strong—but don’t just grin and bear it,” Dr. Flanagan says. “Take care of yourself and take action when needed.”
Your obstetrician can provide a list of over-the-counter drugs that are safe during pregnancy and will help relieve common symptoms. Some of the drugs you’re used to reaching for are still OK during pregnancy, but others are not. For example, while Tylenol has been shown to be safe, doctors advise against taking ibuprofen (Advil, Motrin) because of concerns about the baby’s kidney health and other complications.
Staying Healthy During Pregnancy
Of course, the best way to avoid the double whammy of pregnancy and illness is to try to stay well. That can be easier said than done when so many viruses are always circulating, but a few basic steps can help your odds.
Rest, sleep, moderate exercise, a balanced diet and stress reduction are good for everybody—and especially good for pregnant women. You’ll want to stay up to date on vaccines, particularly the flu and COVID-19 shots, which can be safely given during pregnancy.
Don’t be afraid to call your doctor if you have questions or concerns about symptoms, medications or anything else, Dr. Flanagan says.
“As doctors, we are here to support you during this exciting and remarkable time,” she says. “We want to answer your questions and help you feel better.”
Do you have questions about your reproductive health? Ask your doctor or find one near you.