Asthma and pregnancy

[Rachey1969]

I am currently 20 weeks pregnant with my 4th. I have had quite bad asthma recently and am on pulmicort (inhaled steroids) and resisting oral steriods for the obvious reasons and because I don't feel that bad. Normally I take nothing at all but have maybe one flare up a year, usually after a viral infection. Does anyone else have taking inhaled steroids at this stage and does it have any adverse effects on labour - particularly any adverse effects on midwifes and doctors etc insisting on continual monitoring or interventions?

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R1969 - my asthma is usually seasonal ie. Hay Fever triggered, but during my pregnancy with dd (12mths) I had to take becotide twice daily. It had no adverse effect on the baby and labour was fine (as fine as labour can be ). Absolutely no mention of increased intervention.

Rachey: it's actually far far better that your asthma is correctly controlled while pregnant and the inhaled steroids are miniscule doses (because they get taken right to the point of need) and have a good safety record. There's some excellent information at Asthma UK - in particular the Asthma and Women document. I'll copy and paste the relevant bit:

Asthma during pregnancy

So many hormonal changes take place during pregnancy, that it is hardly surprising many women report changes in their asthma too.

For most women with asthma, there is every chance that their pregnancy will be trouble-free. But many women do have concerns at this important time in their lives. Here are the answers to some common questions about asthma in pregnancy.
Will my asthma get worse during pregnancy?

Like pregnancy itself, asthma varies enormously from woman to woman. Around one third of women find their asthma symptoms improve in pregnancy, one third stay the same and one third find their asthma gets worse. If your asthma gets worse, you may need to increase your medication.
Can my asthma treatment harm my baby?

No. Your baby will do best if you are breathing well and easily, so it is important that your asthma is well controlled.

Most asthma medicines are inhaled. These are entirely safe for your baby.

There are two types of asthma treatment:
Relievers

• Relievers help prevent breathing difficulties when they happen. Relievers (eg Ventolin, Bricanyl) are perfectly safe to use during pregnancy.

Preventers

• Preventers help protect the airways. They make asthma symptoms less likely.

• Preventers usually contain an inhaled steroid. Many people worry about the effects of steroids. Inhaled steroids (eg Becotide, Flixotide and Pulmicort) go straight down to the airways where they are needed, so very little is absorbed into the bloodstream. This means the medicine is highly unlikely to reach the baby. If high doses of inhaled steroids are used, it is sensible to use a spacer device to reduce the risk of absorption.

• For full details of asthma treatments, see our booklet Take Control of Asthma.

Steroid tablets

• Very rarely more severe asthma in pregnancy needs treating with steroid tablets. Short courses for 1-2 weeks can do no harm to your baby.

• A very small minority of people with severe asthma need to take steroid tablets for a longer period. Using steroid tablets for long periods of time or repeatedly during pregnancy can increase the risk of your baby being born underweight. In severe long-term asthma you and your doctor will have weighed up the risks against the benefits of using steroid tablets to control your asthma.

• For more information about steroids, see our booklet Steroids for Asthma.

Other medicines

• Chest infections may occasionally need to be treated with antibiotics. Commonly used antibiotics, such as amoxycillin, are safe. Others, such as tetracycline, are not used in pregnancy.

• If you are worried, discuss your treatment with your doctor or practice nurse.

I should mention Asthma Nurses - they are completely utterly FAB and are well worth a visit if you want someone knowledgeable to chat through all the options with and get some reassurance. Your GP's surgery should have one.

Alternatively, the Asthma UK site (that I just linked to) has a helpline number you can ring, and they have trained nurses there to answer any queries.

Other things you might like to try are gentle exercises that include breathing exercises - yoga and tai chi come to mind. Obviously, going to a proper "in pregnancy" class is the ideal, or at least inform your teacher you are pregnant. I find that learning to breathe deeply in both these types of class helped to reduce stress and reduced asthma symptoms, so they may well be of help to you.

Hope that helps

hi r1969 through my pregnancy with my ds and this baby my asthma has been worse so have continued to use both preventor and reliever on 2 puffs 4 times day of each as its only thing keeping it under control. Had no adverse affects with ds birth but was just told to let them know if i got into difficulty and had to show i had inhalers and they were both in date etc before i was induced.

Thanks for the advice, I am seeing our 'nurse practitioner' but I feel she is being a little over agressive with my treatment - she wants me on antibiotics now for no specific reason. 10 years ago I was a medical researcher and did a lot on asthma so I am fairly knowledgeable about it - it's just that some medical staff seem to panic when they see the word 'asthma' on your notes.

My asthma was bad in my first three pregnancies (and had been since I was 14) but it completely disappeared in my 4th pregnancy. This was because I was no longer eating wheat or dairy. I had excluded them from my diet in sympathy with my son whom I found to be intolerant.
My asthma completely vanished and I've been drug free ever since. (Well over a year now).

Of course everybody's different but I'm not the only person to have 'cured' asthma this way. If only my doctors had suggested food intolerance I could've avoided twenty years of asthma attacks and drug dependence.

I can only urge you to give it a go. If it doesn't work for you, no harm done.

All the best with the pregnancy.

Thanks for the tip, I don't eat much wheat now cos it gives me heartburn and I only really have milk to cure it!

Just I expected, my asthma has been used as a reason for me to have consultant led care rather than midwife led care. At the moment I don't really know what the implications of this are.