TRANSCRIPT EPISODE 43 – All About Pregnancy & Birth With Dr. Nicole C. Rankins

Transcript episode #43:What You Need to Know About the Flu and Pregnancy

Transcript

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(00:00)

It's an important topic this week, ladies, the flu and pregnancy.

(00:10)

Welcome to the All About Pregnancy & Birth podcast. I'm your host, Dr. Nicole Calloway Rankins, a board certified OB GYN physician, certified integrative health coach and creator of The Birth Preparation Course, an online childbirth education course that will leave you feeling knowledgeable, prepared, confident, and empowered going into your birth. Quick note, this podcast is for educational purposes only and it's not a substitute for medical advice. See the full disclaimer at www.ncrcoaching.com/disclaimer.

(00:42)

Hello, hello. Welcome to another episode of the podcast. This is episode number 43 and thank you so much for being here. Okay, so today's episode is on influenza or the flu and pregnancy and this is actually kind of an add in episode. It wasn't initially in my publishing schedule, but I realized that I need to talk about it because number one, it's flu season and the flu can have pretty devastating effects in pregnancy and I'll talk about that in a minute. And number two, I saw a recent article that showed only about 50% of pregnant women get the flu vaccine and that number needs to be higher. And I hope that by the end of this episode you understand why that number needs to be higher. So in today's episode you're going to learn about what exactly is the flu, how it's spread, and why the flu is particularly a problem during pregnancy. Of course, I'm going to talk about the flu shot and then what to do if you actually catch the flu.

(01:55)

All right. Now, real quick, let me give a quick listeners shout out and this one is to Andrea418 and the title of her review says, I love this woman, and the review says, "if this woman came to deliver my baby, I'd be so happy. Her voice is so calm and soothing and the advice she gives is so even keeled. I love the unbiased information that is holistic in nature, but not fear-mongering and still appreciates the medical side of things too." Well, thank you so much for that lovely review. Andrea, I'm sorry, or Andrea, I'm sorry if I'm pronouncing that incorrectly. I'm also sorry that I can't come to deliver your baby, but I will keep providing holistic, unbiased information on the podcast every single week. I also appreciate the kind words about my voice. I don't know if I've said this before, but I've had quite a few people say that my voice is soothing, which I think is a really kind thing to say and it's not something that I ever would have thought about my voice, so I really, really appreciate that.

(03:02)

Now, quick question before we get into the episode. What do Illinois, California, Hawaii, Texas, Virginia, New York, Delaware, Idaho, and Australia have in common? Well, these are all places where women live who have enrolled in The Birth Preparation Course. This is one of the great things about my signature online childbirth education class. Everything is online so you can go through it literally anywhere. And although I've been pleasantly surprised about women enrolling from Australia and a couple of other foreign countries, actually the course is really geared towards birth in the US. Now at any rate, all you need is an internet connection and you can go through the course on any device, your phone, tablet, desktop, laptop, wherever, and whenever it works for you. It is designed to work for your life. So if you want to learn more about the course, go to www.ncrcoaching.com/enroll. If you want to do a bit of a test run and kind of check out a preview of the course so to speak, enroll in my free online class on how to make a birth plan. Gives you great information on how to make a birth plan that works to help you have the birth you want and you also get access to a discount on the course if you go through the free class. So the online birth plan class is www.ncrcoaching.com/register.

(04:33)

Okay, it is time to talk about the flu. So what is the flu? The long name for it of course, is influenza and it is a virus and there are many different types of flu virus, but in general it's a family of viruses and it can cause pretty serious illness. It's more than just like a runny nose and a sore throat. The flu can actually make you pretty sick and it can be especially harmful if you get it during pregnancy. And I'll talk about why in just a minute. Now, the reason that the flu can be so potentially devastating is that it spreads very easily from person to person. So when someone with the flu coughs or they sneeze or even when they speak, the virus can spread through the air and then you can also get infected. If you touch something like a door handle or a phone that has the flu virus on it, and then you inadvertently touch your nose, your eyes, or your mouth you can get infected if you breathe it in. If somebody coughs, sneezes or speaks, and then you can get infected if you touch it and pick it up on a surface and then touch your own eyes, nose and mouth, and the flu virus can survive on hard surfaces for 24 hours, so it could have been many, many hours before and the flu virus is just hanging out there.

(06:03)

You touch a door knob and then rub your eye and then boom, you have the flu. Now why is the flu such a problem? Well, it's really complications that can develop from the flu. The biggest one is probably pneumonia and it can be quite serious and unfortunately even fatal. Now if you're pregnant, it can be even more serious because you are more likely than other adults to have pretty serious complications from the flu. At least once during my career, I've seen a woman in the intensive care unit as a result of complications from the flu. She was on a ventilator for quite some time because of issues from the flu, so it can be quite devastating during pregnancy and a lot of that is because during pregnancy your immune system is not as strong and not only your immune system, but your heart and lungs are a little bit different and the flu can influence your body in those ways too.

(07:05)

Now as far as your immune system, your immune system is the way we fight infection, the way we protect ourselves from illnesses, and when your body normally senses something like a virus, then your immune system works to fight that virus. Well, when you're pregnant, your immune system actually isn't as quick to respond to illness as when you're not pregnant. Your immune system is a little bit weaker. We think that may be part of the reason why a body doesn't reject a pregnancy, that some changes in the immune system make it so that a body doesn't interpret the pregnancy as a foreign thing. Like if you got an organ transplant for instance then your body would immediately detect that as foreign. Whereas this pregnancy, which is something that can be completely genetically different from you, your body will not attack that as foreign and we think that that's related to changes maybe in your immune system.

(08:09)

Now obviously that is good to help you grow your baby, but a lowered immune system will mean that you are more likely to catch viruses like the flu. So it's not necessarily that pregnant women get the flu more often than women who are not pregnant. It's actually that if you do get the flu, then it tends to be more severe. All right. Now another reason that the flu can be more harmful during pregnancy is that your lungs need more oxygen to help you, you know, nourish and grow your baby. But as, especially in the second and third trimesters as your belly gets bigger, puts pressure on your lungs than your lungs actually have to work a little bit harder because they have less space. That's often why you may feel you're yourself feeling a little bit short of breath when you get towards the end of pregnancy.

(09:10)

Also your heart is working hard during pregnancy as well as supplying blood to use supplying blood to your baby. The uterus gets a ton of extra blood during pregnancy and so it requires a little more work. So when you put the flu on top of that system that's already working hard then it can be even more serious during pregnancy. Now pregnant women who get the flu are also more likely to go into preterm labor. That's labor before 37 weeks and not just labor but also have a premature birth. And then the other thing is that if you have a fever from the flu because some women get very high fevers or some people rather get a very high fever from the flu and if you get it and have a high fever in the early part of pregnancy, then that can increase your risk of having something called neural tube defects, which are issues with the baby's spine.

(10:11)

So that's particularly an issue in the first trimester before that neural tube forms. So again, the flu can have pretty serious problems and issues in pregnancy. Now the way that we know how to best prevent the flu is the flu shot. And what the flu shot is it's a vaccine that helps prevent you from getting the flu. Now the flu shot does not cause the flu. Contrary to popular belief, it does not cause the flu and is safe to get any time during pregnancy. It's best to get it, you know, before flu season really gets going. Like right now, this is October, so between October and May, and I didn't even realize flu season was that long from October to May. But definitely for sure in the winter months where people are closer together and it's easier to spread viruses. So now is the time for sure to get the flu shot.

(11:14)

Now the thing about the flu, as I mentioned in the beginning, it's actually lots of different types of flu viruses and those viruses are always changing. So what happens is each year the flu vaccine, they kind of predict what they think the flu viruses will look like that'll be most prevalent, the ones that are going to be around the most. So the flu vaccine usually protects against three or four different strains of the flu virus. Now here's the thing, sometimes they do a very good job at deciding which three or four viruses to protect against. Sometimes they do a really bad job at deciding which three or four viruses to protect against. So you may find that they picked three or four viruses, these are the ones that we think are going to be the most prevalent and then they make a vaccine for those and it covers like 90% of the flu that we see in the community. Or there have been years and not frequently, where they picked three or four viruses, but those three or four viruses turned out not to be the ones that were prevalent in the community and the flu vaccine only afforded about maybe 45 to 50% protection against the flu.

(12:47)

So it's a bit of an educated guess, and I think this is where some of the confusion comes from about, oh, I got the flu, even though I got the flu shot or the flu shot gave me the flu. It's probably that you got a different virus than what the flu shot offered protection against. And that protection only lasts for about a year. So that's why you have to get a flu shot every single year. The vaccine really only lasts for a year, and these days you can get it in tons of different places. Your OB GYN, your doctor should have flu shots available, most do, but you can get it in pharmacy, you can get it in the grocery store or you can get it at work. So there are lots of different options to get it and most often it's free or very low cost. And once again, I want to reiterate that the flu vaccine is considered very safe in pregnancy. It's been given to millions and millions of pregnant women over many years and it has a very good safety record. Now of course there's risk to anything and those risk are small. You could have an allergy to the flu vaccine. If you have an allergy to eggs, then you can't do the flu vaccine. You can have a injection site reaction to the flu vaccine. So yes, I'm not saying that there are zero risk to it. Everything has risk, but the risks are very, very small and it has a very long safety record.

Speaker 1: (14:18)

Now you may hear about nasal flu vaccines, but pregnant women can not get those nasal spray flu vaccines because it contains a live version of the virus and a live version of the virus is more likely to cause infection. So pregnant women can't do any live vaccines at all in pregnancy. So you can't do the nasal spray version. It has to be the shot. Now also the other side effect, I'm not going to let that thing can be a little bit sore. So you might need to take a little bit of Tylenol afterwards and you can't take Motrin or ibuprofen in pregnancy because of the risk of the effects on your baby's kidneys. So you really only can take Tylenol, but you may need to take some Tylenol or put an ice pack on it, or warm compress in order to help with that soreness. And that soreness usually goes away in a few hours, no more than a day or so.

(15:15)

Now in addition to the benefits of helping you not get the flu, the flu vaccine also has some positive effects for your baby. So when you get the flu vaccine, while you're pregnant, antibodies and antibodies are what help fight infections in our bodies and antibodies that you make actually get transported across the placenta and they get to your baby. So the vaccine that you get can protect your baby for up to six months after birth. So giving you a flu vaccine in pregnancy can help prevent your baby from getting flu. So I think that's particularly important for moms who are going to deliver during the height of flu season. You know, November, December, January. If you get the flu vaccine, you are protecting your baby against the flu as well. You can also get the flu shot while you're breastfeeding. So even if you don't get it during pregnancy, you can still get it while you're breastfeeding and the antibodies will actually pass through your breast milk and get to your baby as well.

(16:35)

Okay, so what happens if you actually get the flu? Because even though the vaccine is great, the vaccine is not 100%. It doesn't protect against all strains and it's still possible to get the flu when pregnant. Now common signs and symptoms of the flu in pregnancy are chills and these are like for real off the chains chills, not like feeling a little bit cold. You may also have a cough or a sore throat. You feel very tired like someone has run over you with a truck. So the fatigue can be very overwhelming. Fever is pretty common and it can be high up in the 102 range but not everyone has a fever with the flu, so you may or may not have it, but if you do have it, again, it can be pretty, pretty high.

(17:25)

Headache is common. The body aches I've heard are very, very intense with the flu. Knock on wood, I have not ever had the flu. Hopefully will never have the flu, but just talking to people that have it, it feels so much different than a run of the mill cold. It's not just stuffy nose and sore throat. It's like an overwhelming fatigue, aches and the fever, headache, all of this stuff is like on a level 10 compared to a level 3 with a cold. Rarely some folks have vomiting and diarrhea, so kind of gastrointestinal symptoms with it. That's more common in children, but that can happen as well. Now the flu can come one like very quickly. You know, you're feeling fine in the morning by the afternoon feeling pretty bad. Now the symptoms can last a week or even longer. But occasionally some folks can be sick from the flu for a long time. And that's particularly people who have more vulnerable immune system. So children, people who are older than 65 and of course pregnant women, pregnant women can be sicker longer from the flu or also if you've recently had a baby. So within those first few weeks postpartum as well.

(18:47)

Now if you think you have the flu, even if you've been vaccinated, you really want to call your doctor as soon as possible. If the office is open, obviously call during office hours, but even if it's at night, you could potentially get a prescription called into a 24 hour pharmacy because it's really important to start antiviral medications as soon as possible. So what the antiviral medication does is it kills the flu virus in your blood and what it does, it'll make your flu milder so you don't feel as bad. And the flu treatment medication and the most common one used in pregnancy is Tamiflu. Actually the most common one period used as Tamiflu. It will also help you feel better faster. And probably the most important thing is that if you start those antiviral medications as soon as possible, it'll help prevent those serious flu complications, particularly pneumonia. So there's a bit of a time limit on when those antiviral medications are most effective. So if you think you may have the flu, you really need to start taking that medication within two days of having symptoms. That's when we know is going to be most effective. That quick treatment within two days will help prevent those serious complications, help you feel better faster and it will be milder.

(20:22)

Now pregnancy is also one of the circumstances where you can take the Tamiflu to prevent the flu. If you've been around someone who's had the flu. So if you have had close contact with someone who you know has the flu and you are pregnant, or even within the first couple of weeks after your birth, if you've had close contact with person, then you can call your your doctor. And even if you do not have signs or symptoms of the flu, your Dr. may want you to go ahead and take a short course of that antiviral medication, the Tamiflu to help prevent you from getting the flu and prevent those serious complications. I think it's like a five day course. I can't remember off the top of my head, but if you've been again in close contact with someone who had the flu, call your doctor. The most common circumstance that I've seen is a child gets the flu and then mom who's pregnant, you know, wants to know if she should take antiviral medication as well to help prevent her from getting the flu in. The answer is generally yes.

(21:31)

Now when you have the flu it can spread very easily to others. Like I said in the beginning it spreads quickly. It lasts on hard surfaces longer, so you really want to help prevent it from spreading and from other people getting it. So some important things to do. You want to stay home when you're sick, stay home until you feel like you're better. Limit your contact with other people. I know in our culture and our society, there's this work, work, work, work, work, go, go, go, go, go. But if you get the flu, you need to sit down somewhere and rest, hydrate yourself. Don't push yourself beyond what you need to do. Of course things like don't kiss anyone, always do the cough or sneeze into a tissue or into your elbow. Thankfully my girls go to a school that has taught them this very well, but don't cough or sneeze into your hand. You want to do it into a tissue or do it into your your arm. And if y'all could see me sitting here on my desk right now, I'm actually holding up my arm like the little, the way that you should like cough or sneeze into your elbow.

(22:38)

Also don't touch your eyes, your nose or mouth so you don't inadvertently almost reinfect yourself. And then of course, good handwashing techniques with soap and hot water before you touch anyone. You can use alcohol based sanitizers, those work as well, but you really need to make sure that they are dry before they are effective. And the last thing you wanna do is wipe down your surfaces with like those Clorox bleach wipes. Cause remember I said that it can last for up to 24 hours on hard surfaces. So if you've been around someone with the flu or if you had the flu, then just wipe those surfaces down. Really good to try to get rid of things as much as you can or have somebody else do it. Because obviously if you're sick, you can't be doing a whole lot of cleaning.

(23:27)

Okay. All right, so that is it for this episode of the podcast. So to summarize, the flu is highly contagious. When pregnant women get the flu, it is usually more severe and it can be quite devastating in pregnancy. The pneumonia and subsequent respiratory issues that can develop. That does not happen frequently. I don't want to scare you. It's not a common thing that happens, but it is possible. And if you see it like I've seen it is something that sticks with you for sure. Now, the best way to prevent the flu is the flu vaccine. The flu vaccine is safe. It's been given to millions of women. It helps protect you. It also helps protect your baby within the first six months of life. And I forgot to say your baby can't get the flu vaccine. It's not recommended that early. So really that's the best protection that you can give your baby, is for you to get the vaccine. And then finally, if you do get the flu, then you want to call your doctor right away so you can get started on the antiviral medication within 48 hours after your symptoms start.

(24:38)

All right, now be sure to subscribe to the podcast in Apple podcast or wherever you listen to your podcasts. And you know I would love it if you leave an honest review. I love giving shout outs on the show. It helps other women to find the show if you leave reviews and helps the show to grow. Also, don't forget to check out my free online class on how to make a birth plan that works. This gives you great information on making your birth plan that works to help you have the birth you want. You can go to www.ncrcoaching.com/register. Right now I only offer the class a couple times a month. One of the things I get, the feedback I get is that people have a hard time making the timing cause I usually do it in the middle of the day so I'm considering turning it into an on demand class. So stay tuned for that and see how that goes.

(25:29)

Now next week on the podcast I have a guest coming back on. Yay. I'm excited to have a guest on since I've been talking a lot like the last four episodes I believe it's been just me. You're probably tired of hear my voice. I'm ready for a guest to come back on. Well I am excited about the guest who will be on the podcast next week. He is a prenatal chiropractor, Dr. Elliot Berlin and you may have heard of him. He actually has a podcast related to pregnancy called Informed Pregnancy Podcast. This was one of my most enjoyable interviews for sure. So be sure to come on back next week to check that out. And until then, I wish you a healthy and happy pregnancy and birth.

(26:14)

Today's episode is brought to you by Women's Wellness Coaching by Doctor Nicole Calloway Rankins. Head to www.ncrcoaching.com to check out my free one hour mini course on how to make your birth plan as well as my comprehensive online childbirth education class, The Birth Preparation Course with over eight hours of content and a private course community. The Birth Preparation Course will leave you knowledgeable, prepared, confident, and empowered going into your birth. Head to www.ncrcoaching.com to learn more.

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