Asthma and Pregnancy
My asthma is severe. It started out mild when I was a child and progressed into the severe category when I was in my 20s. When my husband and I were ready to start a family my asthma was a huge concern. We were not sure how my own body would be able to handle a pregnancy. And what if my children end up with asthma as well? I'm the only person in my family with asthma so the genetic component isn't there for me. If my asthma acts up or I have a severe exacerbation while pregnant, how will my baby get enough oxygen if I'm not? The thought of my baby suffering while in the womb scared me so much.
My first conversation about pregnancy before I got pregnant was with my primary/general doctor. He suggested I consult with both my Pulmonologist and OB/GYN doctor. Both my Pulmonologist and OB doctor explained to me that most asthma medications are safe while pregnant (an also while breastfeeding) and I wouldn't have to stop taking any of them. This was a huge relief. The way it was explained to me is that if I'm not breathing well neither is the baby, thus needing to continue on with my inhalers. Not using my inhalers to help keep my asthma in control while pregnant could lead to pre-term birth, pre-eclampsia, low birth weight, and reduced growth.
While it is true that most asthma medications have not been tested specifically on pregnant women, there are no major safety concerns. The benefit far outweighs the risk, at least for me personally.
Using inhaled steroids to keep asthma under control is preferred over oral steroids such as prednisone. When using an inhaled steroid, the vast majority of the medication goes directly to the lungs and not a lot enters your bloodstream. With prednisone, more of the medication is in your blood and reaches the baby. Not that it is necessarily a bad thing for prednisone to reach the baby, it is preferred that inhaled steroids are used to keep asthma under control.
Remember that one burst of prednisone is the equivalent of an entire years worth of an inhaled steroid. However, it is okay to take prednisone if your doctor recommends it if your asthma is flaring up while pregnant. Breathing mama equals breathing baby. This is the most important thing to remember. If you are suffering, so is your baby.
With pregnancy, 1/3 of women will get worse, 1/3 will stay the same, and 1/3 will get better in terms of their asthma. For me, my asthma went into an almost complete remission when I was pregnant with all three of my children. I stayed on all of my medications as recommended by my doctors and had regular check-ups. One time out of all three pregnancies I needed a short burst of prednisone and it was totally okay. Once my babies were born, my asthma returned to its usual stubborn self. All three of my children are healthy and as of now, have no sign of asthma.
Everyone’s health and pregnancy is different so it is always important to speak to your own healthcare professional before making any changes to your asthma treatment or therapy.
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