Questions and Answers: Use of Antiviral Medicines for the Treatment and Prevention of Flu among Women who are Pregnant or Postpartum for the 2009–2010 Season

October 23, 2009, 3:30 PM ET

Pregnant women who are healthy have had severe illness from the 2009 H1N1 flu (also called “swine flu”). Compared with people in general, pregnant women with 2009 H1N1 flu have been more likely to be admitted to hospitals. Some pregnant women have died.

Changes in the immune system, heart, and lungs during pregnancy make a pregnant woman more prone to severe illness from the flu.  It takes about two weeks after birth or loss of a pregnancy for a woman’s immune system, heart, and lungs to get back to normal.  For this reason, CDC advises doctors to give antiviral medicines that treat 2009 H1N1 flu to pregnant women and women who have given birth or lost a pregnancy within the past two weeks and who have symptoms of flu.

For general information on 2009 H1N1 flu, see CDC’s H1N1 Flu ("Swine Flu") and You.

How does 2009 H1N1 flu affect a pregnant woman?

Pregnant women have signs and symptoms of 2009 H1N1 flu similar to those in other people.  Flu signs and symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, and chills. Some people with this virus also have had diarrhea or vomiting. People may only have some of these symptoms and still have flu.  Some people have not had a fever but still have had 2009 H1N1 flu.

For most pregnant women, 2009 H1N1 flu has been a mild illness.  However, some pregnant women have become very sick.  Also, some women have become very sick in the two weeks after birth or loss of a pregnancy.  These women needed to be admitted to the hospital.  Some of these women have died.  For this reason, a pregnant woman or a woman who has given birth or lost a pregnancy in the past 2 weeks and who thinks she might have the flu needs to call her doctor right away.

Is there a test to know for sure if I have 2009 H1N1 flu?

Some health care providers will do a rapid test (one that gives results the same day) to see if a patient has flu.  The rapid test looks for several flu viruses, not just for the 2009 H1N1 flu virus.  Even when a person has 2009 H1N1 flu, the test is sometimes negative.

There is another test that will look just for 2009 H1N1 flu.  This test is only done in a few places.  The results from this test usually take a few days. If the doctor thinks a pregnant woman or woman who has given birth or lost a pregnancy in the past two weeks has flu, he or she should not wait for test results to start the woman on antiviral medicines.

What should I do if I think I have the flu? 

If a pregnant woman or woman who has given birth or lost a pregnancy in the past two weeks thinks she has flu, she should call her doctor right away.  If needed, he or she will prescribe an antiviral medicine that treats the flu.  The medicine is most helpful if it is started soon (within the first 48 hours) after the woman becomes sick.

Not everyone with flu in the general population needs to get antiviral medicines.  Flu antiviral medicines should be used mostly to treat people with the flu who have a condition that increases their chances for serious problems from flu, such as pregnant women and women who have given birth or lost a pregnancy in the past two weeks. These medicines are also used to treat people with flu who have more severe flu illness or who are in the hospital.

What should I do if I have a fever?

Fever should be treated right away. Having a fever caused by flu infection or other infections early in pregnancy can lead to birth defects in a baby.  Acetaminophen (Tylenol®) is best for a pregnant woman to use to lower a fever. 

What antiviral medicines are available for pregnant women who have the flu?

Oseltamivir (Tamiflu®) or zanamivir (Relenza®) can be used to treat 2009 H1N1 flu. To get these medicines, a doctor needs to write a prescription. These medicines fight against the flu by keeping flu viruses from making more viruses in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious health problems that can result from flu illness. At this time, Tamiflu® is the best medicine to treat pregnant women and women who have given birth or lost a pregnancy in the past 2 weeks and who have 2009 H1N1 flu.

Is it safe for me to take an antiviral medicine for flu while I am pregnant?

The flu can cause severe illness and even death in pregnant women and women who have given birth or lost a pregnancy in the past two weeks. Taking antiviral medicine can help prevent these severe outcomes.  At this time, there are no studies suggesting harm to a pregnant woman or her developing baby if she takes antiviral medicine.  Studies in pregnant animals also have not raised concern for problems from taking these medicines.   Even if there was a very small chance that antiviral medicines might cause harm, having the flu could cause more harm.  Being pregnant should not stop women from using antiviral medicines if their doctor advises them to take the medicine.  Antiviral medicines can be taken at any stage during pregnancy.  Tamiflu® and Relenza® are antiviral medicines that are FDA approved for treatment of influenza.

What is the difference between antiviral medicines for flu and antibiotics?

Antiviral medicines for flu (pills, liquid, or an inhaled powder) reduce the ability of the flu viruses to make more flu viruses in the body.  Antibiotics kill or stop the growth of bacteria. Most women with the flu will be prescribed an antiviral medicine (Tamiflu® or Relenza®).  But, if the doctor is concerned that a woman also has a bacterial infection, in addition to the flu, an antibiotic may also be prescribed.

What should I do if I have come in close contact with someone who has the flu?

A pregnant woman or woman who has given birth or lost a pregnancy in the past 2 weeks should call her doctor right away to talk about what she should do.  Sometimes, doctors will give the woman an antiviral medicine to decrease the chance that she might become sick with flu.  Other times, this might not be needed.  The doctor may instead recommend that the woman take antiviral medicines right away if she gets sick.

I’m pregnant -- is there anything I should do now?

All pregnant women should talk to their doctors now about the early symptoms of flu.  Also, they should discuss a plan to be sure they can get treated quickly if they get sick with the flu.

It’s always better to avoid getting the flu in the first place.  The best way to prevent the flu is by getting a flu vaccine.  CDC advises that pregnant women and women who have given birth in the past 2 weeks get both the 2009 H1N1 and the seasonal flu shots.  Other ways that may help lower the chance of getting the flu are washing hands often; avoiding touching eyes, nose and mouth; and staying away from sick people.
Learn more about the 2009 H1N1 Flu Vaccine.