How to reduce fever during pregnancy

How to reduce fever during pregnancy

It's best to treat your fever by drinking plenty of water and resting, if you can. Stay in bed if that makes you feel better, but don't get too hot and sweaty under the duvet. It can be easy to overheat when you're pregnant, but it's not good for you or your baby.

If your temperature is more than 38 degrees C, call your GP the same day. If your temperature reaches more than 39 degrees C, call your GP straight away. You may have an infection and a temperature of more than 39 degrees C for a long time may be harmful to your baby.

Your GP or midwife may offer you some tests if she’s not sure of the reason for your high temperature. These could involve a urine sample and a blood test, which will tell your doctor more about what's causing your fever. She’ll then be in the best position to look after you and your baby.

If your waters have broken and you have a fever, contact your midwife or call the maternity unit at the hospital straight away. Having a high temperature during labour could cause problems for your baby, so don’t delay. Your midwife will be able to help bring your temperature down.

If you know you just have a cold and you feel uncomfortable or in pain too, paracetamol is the safest medicine. Just be sure to follow the dosage instructions on the packet and only use it for the shortest time possible.

Don't take non-steroidal anti-inflammatories (NSAIDs), such as ibuprofen and aspirin, while you're pregnant, unless advised by your GP. These may not be safe for your developing baby.

Having a fever under any circumstance can be concerning, but a fever during pregnancy can be particularly unsettling. Your immune system is actually weaker when you’re expecting, so you’re more susceptible to getting sick—and your symptoms may linger for longer. Aside from feeling especially crappy, it’s natural to worry whether your spike in temperature will affect baby. Here’s what you need to know about keeping you and baby safe and getting you back to good health.

Symptoms of Fever in Pregnancy

A fever is clinically defined as having a temperature of 100.4 degrees Fahrenheit or greater. But of course there’s a range of severity. A person’s normal body temperature is 98.6 degrees, so anytime your temperature is above that, you could technically have a fever (albeit a mild one), says Christine Greves, MD, an ob-gyn at the Orlando Health Winnie Palmer Hospital for Women & Babies in Orlando, Florida. “We usually consider a fever something that needs extra attention if it’s over 102 degrees,” she adds.

If you have a fever during pregnancy, the symptoms you may experience would be the same as if you weren’t expecting. “Being pregnant shouldn’t alter that,” says Julie Lamppa, CNM, RN, a certified nurse midwife at Mayo Clinic. Those symptoms include:

  • Chills
  • Shivering
  • Feeling hot and flushed
  • Muscle aches
  • Sweating
  • Loss of appetite
  • Dehydration
  • Irritability
  • Weakness

Dangers of Fever in Pregnancy

Wondering how baby may be affected by your fever? Rest assured, just because you’re sick doesn’t mean baby is also infected. Rather, the risks depend on how high your temperature gets. When you have a fever, your internal body temperature rises, which can also increase baby’s temperature, Lamppa says. “When a fetus becomes too warm, their heart rate may increase,” she says. However, Lamppa adds, “this is usually temporary and shouldn’t cause any long-term concerns.”

A low-grade fever usually isn’t something to be too concerned about. That said, if a woman has a prolonged fever due to an infection, there’s a chance it could harm baby, Greves says. That’s also true if your temperature spikes in the first trimester, since a fever in early pregnancy—a critical period of fetal development—can increase the odds that baby could develop neural tube defects and other congenital abnormalities, Lamppa says.

Causes of Fever in Pregnancy

If you’re having a fever, there’s a reason for it. “A fever is a symptom,” Greves says. “You need to ask why this person is having a fever.”

There are a few things that could be behind this, she says. Maybe it’s just because you have a little cold—in which case, the odds of your fever affecting your pregnancy are really low, Greves says. Other common culprits behind a fever in pregnancy include the flu, a urinary tract infection (UTI) and a stomach bug. But it’s also possible to have a fever due to something more serious like listeriosis (a bacterial infection), toxoplasmosis (a parasitic infection) or encephalitis (an inflammation of the brain), she says. “That’s when the fever can be a problem—because of the reason behind it,” Greves says. Which is why it’s important to alert your doctor of your symptoms.

Treatment for Fever in Pregnancy

In general, it’s okay to take acetaminophen (Tylenol) when you have a fever during pregnancy, Lamppa says. Other than that, make sure you stay well hydrated and get a lot of rest, she says. Putting a cool washcloth on your forehead may help you feel better as well.

Things you shouldn’t take for a fever in pregnancy include aspirin and ibuprofen (i.e., Advil or Motrin), or, according to Greves, any herbal medication. “This is a very important period of time, and we don’t have any controlled studies that say herbal medications are safe,” she says.

Call your doctor if your fever doesn’t come down with Tylenol or if you notice an increase in contractions, abdominal pain or tenderness, loss of fluid or decrease in fetal movement, Lamppa says. And, of course, don’t hesitate to check in with your doctor if you have any concerns at any point.

Updated February 2020

Expert bios:

Christine Greves, MD, FACOG, is an ob-gyn at the Orlando Health Winnie Palmer Hospital for Women & Babies in Orlando, Florida. She received her medical degree from the University of South Florida College of Medicine.

Julie Lamppa, APRN, CNM, is a certified nurse midwife at Mayo Clinic in Rochester, Minnesota.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

Experiencing a fever during pregnancy can feel like an extremely scary thing for an expecting mom. Having a fever during pregnancy (or a body temperature over 100.4 degrees Fahrenheit) can cause alarm for a mom, her support system/spouse, and immediately cause her to grow concerned for her unborn child as well. If an expecting mom’s body produces an elevated temperature, that correlates to her baby in utero as well. But what can pregnant women take for a fever? It’s a serious question with a serious answer. If you are currently pregnant or have someone in your life who will be welcoming a new bundle of joy soon, we urge you to pay attention to these tips and information on handling fevers while expecting.

How to reduce fever during pregnancy

First things first: Stay calm and confirm your temp

As a pregnant mom who’s found herself overheated — or warm to the touch — it’s completely normal to become alarmed at the possibility of being ill. It’s vital during this time of worry that moms-to-be remain as calm as possible. Staying calm redirects feelings of anxiety and allows mothers to focus their energies on diagnosing and treating their possible issue(s). Once moms have regained their sense of order, confirming the suspected fever is the next step in handling the situation. Ensure you’re testing your body temperature with a clean and working thermometer. Repeat the procedure at least twice to confirm an accurate reading has been taken. A fever is considered such when the human body reaches a temperature of 100.4 degrees or higher.

Call your doctor

Once you have confirmed that you have what’s classified as an active fever, the next step in treating the issue is contacting your OBGYN. It’s important to do this, especially in high-risk pregnancy situations, to obtain exact and up-to-date treatment for the fever by the doctor who is following the pregnancy. When phoning the doctor’s office, be sure to relay to the medical staff the exact reading received when your temperature was taken, and how it was taken (either oral, axillary, or rectal). This helps staff members accurately process the information and treat the malady appropriately. Depending on the temperature and the personal health information of the patient, the OBGYN might request that you come in to be seen in the office for further testing and diagnostics. These types of scenarios usually only occur when fevers are accompanied by correlated symptoms that could be attributed to:

  • Urinary Tract Infections (UTIs)
  • Bacterial or viral infections
  • Food poisoning

What can pregnant women take for a fever?

You’ve stayed calm, confirmed your fever, and spoken with your doctor about any high-risk issues or special medical situations, and now you’re ready to start treating the problem. What do you do?

  1. The first, and best, thing to do when you’ve discovered a fever as an expecting mom is to take the recommended dosage of acetaminophen. This medication, also known by its branded name, Tylenol, is a mom’s first line of defense in treating fevers. Acetaminophen has been proven safe for pregnant mothers, and small children to take to ease discomfort and fevers due to its ability to lower the body’s core temperature without causing internal damage. Dr. Laura Laursen, a practicing OBGYN from Chicago talked to Insider about Tylenol and its uses during pregnancy, “Tylenol is one of the front-line pain meds that we use during pregnancy. It’s safe from your first trimester through the third.”
  2. Stay hydrated by drinking lots of fluids — most importantly water. By keeping your pregnant body as hydrated as possible, you are supplying yourself and your baby with a valuable tool it needs to cool itself internally.
  3. Dress yourself down in more lightweight and breathable fabrics. Now is the time to reach for those soft and comfortable cotton t-shirts and oversized pajama bottoms. Give your skin the chance to breathe, sweat if necessary, and cool naturally without any restrictive materials covering it.
  4. Take a lukewarm bath. By soaking your overheated skin in a tub filled with lukewarm water, you’re physically changing the temperature of your body and bringing its core temperature down gradually. This soothing time spent in the tub can also double as essential self-care for expecting moms. Use the time to relax, reflect, and prepare for the upcoming excitements of birth, or simply space out for a few minutes of precious “you time.”
  5. Stay inside and use a fan to remain cool.

Final thoughts

Whether you decide to do one thing or another, it’s always recommended to speak with your doctor prior to taking any medications or engaging in any activities that might put yourself or your baby at risk. Medication allergies, interactions, or catastrophic outcomes should be always avoided, making communication between you and your OBGYN paramount when treating any kind of ailments. Fevers, while normal at any stage during pregnancy when isolated and self-treated, can also be a sign of a more extensive problem at play, making discussions between you and your doctor even more vital.

This article was medically reviewed by Lacy Windham, MD. Dr. Windham is a board certified Obstetrician & Gynecologist in Tennessee. She attended medical school at the University of Tennessee Health Science Center in Memphis and completed her residency at the Eastern Virginia Medical School in 2010, where she was awarded the Most Outstanding Resident in Maternal Fetal Medicine, Most Outstanding Resident in Oncology, and Most Outstanding Resident Overall.

There are 36 references cited in this article, which can be found at the bottom of the page.

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Research suggests that you may be able to bring down a high fever by taking acetaminophen (Tylenol) and using cooling blankets, though you need to check with your doctor first. [1] X Research source A fever is your body’s natural response to an infection or injury, so you’ll likely need to treat the underlying cause before you’ll get better. Studies show that a high fever during pregnancy might be harmful, so it’s important to see your doctor. [2] X Trustworthy Source Centers for Disease Control and Prevention Main public health institute for the US, run by the Dept. of Health and Human Services Go to source Try not to worry because having a fever is a normal, common experience, and your doctor can help you recover as fast as possible.

How to reduce fever during pregnancy

A study from the Slone Epidemiology Center at Boston University, in collaboration with the Centers for Disease Control and Prevention (CDC), found that women who reported having a fever before or during early pregnancy were more likely to have a baby with a neural tube defect compared to women who did not report having a fever. However, women who reported having a fever before or during early pregnancy, but who were consuming 400 micrograms (mcg) of folic acid every day, did not have this increased risk for having a baby born with a neural tube defect.

Main Findings:

  • Women who reported having a fever just before or during early pregnancy were more than twice as likely to have a baby with a neural tube defect compared with women who did not report having a fever.
  • Women who reported having a fever and did not consume the recommended 400 mcg of folic acid each day had the highest risk of having a baby with a neural tube defect.
  • Women who are planning a pregnancy should consider taking steps to protect themselves from fever and infection during early pregnancy to help prevent birth defects.
  • Neural tube defects are serious birth defects of the brain and spine.
  • The two most common neural tube defects are spina bifida (affects the spine) and anencephaly (affects the brain).
  • Neural tube defects happen during the first month of pregnancy.
  • Consuming 400 mcg of folic acid daily, before and during early pregnancy, can help lower the risk of neural tube defects.

About This Study

  • Researchers used data from the Slone Epidemiology Center Birth Defects Study external icon , which collected information on pregnancies affected by birth defects and babies born without birth defects in order to study what might cause or prevent birth defects.
  • Researchers looked at the following neural tube defects in this study: spina bifida, anencephaly, and encephalocele.

About Birth Defects

Birth defects are common, costly, and critical conditions that affect 1 in every 33 babies born in the United States each year. Birth defects are structural changes present at birth that can affect almost any part or parts of the body (such as the heart, brain, face, arms, and legs). They may affect how the body looks, works, or both.

Our Work

CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD) saves babies by preventing birth defects. NCBDDD identifies causes of birth defects, finds opportunities to prevent them, and improves the health of those living with birth defects. Learn how NCBDDD makes a difference by visiting https://www.cdc.gov/ncbddd/aboutus/saving-babies/index.html.

More Information

  • Facts About Birth Defects: https://www.cdc.gov/ncbddd/birthdefects/facts.html
  • Facts About Folic Acid: https://www.cdc.gov/ncbddd/folicacid/about.html
  • 10 Tips for Preventing Infections Before and During Pregnancy: https://www.cdc.gov/pregnancy/infections.html

Key Findings Reference

Kerr SM, Parker SE, Mitchell AA, Tinker SC, Werler MM. Periconceptional maternal fever, folic acid intake, and the risk for neural tube defects. Annals of Epidemiology. 2017 Nov 2.

It is not unusual to develop a viral illness that causes a fever during pregnancy or after your delivery. Mild fevers that last only a short time usually are not a concern.

An ongoing fever that does not get better with home treatment, such as taking acetaminophen, or that does not improve after several days may mean that you have a more serious problem, such as a bacterial infection . Talk to your doctor if:

  • A fever develops and you have other health risks, such as diabetes or other chronic conditions.
  • A fever develops with other symptoms, such as symptoms of a kidney infection .
  • Dehydration develops.
  • A mild fever without an obvious cause lasts longer than 4 full days.
  • A fever without an obvious cause comes back more than once in 3 weeks.
  • A fever with an increase in vaginal discharge or a bad smell from vaginal discharge.

Remember, fever is only a symptom. Often the importance of a fever can only be seen when other symptoms are present.

Related Information

Credits

Current as of:
February 11, 2020

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP – Emergency Medicine
Adam Husney MD – Family Medicine
Kathleen Romito MD – Family Medicine
H. Michael O’Connor MD – Emergency Medicine
Kirtly Jones MD – Obstetrics and Gynecology

Current as of: February 11, 2020

Medical Review: William H. Blahd Jr. MD, FACEP – Emergency Medicine & Adam Husney MD – Family Medicine & Kathleen Romito MD – Family Medicine & H. Michael O’Connor MD – Emergency Medicine & Kirtly Jones MD – Obstetrics and Gynecology

Colds and flu symptoms can be very similar to the symptoms of COVID-19. Even if your symptoms are mild, get tested for COVID-19 immediately — use the colds and flu Symptom Checker if you’re not sure what to do. You can also learn more here about COVID-19 during pregnancy.

Getting the cold or flu when you are pregnant can affect your unborn baby. If you are considering pregnancy or are already pregnant, it is highly recommended that you have the flu vaccination to help protect you and your baby.

Dealing with a cold while pregnant

A cold is a very common mild viral infection of the nose, throat, sinuses and upper airways. It can cause a blocked nose followed by a runny nose, sneezing, a sore throat and a cough. The cold will usually last for about a week as the body fights off the infection.

There is no cure for a cold, although you can usually relieve the symptoms of a cold at home by taking over-the-counter medication, such as paracetamol, and drinking plenty of fluids.

Dealing with the flu while pregnant

Flu is an infectious viral illness spread by coughs and sneezes. It’s not the same as a cold. Flu is caused by a different group of viruses. Symptoms tend to be more severe and last longer.

You can catch flu — short for influenza — all year round, but it is especially common in winter.

If you are pregnant and think you have the flu, see your doctor as soon as possible. It is recommended that pregnant women who have the flu are treated with antiviral medicines because they are at much higher risk of complications. Antiviral medicines work best when started within 48 hours of symptoms starting.

Antivirals will not cure flu, but they will help to:

  • reduce the length of time you are ill by around one day
  • relieve some of the symptoms
  • reduce the potential for serious complications

If this is the case, you should also:

  • rest
  • keep warm
  • drink plenty of water to avoid dehydration

You can take paracetamol to help lower your high temperature and relieve aches.

Medication during pregnancy

Ideally, you should avoid taking medicines when you’re pregnant, particularly during the first 3 months. Conditions such as colds or minor aches and pains often don’t need treating with medicines. However, if you’re pregnant and feel you need to take medicine, paracetamol is safe to take.

Before taking any medicine when you’re pregnant, you should get advice from your midwife or doctor.

Paracetamol during pregnancy

When you’re pregnant, paracetamol is the preferred choice to treat:

  • mild or moderate pain
  • high temperature (fever)

Paracetamol has been used routinely during all stages of pregnancy to reduce a high temperature and for pain relief. There is no clear evidence that it has any harmful effects on the unborn baby.

However, as with any medicine taken during pregnancy, use paracetamol at the lowest effective dose for the shortest possible time. If the recommended dose of paracetamol doesn’t control your symptoms or you’re in pain, get more advice from your midwife or doctor.

Ibuprofen during pregnancy

Ibuprofen is a non-steroidal anti-inflammatory medicine (NSAID). Talk to your doctor before taking ibuprofen or any non-steroidal anti-inflammatory drugs (NSAIDs) if you are pregnant, or planning a pregnancy.

It is not known for sure whether or not taking NSAIDs such as ibuprofen or aspirin in the early stages of pregnancy increases the risk of miscarriage. NSAIDs should not be taken in the last three months of your pregnancy when use can lead to bleeding before and after childbirth, delayed labour and birth, and heart or kidney problems for your unborn baby.

Paracetamol, which is not an NSAID, is the preferred medicine for pain relief and temperature control during pregnancy.

Flu vaccination during pregnancy

The flu jab will protect both you and your baby.

Pregnant women have a much higher chance of developing complications (including life threatening complications) if they get flu, particularly in the later stages of pregnancy. One of the most common complications of flu is bronchitis, a chest infection that can become serious and develop into pneumonia. Other complications are not common, but include:

  • middle ear infection (otitis media)
  • blood infection that causes a severe drop in blood pressure (septic shock)
  • infection of the brain and spinal cord (meningitis)
  • inflammation of the brain (encephalitis)
  • Inflammation of the heart muscle (endocarditis)

If you have flu while you’re pregnant, it could mean your baby is born prematurely or has a low birthweight, and can even lead to stillbirth or death in the first week of life.

Getting the flu vaccine is safe during any stage of pregnancy, from the first few weeks up to your expected due date. The vaccine doesn’t carry risks for either you or your baby.

Women who have had the flu vaccine while pregnant also pass some protection on to their babies, which lasts for the first 6 months of their lives.

The vaccine also poses no risk to women who are breastfeeding, or to their babies.

The flu vaccine is free for pregnant women as part of the National Immunisation Program.

This sheet is about fever and hyperthermia in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare providers.

What is a fever?

Fever refers to a temporary rise in body temperature, usually due to an illness. A person’s typical body temperature is around 98.6 o F (37 o C). In pregnancy, a body temperature over 101 o F (38.3 o C) can be of concern, especially if it lasts for a long period of time in very early pregnancy.

What can cause a fever?

Infection is one of the most common causes of fever. Autoimmune conditions, some cancers and allergic reactions can also cause fever.

What is hyperthermia?

Hyperthermia refers to heat-related conditions/symptoms due to an abnormal rise in body temperature when the body absorbs more heat than it releases (overheating).

What can cause hyperthermia?

The most common causes of hyperthermia are heat stroke and severe reactions to medications (malignant hyperthermia). Long exposure to hot temperatures on hot days (often described at 86 o F (30 o C) or higher) can also cause hyperthermia. Extreme exercise or exposure longer than 10 minutes to heat sources such as hot tubs or saunas might also cause hyperthermia.

I have a fever. Can it make it harder for me to get pregnant?

It is not known if having a fever could make it harder to get pregnant.

Does having a fever increase the chance for miscarriage?

This is not known. Some studies suggested that there might be an increased chance for miscarriage with fever in pregnancy. A more recent study did not find an increased chance for a miscarriage with fever up to 16 weeks gestation.

Does having a fever increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Studies in humans and animals have reported a small increased chance for birth defects called neural tube defects (NTD) in babies of people who had fevers early in pregnancy. Neural tube defects occur when the spinal cord or brain does not form properly.

A few studies have reported a small increased chance for heart defects, abdominal wall defects (organs such as intestines or stomach still work but do not form in their correct spots), or an oral cleft (lip and or roof of mouth do not form correctly) when a fever occurs in early pregnancy, especially if the fever is untreated. However, there are also studies that have not found these results.

Fevers are often due to infections. The small risks being looked at could be due to the illness / infection, medications used to treat the illness, the fever itself, or a combination of all of these factors. If you are pregnant and have a fever, contact your healthcare provider right away. Your health care provider can determine if the illness causing your fever needs to be treated. Your healthcare providers can also talk with you about screening options for birth defects if there is a concern related to a fever or hyperthermia.

I had a fever in the second trimester. Could this have caused a neural tube defect?

The neural tube (which forms the spinal cord) is formed by the beginning of your 6th week of pregnancy (dating from the first day of your last menstrual period). After the neural tube has closed (finished forming), a neural tube defect cannot occur. So, if your high temperature occurs after the 6th week of pregnancy, then your pregnancy is not at an increased risk for this birth defect due to the hyperthermia.

I have been using the hot tub and sauna. Is there an increased chance for birth defects or pregnancy complications?

Hot tub or sauna use during pregnancy should be limited in a pregnancy. This is because it can take only 10 to 20 minutes to raise body temperature to 102 o F (38.9 o C). Some people may not feel uncomfortable at this temperature, while others might. Although hot tub or sauna use alone has not been as strongly associated with an increased chance for neural tube defects, if you were in a hot tub or sauna for a long period of time early in pregnancy, talk with your healthcare provider about available screening tests for neural tube defects.

Does having a fever cause other pregnancy complications?

It is not known if having a fever, itself, can cause other pregnancy complications. Talk with your healthcare providers to learn if a fever from an infection or illness needs to be treated.

Will having a fever during pregnancy cause long-term problems in behavior or learning for the baby?

Studies have not found that fever in a pregnancy could affect learning or behavior. Some forms of neural tube defects can affect learning.

Can I breastfeed if I have a fever?

It is unlikely that a person needs to stop breastfeeding due to hyperthermia/fever or illness. There are antibodies in the breast milk to help prevent the baby from getting sick. Be sure to wash your hands frequently and wear a mask or try not to breathe directly on the baby’s face while nursing. It is important to treat a fever with a medication that has been approved for use while nursing. Contact your healthcare provider as well your baby’s health care provider to discuss the best treatment of your fever or illness while breastfeeding. Talk with your healthcare providers about all of your breastfeeding questions.

Males: Can having a fever make it harder for me to get my partner pregnant or increase the chance of birth defects?

Heat can have a negative effect on the process of making sperm (spermatogenesis). Studies looking at high temperature to the testes, mostly from occupational heat exposure, have found lower sperm production, which might make it harder to get a partner pregnant. Fever has not been directly associated with this chance, but it could possibly lower sperm production. Fever in males at the time of conception or in early pregnancy has not been associated with an increased chance for a birth defect. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references.

OTIS/MotherToBaby recognizes that not all people identify as “men” or “women.” When using the term “mother,” we mean the source of the egg and/or uterus and by “father,” we mean the source of the sperm, regardless of the person’s gender identity.

Before taking any medicine when you’re pregnant, including painkillers, check with your pharmacist, midwife or GP that it’s suitable.

When deciding whether to take a medicine during pregnancy, it’s important to find out about the possible effects of that medicine on your baby.

This is the case both for medicines prescribed by a doctor and for medicines you buy from a pharmacy or shop.

Which medicines are safe?

You can find out information on medicines in pregnancy on the bumps (best use of medicines in pregnancy) website.

They also have advice on what to do if you have already taken a medicine in pregnancy.

But it’s also important to never stop taking a medicine that’s been prescribed to keep you healthy without first checking with your doctor.

Stopping taking your medicine could be harmful to both you and your baby.

If you’re trying for a baby or are already pregnant, it’s important to always:

  • check with your doctor, midwife or pharmacist before taking any prescribed medicines or medicines that you have bought
  • make sure your doctor, dentist or another healthcare professional knows you’re pregnant before they prescribe anything or give you treatment
  • talk to your doctor immediately if you take regular medicine, ideally before you start trying for a baby or as soon as you find out you’re pregnant

If you cannot find information about a specific medicine on bumps, you can ask your doctor, midwife or pharmacist to contact the UK Teratology Information Service (UKTIS) for advice on your behalf.

Herbal and homeopathic remedies and aromatherapy in pregnancy

Not all “natural” remedies or complementary therapies are safe in pregnancy.

Some products used may not be of a high quality and may contain other substances, such as lead, that could be harmful.

Tell your midwife, doctor or pharmacist if you’re using herbal, homeopathic or aromatherapy remedies or therapies.

If you do decide to use these therapies, you should always consult a qualified practitioner.

You should tell your practitioner that you’re pregnant before discussing any treatment.

The Professional Standards Authority for Health and Social Care (PSA) provides information on qualified or registered practitioners.

Organisations with PSA-accredited voluntary registers include:

  • the Complementary & Natural Healthcare Council
  • the Federation of Holistic Therapists

Complementary remedies or therapies cannot replace conventional antenatal care.

It’s important to go to all your regular antenatal check-ups throughout your pregnancy.

Debra Kennedy is affiliated with MotherSafe, the NSW Statewide Medications in Pregnancy and Lactation Advisory Service at the Royal Hospital for Women.

Partners

Flinders University and UNSW Sydney provide funding as members of The Conversation AU.

Pregnancy comes with aches and pains and heightened anxiety about what we put into the body.

A new article published in Nature Reviews Endocrinology has urged caution around taking paracetamol during pregnancy. The paper is a “consensus statement” that brings together analysis by a panel of experts who looked at evidence from human and animal studies of paracetamol use in pregnancy.

Paracetamol use during pregnancy may alter fetal development, say the authors, with long-lasting effects on child health. The authors call for improved education for health-care professionals and patients, less paracetamol use during pregnancy and further research.

Alert but not alarmed

At first glance, calls to minimise paracetamol use during pregnancy are alarming. For those who have taken paracetamol (commonly marketed in Australia as Panadol, Herron Paracetamol, Panamax, Chemist Own or Dymadon) during pregnancy, this could cause anxiety.

This new consensus statement calls for caution, but not concern. The proposed recommendations are largely consistent with current advice provided to pregnant women in Australia.

With any medication in pregnancy, there needs to be a careful balance between treating a maternal condition and protecting the unborn. A trusted health care provider can help reach an informed decision. Paracetamol is no different.

How to reduce fever during pregnancy

What are the concerns?

Worldwide, more than 50% of pregnant women use paracetamol to treat pain and/or fever. Paracetamol is the active ingredient in hundreds of prescription and non-prescription products. It has been widely regarded for many years as safe to use during pregnancy.

Some, but not all, observational studies in humans suggest paracetamol use during pregnancy may alter fetal development. The new statement notes that paracetamol has been linked to increased risk of certain neurodevelopmental, reproductive and urogenital disorders.

But these studies have limitations. Researchers have found it hard to distinguish the effects of paracetamol from the effects of underlying illness. And there are potential inaccuracies in recording the amount and timing of paracetamol use across an entire pregnancy as are highlighted in the accompanying editorial.

Possible risks of paracetamol use in pregnancy are supported by a number of animal studies, the authors say. For this reason, caution regarding paracetamol use has been advised until a definitive link can be proven or disproven.

It’s worth noting the available evidence suggests any possible harms of paracetamol are likely to be dose-related. As highlighted by the review article, most increased risks have been linked with use in pregnancy for more than two or four weeks. Current evidence suggests limited risks to unborn babies when paracetamol is taken short term.

Timing is also important. Taking paracetamol during the first trimester has been linked to an increased risk of reproductive and urogenital disorders. Neurodevelopmental disorders have been linked to use in the second or third trimester.

When the benefits outweigh the risks

The potential benefits of taking medication need to be weighed against any possible risks. Paracetamol is recognised as an important medication for treating pain and fever during pregnancy.

If left untreated, these conditions could harm the fetus or the pregnant person (the Nature editorial and statement say the expert advice is “relevant for all people who wish to become pregnant, including transgender individuals, non-binary people and intersex people”).

The review authors recognise the potential benefits of paracetamol use and note untreated pain has been linked to increased risks of depression or anxiety as well as hypertension during pregnancy. Fever in pregnancy is a risk factor for multiple neonatal and childhood disorders, including certain birth defects and miscarriage. There is evidence to suggest that use of paracetamol may reduce these risks.

What are the alternatives?

The optimal management of pain or fever during pregnancy has not been well studied and treatment options remain limited.

Non-steroidal anti-inflammatory medications (such as ibuprofen) have been linked to miscarriage when used in the first trimester, whereas use after 30 weeks’ gestation can negatively impact kidney and heart/lung function in the fetus. For this reason non-steroidal anti-inflammatory medications are best avoided unless advised by a healthcare professional. The same goes for strong pain medications such as opioids, which should be reserved for the management of severe pain. Paracetamol remains the best choice for the short-term treatment of pain and/or fever during pregnancy.

It is also important to identify the cause of the pain or fever, particularly during pregnancy. Discussions about paracetamol use can lead to further investigation, recommendations for non-medication treatments or the need for different medications.

How to reduce fever during pregnancy

The bottom line

The new consensus statement does not alter existing recommendations regarding paracetamol use during pregnancy. But it does highlight the importance of thinking carefully before using any medications during pregnancy and raises greater awareness about how challenging making informed decisions about medication use can be.

Better evidence is needed to support decision-making during pregnancy and reduce unnecessary anxiety and concern.

Paracetamol use during pregnancy should be discussed with a health-care professional and used at the lowest effective dose for the shortest possible duration. Non-medication therapies for treating pain or fever should be tried before or in addition to paracetamol. When indicated, short-term use of paracetamol remains the safest medication for the treatment of pain and/or fever during pregnancy.