Pregnant women are deluged with advice about things to avoid: caffeine, paint, soft cheese, sushi. Even when evidence of possible harm is weak or purely theoretical, the overriding caveat is, “Don’t take it, don’t use it, don’t do it.”
In a few contexts, the admonition is warranted; in most, it is merely inconvenient and anxiety provoking. But in the case of pandemic influenza, it may be deadly. With the second wave of swine flu at hand, and up to 50 percent of the public at risk, the usual mode of thinking about pregnancy and medications threatens to make a worrisome situation worse.
The dangers of this mentality became frighteningly apparent this summer, when a study in The Lancet reported strikingly high rates of death and of complications like pneumonia in pregnant women with H1N1 influenza. Pregnancy meant a fourfold risk of hospitalization, sometimes with a tragic outcome; all the pregnant women who died had been relatively healthy to begin with.