Expectant mothers with preexisting medical conditions often find themselves with added stress during pregnancy; the new Breathe Well for Your Baby program aims to ease their minds. The yearlong public awareness and professional development campaign launched this week to help the more than one in ten mothers who suffer from asthma navigate breathing conditions while expecting.

Officially launched in Canberra and supported by the ACT Government, the program has been based on the Asthma in Pregnancy Toolkit, a worldwide resource guide specifically for pregnant women with asthma. The website was created by researchers at the Hunter Medical Research Institute (HMRI) and the University of Newcastle in collaboration with global scientists and clinicians.

The campaign aims to inform the public and professionals on how to manage asthma in pregnancy through workshops and the free resource guide. Associate Professor Vanessa Murphy says they want to get the message to GPs, midwives, obstetricians, and pharmacists that well-managed asthma is best.

The online toolkit has information for families in an easy-to-access and read website covering questions about what medications are safe, what to ask your doctor, and how to use an inhaler correctly. It also covers external factors like how air quality can impact you or what happens if you get Covid, as well as resources for labour and post-birth care, such as breastfeeding.

“Then there’s a section for health professionals, there’s a big section on medications and their safety. There’s a section on comorbidities or treatable traits, other aspects of a woman’s experience that might influence her. For example, someone with anxiety and depression might find that it affects their asthma, so, it’s important to treat the whole human,” says Associate Professor Murphy.

She says there are no set dates for the workshops yet; healthcare professionals can request one via the website, and dates will be added to the site as the year progresses.

Associate Professor Vanessa Murphy

Associate Professor Murphy has dedicated her career to researching asthma and pregnancy and was a driving force behind the HMRI program. She says asthma can be quite unpredictable during pregnancy; they can’t pinpoint why it can be exacerbated or how to predict who may be affected.

“Asthma should be a priority for women when they’re pregnant if they’ve got asthma; they should talk to their doctor about what medications they’re using, whether they have an action plan.”

While the statistics say it is unlikely for a woman to develop asthma while pregnant, around 13 per cent of expectant mothers in Australia have asthma. Of those, a significant portion experience an increase in asthma-related symptoms.

“It’s one of the most common chronic diseases in pregnancy. In pregnancy, asthma symptoms can change, so about 40 per cent of women find that their asthma worsens,” she says.

The goal is to manage asthma and avoid flare-ups and keep mum and bub both happy and safe for the full duration of the pregnancy. Flare-ups differ between people; Associate Professor Murphy says symptoms get progressively worse until medical intervention is needed, whether that’s an unscheduled doctor’s visit, a trip to the emergency department or a hospital admission.

She says mothers should check in with their doctors every four to six weeks to ensure everything is being managed correctly. The impact asthma can have on pregnancy outcomes can include low-weight or preterm births, while data has shown an increased risk that the baby may need to spend time in a neonatal unit. Associate Professor Murphy says the data has been taken from broad research, with worst-case scenarios hard to pinpoint for individual cases, however, management is key.

“Having your asthma actively managed in pregnancy can actually lower those risks back to the baseline. So the risk of preterm birth, for example, becomes no risk when asthma is actively managed.”

Lisa Randone is navigating her second pregnancy with asthma. While she has controlled it well, she says there were times when asthma had her concerned.

“It was a bit hard because when I had some kind of asthma event, especially at night, obviously I could not see the doctor straight away, you need to make an appointment, and it might take a few days; while if you have something available online 24/7, you can just open the app and check,” Ms Randone says.

Lisa Randone and the Asthma in Pregnancy Toolkit.

The thought of labour was another concern, worrying about what might happen if she had a flare-up, and couldn’t get her breathing under control. Towards the end of her first pregnancy, Ms Randone started to worry about the movement and pressure on her baby from the coughing. She often found herself feeling unwell but was worried about the impact medication could have on her unborn child.

“At the beginning, especially my first pregnancy, I was too concerned about what was going to happen to the baby if I took medication – I wasn’t thinking about what is going to happen if I don’t take any action,” she says.

Her doctor reassured her that she needed to be well for the baby to be well.

Ms Randone says the toolkit is an easy, accessible way to see what medications are safe for the baby. Her advice for other expectant mothers with asthma is to discuss and research prevention plans with a doctor to avoid needing treatment for an asthma flare-up. She says the resource guide is helpful when she has forgotten something she discussed with her doctor.

“I have a bad memory; even if the doctor tells me something, after a while, I might forget it. Having something that I can constantly go and check is useful,” she says.

To find out more about the toolkit, visit asthmapregnancytoolkit.org.au

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