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11 October 2021

We’re still missing the point on the Covid vaccine and pregnancy

The fact unvaccinated pregnant women make up almost a sixth of the most critically ill Covid patients in hospitals suggests the government must change its message.

By Emma Haslett

Pregnant women are used to avoiding things for their baby’s sake. Alcohol and smoking aren’t great for them, but they’re much worse for their babies – so they avoid them. The risk of food poisoning from brie and shellfish is the same whether you’re pregnant or not – but because it could be fatal for their babies, pregnant women avoid those too, as well as caffeine, cured meat and runny eggs.

If they have a cold, pregnant women don’t take anything stronger than paracetamol, because we don’t know what decongestants do to unborn babies – even though colds during pregnancy are, I can tell you from experience, biblically bad. During the worst of the pandemic, pregnant women mostly avoided leaving the house at all, even though that was terrible for maternal mental health.

So messaging around the Covid vaccine and pregnancy, which seems to focus on the risk to mothers-to-be of catching the virus, rather than emphasising the benefit to the baby, continues to miss the point. New figures from NHS England, which show unvaccinated pregnant women make up almost a sixth of the most critically ill Covid patients in hospitals, shows it’s not working.

Since it changed its vaccine guidance in April, the government has tried different strategies to persuade mothers-to-be to get vaccinated – up to and including wheeling out Carrie Johnson.

But its messaging has remained consistently terrible, with many experiencing a confusing U-turn from those in charge of their care. At one appointment, a friend who is currently pregnant was given the advice that “there’s no evidence that the vaccine won’t harm your baby”, before being told at her next appointment that actually, she should have it. At points, even women who wanted the vaccine were struggling to get it, MP Stella Creasy said in May.

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And then there’s the uncertainty. “I know thousands of women have had it,” another friend told me. “But I don’t think it’s been long enough to know if there’s been an impact on their babies’ development.”

The thalidomide scandal looms large. The morning sickness drug was banned in 1962 after it was proved to cause birth defects. It doesn’t matter that regulations over drug trials have tightened considerably since then, or that the reason the Covid vaccines were rolled out far more quickly than other drugs is because of the sheer scale of the trials and funding involved. All mothers-to-be see is another drug that was made available more quickly than usual.

What would it take to convince them? A change of messaging for one: more “Covid is bad”, less “the vaccine is fine, honest”.

The fact that Covid in unvaccinated women doubles the risk of stillbirth was barely mentioned in this morning’s news stories. In May (before pregnant women were being routinely vaccinated), Tommy’s, the baby loss charity, released a study that showed having Covid in the third trimester more than doubles the risk of stillbirth, from 3.4 stillbirths per 1,000 pregnancies to 8.5 per 1,000 for the group with Covid.

Premature birth is another risk of the disease. The same study showed 12 per cent of women with Covid gave birth prematurely, up from 5.8 per cent of women who had negative tests. Complications of premature birth include problems with brain development leading to learning and behavioural difficulties, chronic health issues and physical problems with organ development, as well as cerebral palsy.

The fact is, pregnant women are hard as nails. Most know that merely by allowing their pregnancies to progress, they are putting their wellbeing and even their lives at risk. According to figures from the UN, 303,000 women a year die of complications related to pregnancy. Women go into this knowing their body will be subjected to wear and tear(s) it would never otherwise experience, so they’re not worried about what Covid will do to them.

What most are not prepared to risk is the life or health of their babies. So let’s make it abundantly clear that it’s Covid, rather than the vaccine, that poses the greatest risk – and that it is unborn babies’ lives that are at risk, as well as their mothers’. When the government stops dithering over its messaging, pregnant women will get it. Until then, avoiding things will continue to feel like the safer option.

[See also: Why are so many pregnant women in hospital with Covid-19?]

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