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Illustration: Tina Tiller
Illustration: Tina Tiller

OPINIONSocietySeptember 18, 2021

Siouxsie Wiles: Should I get vaccinated if I’m pregnant, trying to get pregnant, or breastfeeding?

Illustration: Tina Tiller
Illustration: Tina Tiller

I know from personal experience the anxiety, the nausea, the uncertainty that can surround decisions at such sensitive times, writes Siouxsie Wiles.

I’ve been inundated with emails and messages from people worried about getting vaccinated if they are trying for a baby, or pregnant, or breastfeeding. Before I tell you what the science says, I want to tell you a very personal story. 

My journey to parenthood

I was in my late teens and skinny as a rake when I was diagnosed with Polycystic Ovarian Syndrome, PCOS for short. If you don’t know what PCOS is, it’s a hormonal disorder in which the ovaries develop fluid-filled cysts and fail to regularly release eggs. The specialist told me I’d likely struggle to get pregnant and have problems with my weight as I got older.

Fast forward to my late 20s. I was married and my husband was making noises about wanting to start a family. We knew it was a long shot but thought we’d give it a try. I gave up coffee and alcohol and feta cheese and all those others things you are told to cut back on if you want to get pregnant. While my weight had crept up, I was keeping fit, cycling across London to work and back every day, a nearly two-hour round trip. 

After a couple of years of trying and no sign of a baby, we were referred to a specialist and the scans and tests started. In preparation for one particular test, I was given some tablets to take – I don’t remember what they were – and a few days later had my first period in years. And then, while we were still waiting for the results of the test, I found out I was pregnant. We were elated. 

But at the back of my mind was a gnawing feeling that the pregnancy wouldn’t last. We kept the news quiet, as you do in those early weeks. I put off making an appointment to see my doctor. I was trying not to get too emotionally invested, just in case.

When I was about nine or 10 weeks pregnant, I went to see my GP. We talked about next steps and I left feeling excited and a little terrified about the future. We were having a baby! I was a postdoctoral fellow at the time, working in the lab with all sorts of dangerous microbes and chemicals. I asked my boss for a meeting and told him I was pregnant. He was really supportive and we talked about how it would impact my research project, what I could still safely work on during my pregnancy, and the practicalities of me taking maternity leave.

A few hours later I started to bleed. The timing felt so cruel. On the day I’d finally accepted I was pregnant, it looked like I was having a miscarriage. I ran to my boss’s office in tears. He drove me to my local hospital, trying to reassure me on the way that lots of people bleed during pregnancy without losing their baby.

But it was a miscarriage. And just like that I wasn’t pregnant anymore. We felt bereft.

I threw myself back into work. I met up with friends for cocktails. I started drinking coffee again. We were still trying for a baby, but I’d resigned myself to parenthood not being in our future. 

And then the morning sickness started. I was pregnant. Surely this time I would miscarry too? After all, I’d given up on being the perfect host-in-waiting. But, no, that little embryo held on tight and nine months later I found myself in hospital alone with a new baby just hours after having an unexpected caesarean section. Our daughter was born just before midnight so my husband was sent home after a couple of hours and told to come back when visiting hours started.

Tears streaming down my face, I lay in the dark trying to figure out how to get my wailing child to latch on. I found breastfeeding the most painful thing I have ever experienced. And I had to do it every few hours. Of course, I didn’t have to do it. I could have stopped at any moment and put my baby onto formula. But my social programming had told me that was the wrong thing to do. Breast is best, and all that. So I persevered. Never again will I ever judge another parent for how they choose to feed their child. 

I kept struggling and our baby lost a lot of weight in those first few weeks. It was horrible seeing the words “failure to thrive” on her chart. We started giving her one bottle of formula a day and I got help from a lactation consultant, a wonderful woman called Sarah Millar, through my local branch of NCT, a UK parenting charity. After a couple of months, breastfeeding just became painful rather than excruciating, so I kept going until the baby weaned herself off. I became the treasurer of our NCT branch and flung myself into finding ways to fundraise to support Sarah to help more people who wanted to breastfeed. 

My first big parenting decision: to vaccinate or not

I’ve written about my daughter’s first vaccination before. She was just a few days old. She was born in a part of London where the BCG vaccine was routinely given to new-born babies to protect them from the bacterial disease tuberculosis. 

Holding her little body as the nurse prepared the vaccine, I vividly recall experiencing a whirlwind of conflicting emotions and thoughts. As a medical researcher specialising in infectious diseases, I remembered the pictures from my university textbooks showing all the polio patients being kept alive by the “iron lungs” helping them breathe. I thought about all the studies I’d read showing just how safe and effective vaccines are. 

As a tuberculosis researcher I even knew what BCG stood for – Bacillus Calmette-Guérin – after the two researchers, Albert Calmette and Camille Guérin, who developed the vaccine over 100 years ago. I also knew that it was a version of the bacterium that causes tuberculosis in cows, and that Calmette and Guérin had grown it in their lab for over a decade until it was no longer able to cause disease, at least in immunocompetent people. I even knew what genes it had lost in the process. 

As an exhausted new mum, still feeling pretty traumatised after that unexpected caesarean section, I didn’t want my new baby to experience any pain. I didn’t want her to have a fever, even though I knew that would be a sign her body was doing exactly what it needed to do to protect her. 

I held her close as the nurse gave her the injection.

A gift for someone special

Today, I am navigating being a parent of a teenager. But there is one last part of my motherhood story I want to share. Because while having one child was enough for me, technically I am the biological mother of one other. 

In 2014, I was an egg donor. I blogged about the experience at the time. I was in my late 30s and someone very special to me was struggling to get pregnant. I offered her my eggs. To get them involved lots of counselling sessions, ethics approval, and me going through the first part of an IVF cycle. That IVF cycle was brutal. Having not experienced IVF till then, I’d always thought it must be emotionally draining. But I had no idea how physically hard it was too. Each daily injection really hurt and left a big bruise. After my eggs were extracted, which is not a particularly pleasant experience, I developed a rare complication called Ovarian Hyperstimulation Syndrome. Fortunately, mine was just a mild case. I had a painful swollen abdomen, shortness of breath, nausea, and aching arms. But it only lasted a week and never got serious enough for me to need hospitalising.

Ironically, having PCOS made me a fairly good candidate for being an egg donor, despite my age. In the end, they were able to extract 16 eggs and 11 turned into fertilised embryos. But just one of those survived to the implantation stage, and I was absolutely gutted. I knew the odds going in. We only had a 5% chance of success. But I still wondered if I could have done anything else to improve our chances.

Our story has a happy ending. That one embryo turned out to be a keeper and nine months later a healthy baby was born. 

I want to be really clear about something here. I’m not telling you this story because I want your praise or sympathy. I’m not special. It was in my power to do something to help someone I really care about. It could so easily have been me that needed someone’s eggs. Society functions because ordinary people do generous things. I want to be able to have a life-saving blood transfusion if I need one, something only made possible because people give blood. Life is full of opportunities for us to be generous. I want to live in a society where we all strive to pay it forward. And so, when the chance came for me to do that, I took it. And now someone I love has the family she always wanted.

It is completely normal to feel nervous about getting vaccinated 

So, why am I telling you all this personal stuff? 

Because I understand your worries and fears. I will never forget that constant nausea in the pit of my stomach. That ache in my heart. My head whirling with what-ifs. 

Am I making the right decisions? 

Did I have a miscarriage because I did something wrong? 

Will this embryo be a keeper? 

Was vaccinating my days-old baby the right thing to do? 

Am I putting my baby in harm’s way?

What the science is telling us about Covid-19, vaccines, fertility, pregnancy, and breastfeeding. 

Others will understand those worries too, and I see them preying on them to spread fear and doubt. So how about we start with the experts who spend their lives looking after those who are pregnant? Obstetrician Dr Michelle Wise has done a short video on Facebook here

Put simply, if you are pregnant, you have an increased risk of having a severe Covid-19 infection. But here is the great news. This can be prevented by vaccination. You can be vaccinated at any stage of pregnancy and the benefits far outweigh any potential risks. If you want it in more academic form, here it is in the Journal of Obstetrics and Gynaecology Canada. A paper just published looked at the rates of miscarriage between the vaccinated and unvaccinated. There was no difference. 

If you get vaccinated while pregnant or breastfeeding, the only thing you will pass on to your baby is a heap of protective antibodies. Not the vaccine

As I wrote recently, there is also no evidence that Covid-19 vaccines affect fertility. No impact on ovarian follicles. No impact on sperm. No impact on couples undergoing IVF to have a baby. What will have an impact on fertility is Covid-19. The symptoms of Long Covid include fatigue, shortness of breath, and an increased heart rate that makes vigorous exercise dangerous. Not what you want if you are trying to make a baby. Doctors are also starting to publish case studies describing their patients who’ve had Covid-19 experiencing erectile dysfunction, premature ejaculation, and not being able to ejaculate. Some of the studies are here, here, and here. For a less jargon-filled read, Dr Ranjith Ramasamy, an Associate Professor of Urology at the University of Miami is one of the people doing research in this area and he wrote a really good lay summary of his work here.

To date, over 4,500 doctors in New Zealand have come together and signed an open letter supporting vaccination. They are calling themselves Doctors Stand Up for Vaccination. You can read the open letter and their excellent FAQ on their website.

I completely understand people being nervous about getting vaccinated if they are pregnant or breastfeeding. It is a perfectly normal response to the uncertainty we are all facing. And it’s a response that is being exploited by people spreading misinformation and disinformation. But the experts are all clear. The benefits far outweigh any risks. If you have concerns about how fast the vaccines were developed, Toby Morris and I have addressed that here

Getting vaccinated is an act of generosity we can all extend to each other. It protects us as individuals, and it protects us together. It’s community immunity, the ultimate form of paying it forward. 

Keep going!