Winter Pregnancy Care: Vaccines, Cold Season, and Staying Well
Cold and flu season changes the math when you're pregnant. The same viruses hit harder, and a few of this winter's most useful decisions are vaccines.
Winter brings flu, COVID-19, and RSV into close quarters. Pregnancy raises your risk from some of these infections and gives you a way to protect your newborn before birth. This page covers the seasonal and pregnancy vaccines, how to stay well in cold and flu season, dry skin and icy footing, seasonal low mood, and the fever and warning signs that mean call now. Personal medical and medication choices stay with your provider.
Reviewed against current ACOG and CDC guidance
Vaccines in pregnancy: what and when
| Vaccine | When in pregnancy | What it does |
|---|---|---|
| Flu (inactivated influenza) | Any trimester; CDC and ACIP recommend it during any trimester of pregnancy | Lowers your risk of flu and flu-related hospitalization, which is higher in pregnancy |
| COVID-19 | Any trimester; timing not season-locked | Reduces risk of severe COVID-19, which is more likely to need hospitalization, ICU, or a ventilator in pregnancy |
| Tdap (whooping cough) | 27 through 36 weeks, every pregnancy; earlier in that window is best | Maternal antibodies cross to the baby and protect against whooping cough before the baby can be vaccinated at 2 months |
| RSV maternal vaccine (Abrysvo) | 32 0/7 through 36 6/7 weeks' gestation, given September through January in most of the continental US | Passes antibodies across the placenta so your newborn has protection against RSV from birth. An alternative to giving the baby nirsevimab after birth; most infants do not need both |
Why flu and COVID hit harder in pregnancy
Pregnancy changes your immune system, heart, and lungs, which raises the stakes for respiratory infection. CDC notes flu during pregnancy is more likely to cause illness that results in hospitalization, and that fever, a common flu symptom, has been associated in some studies with neural tube defects and other adverse outcomes. For COVID-19, CDC states pregnant people are more likely to get very sick and more likely to need hospitalization, intensive care, or a ventilator, with higher risk of preterm birth or stillbirth. Both flu and COVID vaccines have large safety records in pregnancy. If you get flu symptoms while pregnant, call your provider right away; prompt antiviral treatment is recommended.
Staying well in cold and flu season
- Wash your hands often with soap and water, especially before eating and after being in public spaces.
- Keep distance from people who are coughing, sneezing, or known to be sick.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
- Ask close contacts and caregivers to stay current on their own flu and COVID vaccines.
- Stay home and rest when you feel unwell, and call your provider rather than waiting it out.
- Keep hydrated and don't skip meals; winter appetite dips still need steady fuel.
Dry skin and icy footing
- Dry winter skin: cold air and indoor heat pull moisture from skin. Use a fragrance-free moisturizer after showering, keep showers warm rather than hot, and consider a humidifier. Itchy, dry skin is common; a new or widespread rash, or intense itching especially on palms and soles, is worth mentioning to your provider.
- Slips and falls on ice: your center of gravity shifts forward as pregnancy progresses, and balance changes with it. Wear shoes or boots with good tread, walk slowly with short steps on ice, hold rails, and clear a safe path before you carry anything. If you do fall, especially on your abdomen, call your provider even if you feel fine.
- Cold-weather layering: dress in layers you can adjust, since pregnancy can run warm indoors and cold outside, and avoid getting chilled and overheated in quick succession.
Seasonal low mood vs prenatal depression
Shorter days and less sunlight can flatten mood for many people. A few low days that lift on their own are different from depression. CDC describes perinatal depression as more intense and longer-lasting than the baby blues, which typically resolve on their own within the first couple of weeks. Warning signs include a lasting sad, anxious, or empty mood, loss of interest in things you used to enjoy, low energy, and doubt about your ability to cope. If these last two weeks or more, interfere with daily life, or include thoughts of harming yourself, seek treatment from your provider as soon as possible. Depression in pregnancy is common and treatable. For urgent support, call or text 988 (Suicide and Crisis Lifeline) or call 1-833-TLC-MAMA (National Maternal Mental Health Hotline).
Call your provider now
- Fever of 100.4°F (38°C) or higher.
- Flu or COVID symptoms while pregnant, so antiviral treatment can start promptly if needed.
- Headache that won't go away or gets worse, especially the worst headache of your life.
- Vision changes: flashing lights, blind spots, or blurred vision.
- Extreme swelling of your hands or face (preeclampsia can occur after 20 weeks and may have few symptoms).
- Pain in the upper right belly, below the ribs.
- Severe nausea and vomiting, or inability to keep fluids down.
- Your baby's movements stopping or slowing.
- Any vaginal bleeding or fluid leaking.
- A fall, especially onto your abdomen, even if you feel okay.
Call 911
- Chest pain or a fast-beating heart.
- Trouble breathing or sudden shortness of breath.
- Thoughts of harming yourself or your baby.
- Fainting, loss of consciousness, or seizure.
- Severe swelling, redness, or pain in one leg or arm.
Quick answers
- Can I get the flu shot in any trimester while pregnant?
- Yes. CDC and ACIP recommend flu vaccination during any trimester of pregnancy. Pregnancy raises the risk of flu-related illness and hospitalization, and the inactivated flu shot has a long safety record in pregnancy. Get it as soon as it's available in your area.
- When is the RSV vaccine given during pregnancy?
- The maternal RSV vaccine (Abrysvo) is given between 32 0/7 and 36 6/7 weeks' gestation, during September through January in most of the continental US. Antibodies cross the placenta so your newborn has protection against RSV from birth. This is an alternative to giving the baby nirsevimab after birth; most infants do not need both, so your provider can confirm which path is right for your baby.
- When should I get the Tdap (whooping cough) vaccine?
- Tdap is recommended in every pregnancy, between 27 and 36 weeks, and earlier in that window is best. Your antibodies pass to the baby and protect against whooping cough until the baby can start their own vaccines at 2 months. Because protection wanes, you get it again with each pregnancy.
- Is the COVID-19 vaccine recommended in pregnancy?
- CDC notes COVID-19 vaccination offers the greatest benefit for people at higher risk of severe illness, which includes being pregnant, since pregnant people are more likely to get very sick and to need hospitalization, intensive care, or a ventilator, with higher risk of preterm birth or stillbirth. Studies in over a million pregnant people found no increased risk of miscarriage, preterm delivery, stillbirth, or birth defects. Discuss timing with your provider.
- When should a fever during pregnancy make me call my provider?
- Call your provider for a fever of 100.4°F (38°C) or higher. Fever can signal an infection, and a common flu symptom is fever, which some studies have linked to neural tube defects and other adverse outcomes. If you also have trouble breathing or chest pain, call 911.
Sources & further reading
What your baby needs, season to season.
ParentFlow tracks feeds, sleep, and milestones and surfaces what matters as your baby grows.
App Store Google Play Open Web AppThis guide reflects current ACOG and CDC guidance and is for educational purposes only. It does not constitute medical advice. ParentFlow is a wellness companion — not a substitute for your OB, midwife, or pediatrician. For any medical concern, contact your healthcare provider.