Infections in pregnancy and childbearing

Infections during pregnancy, childbearing and the postnatal period can have wide ranging physical, psychosocial and emotional consequences for women, their babies and families and the people who provide their care. There are many types and causes of infection that can arise during or shortly after pregnancy; some such as chorioamnionitis are directly related to pregnancy, others such as chest infections may be indirectly related. Some maternal infections increase the risk of perinatal infection. Despite antenatal screening and immunisation programmes, confidential enquiries into maternal and perinatal deaths continue to report infection-related mortalities (Knight et al 2017; Draper et al 2018). The NHS infectious diseases in pregnancy programme (IDPP) (Public Health England (PHE), 2016) offers screening to all pregnant women to identify and treat some of these conditions (HIV, hepatitis B and syphilis) and as a consequence reduce the risk of mother to baby transmission. However, some particularly vulnerable women book late for pregnancy care because of cultural barriers, chaotic or disadvantaged lifestyles (PHE 2013), thus missing opportunities for timely interventions. This chapter provides a brief outline of the physiology relating to the body’s ability to resist infection and an overview of the infectious diseases included in the IDPP. It also includes influenza and group B streptococcal infection since these can have a significant impact on women’s experiences of childbearing and current midwifery care.