Overview: The Gap in Specialist Allergy Care for Expectant Mothers
Pregnancy is a time of heightened vigilance for maternal and fetal health. For many expectant mothers, allergies, asthma, or medication reactions can complicate the journey. Yet a significant number do not receive timely consultation with an obstetric or allergist specialist who can tailor care to the unique needs of pregnancy. Recent research highlighted at the 2025 American College of Allergy, Asthma & Immunology conference underscores a persistent gap: conditions that are manageable in non-pregnant adults often require careful adjustment in pregnancy to protect both mother and baby.
Why Specialist Allergy Care Is Crucial During Pregnancy
Allergic rhinitis, asthma, eczema, and drug sensitivities can worsen during pregnancy due to hormonal changes and shifts in immune function. Poorly controlled asthma, for example, is linked to higher risks of preterm birth, low birth weight, and perinatal complications. On the other hand, many standard allergy medications have been studied for safety in pregnancy, but their use should be guided by a clinician who understands both allergology and obstetrics. The goal is to achieve symptom relief with the smallest possible risk, safeguarding oxygen delivery to the fetus and reducing maternal discomfort.
Common Barriers to Accessing Care
Several factors contribute to the delay or avoidance of specialist care for pregnant patients with allergies: limited awareness among patients and some providers about safe treatment options, concerns about medications crossing the placenta, insurance hurdles, and the challenge of coordinating care between obstetrics and allergy specialists. In some communities, there may be long wait times to see an allergist, or telemedicine options are not readily available. These barriers can result in ongoing symptoms that affect sleep, daily functioning, and overall well-being during pregnancy.
Safe and Effective Approaches When Seeing an Allergist During Pregnancy
When an expectant mother consults an allergist-immunologist, the expert will review the timeline of symptoms, pregnancy course, and current medications. A thoughtful plan typically includes the following components:
- Clarification of which allergens trigger symptoms and whether avoidance is feasible within the home and workplace.
- Assessment of asthma control, with objective measures such as peak flow monitoring when appropriate, to guide therapy decisions.
- Evaluation of medication safety: choosing antihistamines, nasal steroids, inhaled corticosteroids, or other treatments with established safety data in pregnancy.
- Consideration of immunotherapy (allergy shots) timing and safety, recognizing that recommendations vary by trimester and clinical scenario.
- Education on non-pharmacologic strategies, such as environmental controls, humidity management, and lifestyle adjustments to minimize exposure to triggers.
What Pregnant Patients Should Do Next
Every pregnancy is unique, so a personalized plan is essential. Expectant mothers who notice persistent sneezing, nasal congestion, wheezing, coughing, or skin flare-ups should consider requesting a consultation with an allergist, ideally in coordination with their obstetric team. Practical steps include:
- Talk to your obstetrician about your symptoms and ask for a referral to an allergist-immunologist if needed.
- Prepare a symptom diary noting triggers, timing, and medication responses to share during the visit.
- Ask about safety profiles of medications you are taking or considering during pregnancy, including potential effects on fetal development.
- Discuss non-pharmacologic controls, such as air filtration, allergen-proof bedding, and reducing exposure to known irritants.
Looking Toward a Safer Pregnancy Experience
Effective collaboration between obstetricians and allergy specialists improves outcomes for both mother and baby. From safe inhaled therapies to appropriately managed immunotherapy decisions, the right care can reduce discomfort and prevent complications related to allergic disease and asthma during pregnancy. If you suspect you need specialized allergy care, don’t delay—advocating for coordinated care today can pay dividends in comfort, health, and peace of mind for the remainder of your pregnancy.
Conclusion: Proactive Care Reduces Risk
Expectant mothers deserve access to expert guidance that considers the unique physiological changes of pregnancy. By prioritizing specialist allergy care, patients can achieve better symptom control, minimize medication risks, and support both maternal and fetal well-being throughout pregnancy.
