Antenatal
Malaria in Pregnancy
February 06, 2026
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Dear sister,
Pregnancy is a beautiful journey, but in our country Nigeria where malaria is very common, it can bring extra challenges to you and your unborn baby. Malaria is a serious but preventable and treatable disease. This guide explains everything you need to know in simple terms so you can protect yourself and your baby. Use this during your antenatal visits to discuss with your health worker.
What is Malaria and How Do You Get It?
Malaria is caused by tiny parasites called Plasmodium . The most dangerous type in Nigeria is Plasmodium falciparum .
These parasites are carried by female Anopheles mosquitoes. The mosquitoes bite mainly between dusk and dawn. When an infected mosquito bites you, it injects the parasite into your blood. The parasite then travels to your liver and multiplies before entering your red blood cells, where it causes the illness.
Anyone can get malaria, but pregnant women are more vulnerable because pregnancy naturally lowers your immunity.
Why is Malaria More Dangerous During Pregnancy?
During pregnancy, your body goes through many changes to protect and nourish your baby. Unfortunately, these changes make it easier for malaria parasites to infect you, and the infection can be more severe.
The parasites can collect and hide in the placenta (the organ that connects you to your baby and provides oxygen and nutrients). This can block the flow of food and oxygen to your baby.
Risks to you (the mother):
Severe anaemia (very low blood level) leading to extreme tiredness, breathlessness, dizziness, and heart problems
High fever that can cause convulsions or coma
Kidney or lung problems in severe cases
Higher risk of death if not treated quickly
Risks to your baby:
Low birth weight (baby born smaller than normal, which increases risk of illness or death after birth)
Premature birth (baby born too early)
Miscarriage in early pregnancy
Stillbirth (baby dies in the womb)
Baby born with malaria infection (rare but possible)
The good news: With proper prevention and early treatment, most of these problems can be avoided.
Signs and Symptoms of Malaria
Malaria symptoms usually appear 7–30 days after an infected mosquito bite. Common signs include:
Fever with chills and sweating
Severe headache
Body pains, joint pains, and muscle aches
Extreme tiredness and weakness
Loss of appetite, bitter taste in the mouth
Nausea, vomiting, or diarrhoea
Sometimes cough or stomach pain
These symptoms can be confused with normal pregnancy discomfort or ordinary fever. Never ignore them . If you feel unwell, especially with fever, go to the clinic immediately for a malaria test.
How to Prevent Malaria During Pregnancy
Prevention works best when you combine several methods. The Nigerian Ministry of Health and WHO recommend these proven steps:
1. Sleep under a Long-Lasting Insecticide-Treated Net (LLIN) every night
This is the most effective way to stop mosquito bites. Use the net even if you have a fan or air conditioning. Make sure the net has no holes, and tuck it in properly under the mattress. The whole family should use nets to reduce mosquitoes in the house.
2. Take Intermittent Preventive Treatment in Pregnancy (IPTp)
This is a safe medicine called sulfadoxine-pyrimethamine (SP or Fansidar).
- Start from the beginning of the second trimester (after 13 weeks of pregnancy)
- Take one dose every month under direct observation at the antenatal clinic
- Aim for at least 3–5 doses depending on how many visits you have
- It is given with clean water and does not need fasting
This medicine clears any hidden parasites and protects you and your baby.
3. Other important measures
- Use safe insect repellents (those containing DEET, picaridin, or lemon eucalyptus oil are safe in pregnancy when used correctly)
- Wear long sleeves, long skirts/trousers, and socks in the evenings
- Keep your surroundings clean: clear bushes, drain stagnant water (in pots, gutters, old tyres), and cover water containers
- Use window and door screens if possible
- Indoor residual spraying (IRS) is done in some areas by government teams – cooperate when they visit
What to Do If You Suspect Malaria
- Do not delay – go to a health facility the same day
- Ask for a malaria test (Rapid Diagnostic Test or blood smear under microscope)
- If positive, you will be given safe treatment. Artemisinin-based Combination Therapy (ACT) medicines like Artemether-Lumefantrine (Coartem) or Artesunate-Amodiaquine are now the first choice and are safe throughout pregnancy, including the first trimester
- Complete the full course of treatment
- Never self-medicate or buy drugs from chemists without a test – wrong drugs can be dangerous
Severe malaria needs hospital admission with injectable medicines and close monitoring.
Practical Tips for Everyday Protection
- Attend antenatal clinic regularly from the moment you know you are pregnant
- Take your routine antenatal drugs (iron, folic acid, tetanus toxoid) to build your strength and fight anaemia
- Eat balanced meals rich in fruits, vegetables, proteins, and blood-building foods (like beans, liver, and green leaves)
- Drink plenty of clean water and rest well
- Teach your children and family about net use and cleanliness
- If you travel to a high-malaria area, take extra precautions
- Between clinic visits, if you feel feverish, visit the nearest health centre immediately – early treatment saves lives
Frequently Asked Questions (FAQs)
1. Can malaria cause miscarriage or stillbirth?
Yes, especially if untreated. The parasite damages the placenta and reduces nutrients to the baby. But regular IPTp and net use greatly reduce this risk.
2. Is Fansidar (SP) safe for my baby?
Yes, it has been used safely for many years and is recommended by WHO and Nigeria’s health guidelines for all pregnant women in malaria areas.
3. How many doses of IPTp should I take?
At least three doses, starting in the second trimester and one dose every month after that. The more doses you take (up to 5–8), the better the protection.
4. What if I get malaria in the first trimester?
Go for testing immediately. ACT medicines are now considered safe even in early pregnancy when benefits outweigh risks.
5. Can the insecticide in treated nets harm me or my baby?
No. The amount is very small and safe for pregnant women, children, and everyone. It only affects mosquitoes.
6. Will I still get malaria if I use a net and take IPTp?
The risk becomes very low, but no method is 100%. Combining methods gives the best protection.
7. I feel fine – do I still need IPTp?
Yes! Many women have malaria without symptoms. IPTp protects against hidden infections.
8. Can my baby get malaria from me during breastfeeding?
No, malaria is not passed through breast milk. Continue exclusive breastfeeding – it protects your baby.
Stay informed, stay protected, and attend every antenatal visit. You are doing the best thing for yourself and your baby. If you have any worries, always talk to your midwife or doctor – they are there to support you.
Wishing you a safe and healthy pregnancy!
