Andrea Lavigne, 32, of Wakefield, who is four months pregnant, receives a shot from nurse Bobbie Fay, the manager of critical care services and orthopedics at South County Hospital, on Thursday. The Providence Journal / John Freidah

SOUTH KINGSTOWN — A preschool teacher who is 23 weeks pregnant, Danielle Rocheleau considered it a necessity to get vaccinated against swine flu.

Only problem, for weeks there was no vaccine, as manufacturing problems slowed the delivery of vaccine around the country.

Rocheleau, like thousands of other pregnant women in Rhode Island, had to wait — all the while knowing that pregnancy put her at high risk of complications should she come down with the flu.

Finally, Wednesday evening, Rocheleau, 23, of Narragansett, went to the Center for Women’s Health at South County Hospital and rolled up her sleeve. Nurse Debbie Fay, with a swift, sure motion, stuck her arm with a syringe full of vaccine against H1N1. “Better late than never,” Rocheleau said, pulling down her sleeve.

The center administered 128 doses Wednesday, and expects to give out a total of 500 over the next week or so — enough to vaccinate all of its patients, said Lee Ann Quinn, South County’s manager of infection control.

Some 6,500 doses of swine-flu vaccine intended for pregnant women have arrived in Rhode Island, just over half the total amount ordered. The shots are going directly to large obstetrical practices, or to the birthing hospitals, where obstetricians can pick them up.

“The state has ordered more than enough for our pregnant population throughout the state,” said Dr. Brenna L. Anderson, director of the reproductive infectious disease consultation at Women & Infants Hospital. Anderson is coordinating the statewide swine-flu vaccination effort for pregnant women.

Vaccination against flu — swine and seasonal — is recommended in all trimesters of pregnancy.

The vaccine itself does not reach the fetus, Anderson said. But it spurs the production of antibodies against swine flu in the mother, and those antibodies do reach the fetus — giving the baby protection against swine flu for the first two weeks of life. If the mother breastfeeds, that protection can continue.

Pregnancy makes women susceptible to flu complications in two ways. It changes the immune system, so that the woman’s body can tolerate the presence of a fetus with different genetics, Anderson explained. These changes can make it harder for the woman to fight off infections like flu. Also, later in the pregnancy, pressure on the lungs makes it harder for women to breathe deeply and clear an infection.

“Every year in the flu season, we’ll usually get one or two very sick patients who even require being on a ventilator from being sick with flu,” Anderson said. With many more people getting infected with swine flu, those numbers could go up.

Influenza can also threaten the fetus. The stress of sickness can trigger preterm labor. A lung infection, flu can decrease the amount of oxygen the mother can deliver to the fetus, Anderson explained. Additionally, the flu causes fever — and high fevers early in pregnancy have been associated with birth defects. There may also be long-term consequences for babies exposed to influenza in the womb. One small study has found a possible link between getting the flu during pregnancy and having a child who develops schizophrenia.

In contrast to these risks, Anderson said, the biggest risk of a flu shot is a sore arm. Anderson has not heard of any obstetricians or midwives in Rhode Island who are not recommending the swine-flu shot to their pregnant patients. And she has not heard of many women resisting the vaccine. “Most of our experience, so far, has been that women actually are asking for it. They want to know when they can get it.”

That was certainly the case for Lilly Shuey Picchione, 31, of Providence, who spent a lot of time on the phone trying to track down some vaccine. Last week, her doctor had 40 shots — but they were gone before she could schedule an appointment. She even called former doctors, but they said whatever they had would go to current patients.

“I felt so frustrated,” said Picchione, who is RIPTA’s director of finance. She is 22 weeks pregnant and has a 3-year-old son at home, who also couldn’t get vaccinated. “You try to do your best for your baby and your family. On the one hand, everyone is saying ‘go do this.’ On the other hand, it’s not available.”

Finally, Picchione reported with relief, she went for her monthly visit with her obstetrician on Monday. A new shipment had come in, and she got her swine-flu shot. Her son was also able to get vaccinated by his pediatrician.

A similar sense of relief was evident at the South County women’s center Wednesday.

Every woman interviewed had given careful thought to the decision to get vaccinated, and was glad to finally act on it.

“I started seeing healthy children dying. That did it for me,” said Kristen Federico, 30, of Westerly, who is 13 weeks pregnant. She was referring to the two 12-year-old Rhode Island girls who died of swine flu last week.

Laura Smart, a nurse on the hospital’s women’s wing, was among those wielding syringes Wednesday night. “I feel good,” she said, “to be giving out shots tonight.”

ffreyer@projo.com