MONTREAL (CP) - There's a growing belief that pregnant women should be receiving key vaccines, including flu shots, experts say. But two new studies suggest the health-care professionals they see most often don't or can't deliver the vaccines in question.

The studies, by Toronto researchers, found obstetricians often aren't equipped to give vaccines and midwives aren't permitted to give many, including flu shots.

"So now we've said that pregnant women should be vaccinated, we've got this group of women who have a primary-care provider who can't vaccinate them, because influenza vaccine is not on the list" of drugs midwives can administer, said Dr. Allison McGeer, one of the authors of the studies.

Even if midwives could give more shots, the study found they are less enthusiastic about vaccinations in general than other health-care providers. More than 40 per cent questioned the value of influenza vaccine and as a whole the midwives studied were less likely to get a flu shot than other health-care providers.

In fact, 22 per cent of them felt a flu shot was a greater health risk to a pregnant woman than getting influenza, according to the study, which was presented at an immunization conference organized by the Public Health Agency of Canada and the Canadian Pediatric Society.

The study also found midwives had received little training about immunization, leaving them ill-equipped to help teach expectant mothers about vaccination schedules - even though they can be the primary caregiver for women who use their services.

Immunization expert Dr. Ronald Gold said the group is a weak link in the vaccination chain.

"I think they are," said Gold, who headed the infectious diseases division at Toronto's Hospital for Sick Children before he retired in 1996.

"Because they do provide a lot - an increasing amount - of prenatal care. And that's the time to begin educating mothers about vaccination. Not when the baby's two months of age."

Traditionally pregnant women haven't been given many vaccinations. The thinking was that one didn't give a pregnant woman anything that wasn't absolutely necessary, in order to reduce the potential of risk to the fetus.

But that model is changing. In the United States, it is recommended pregnant women get a flu shot. The current Canadian recommendation is that women who are at risk of bad outcomes from flu - asthmatics, for instance - should get a shot.

But this year the committee which advises on immunization policy also urged people who are household contacts of infants to get a flu shot. The aim is to put a ring of protection around children under six months, who are too young to get flu vaccine but who can become seriously ill if they catch influenza.

That's virtually a recommendation that pregnant women get a flu shot, said McGeer, an infectious diseases specialist at Toronto's Mount Sinai Hospital. "If you are pregnant . . . you will become a household contact of a high-risk individual."

Advisory groups are also considering recommending pregnant women get pertussis and Group B strep vaccines, she noted.

This trend led her and her co-authors to examine who looks after pregnant women and how likely those professionals are to fill this function.

The second study, looking at attitudes among family physicians and obstetricians towards flu vaccination during pregnancy, found that only 15 per cent of obstetricians felt it was their responsibility to give their pregnant patients a flu shot, even though most got a flu shot themselves, thought the shots worked and knew flu posed a risk to pregnant women.

Obstetricians haven't been in the business of giving vaccinations and often don't stock vaccines, McGeer explained.