Pregnancy and COVID-19: What are the risks?
If you are pregnant, you were pregnant in the last 42 days (recently pregnant) or you are breastfeeding, you're probably concerned about the impact of coronavirus disease 2019 (COVID-19) on you and your baby. You might also have questions about the safety of the COVID-19 vaccines. Here's what you need to know.
Risks during pregnancy
The overall risk of COVID-19 to pregnant women is low. However, women who are pregnant or were recently pregnant are at increased risk of severe illness with COVID-19. Severe illness means that you might need to be hospitalized, have intensive care or be placed on a ventilator to help with breathing. Pregnant women with COVID-19 are also more likely to deliver a baby before the start of the 37th week of pregnancy (premature birth). Pregnant women with COVID-19 might also be at increased risk of problems such as stillbirth and pregnancy loss.
Pregnant women who are Black or Hispanic are more likely to be affected by infection with the COVID-19 virus. Pregnant women who have other medical conditions, such as diabetes, also might be at even higher risk of severe illness due to COVID-19.
Contact your health care provider right away if you have COVID-19 symptoms or if you've been exposed to someone with COVID-19. It's recommended that you get tested for the COVID-19 virus. Before going to your appointment, call ahead of time to tell your health care provider about your symptoms and possible exposure.
If you have COVID-19 and are pregnant, your health care provider might recommend treatment with a monoclonal antibody medication. Treatment with a monoclonal antibody medication involves a single infusion given by needle in the arm (intravenously) in an outpatient setting. Monoclonal antibody medications are most effective when given soon after COVID-19 symptoms start.
Your treatment may also include getting plenty of fluids and rest. You may also take medication to reduce fever, relieve pain or lessen coughing. If you're very ill, you may need to be treated in the hospital.
Impact on prenatal care
Talk to your health care provider about precautions that will be taken to protect you during appointments or whether virtual prenatal care is an option for you. Ask if there are any tools that might be helpful to have at home, such as a blood pressure monitor or a device to monitor your oxygen levels (pulse oximeter). To make the most of any virtual visits, prepare a list of questions ahead of time and take detailed notes. Online childbirth classes also may be an option.
If you have certain high-risk conditions during pregnancy, virtual visits might not be an option. Ask your health care provider about how your care might be affected.
Labor and delivery recommendations
If you are healthy as you approach the end of pregnancy, some aspects of your labor and delivery might proceed as usual. But be prepared to be flexible.
If you are scheduled for labor induction or a C-section, you and your support person might be screened for COVID-19 symptoms before your arrival at the hospital. You might be screened again before entering the labor and delivery unit. If you have symptoms of the virus that causes COVID-19, your induction or C-section might be rescheduled.
To protect the health of you and your baby, some facilities might limit the number of people you can have in the room during labor and delivery. Visits after delivery might be affected too. Also, during your stay in the hospital, you and your support person might be screened for symptoms every day. Talk to your health care provider about any restrictions that might apply.
If you have COVID-19 or are waiting for test results due to symptoms during your stay in the hospital after childbirth, wear a well-fitting face mask and have clean hands when caring for your newborn. Stay a reasonable distance from your baby when possible. When these steps are taken, the risk of a newborn becoming infected with the COVID-19 virus is low.
However, if you are severely ill with COVID-19, you might need to be temporarily separated from your newborn.
It's recommended that postpartum care after childbirth be an ongoing process. Talk to your health care provider about virtual visit options for checking in after delivery, as well as your need for an office visit.
During this stressful time, you might have more anxiety about your health and the health of your family. Pay attention to your mental health. Reach out to family and friends for support while taking precautions to reduce your risk of infection with the COVID-19 virus.
If you experience severe mood swings, loss of appetite, overwhelming fatigue and lack of joy in life shortly after childbirth, you might have postpartum depression. Contact your health care provider if you think you might be depressed. For example, if your symptoms don't fade on their own, you have trouble caring for your baby or completing daily tasks, or you have thoughts of harming yourself or your baby.
Research suggests that breast milk isn't likely to spread the COVID-19 virus to babies. The bigger concern is whether an infected mother can spread the virus to the baby through respiratory droplets during breastfeeding.
If you have COVID-19, take steps to avoid spreading the virus to your baby. Wash your hands before breastfeeding and wear a well-fitting face mask during breastfeeding and whenever you are within 6 feet of your baby. If you're pumping breast milk, wash your hands before touching any pump or bottle parts and follow recommendations for proper pump cleaning. If possible, have someone who is well give the baby the expressed breast milk.
COVID-19 vaccines during pregnancy and breastfeeding
If you are pregnant or breastfeeding, it's recommended that you get a COVID-19 vaccine. Getting a COVID-19 vaccine can protect you from severe illness due to COVID-19. Vaccination can also help pregnant women build antibodies that might protect their babies. Research shows that infants born to mothers who receive two doses of an mRNA COVID-19 vaccine — such as the Pfizer-BioNTech or Moderna COVID-19 vaccine — might have a lower risk of hospitalization due to COVID-19 infection in their first six months of life.
COVID-19 vaccines don't cause infection with the COVID-19 virus, including in pregnant women or their babies. None of the COVID-19 vaccines contain the live virus that causes COVID-19. Also, keep in mind that mRNA COVID-19 vaccines don't alter your DNA or cause genetic changes.
Findings from a large study of more than 40,000 women show that getting a COVID-19 vaccine during pregnancy poses no serious risks for pregnant women who were vaccinated or their babies. Most of the women in the study received an mRNA vaccine, such as the Pfizer-BioNTech or Moderna COVID-19 vaccine.
The study adds to evidence that COVID-19 vaccination during pregnancy isn't associated with an increased risk of premature birth. Also, babies born to pregnant women who received a COVID-19 vaccine aren't at increased risk of low birth weight.
It's also recommended that you get a COVID-19 vaccine if you are trying to get pregnant or might become pregnant in the future. There is currently no evidence that any COVID-19 vaccines cause fertility problems.
If you haven't yet received a COVID-19 vaccine or if you're due for a booster shot, an mRNA vaccine, such as the Pfizer-BioNTech or Moderna COVID-19 vaccine, is preferred in most situations.
If you become pregnant after receiving the first dose of a COVID-19 vaccine that requires two doses, it's recommended that you get your second shot. It's also recommended that pregnant women receive a COVID-19 booster shot when it's time to get one. If possible, people who live with you also should be vaccinated against COVID-19. If you have concerns, talk to your health care provider about the risks and benefits.
What you can do
There are many steps you and people in your household can take to reduce your risk of infection from the COVID-19 virus and reduce the risk of spreading it to others.
- Get vaccinated.
- Avoid close contact with anyone who is sick or has symptoms.
- Keep distance between yourself and others when you're in indoor public spaces if you're not fully vaccinated. This is especially important if you have a higher risk of serious illness.
- Wear a well-fitting face mask in indoor public spaces if you're in an area with a high number of people with COVID-19 in the hospital and new COVID-19 cases, whether or not you're vaccinated. The CDC recommends wearing the most protective mask possible that you'll wear regularly, fits well and is comfortable.
- Wash your hands often with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer that contains at least 60% alcohol.
- Avoid crowds and indoor spaces that have poor airflow.
- Cover your mouth and nose with your elbow or a tissue when you cough or sneeze. Throw away the used tissue. Wash your hands right away.
- Avoid touching your eyes, nose and mouth.
- Clean and disinfect high-touch surfaces, such as doorknobs, light switches, electronics and counters, regularly.
- Stay home from work, school and public areas and stay home in isolation if you're sick, unless you're going to get medical care. Avoid public transportation, taxis and ride-hailing services if you're sick.
Above all, focus on taking care of yourself and your baby. Contact your health care provider to discuss any concerns. If you're having trouble managing stress or anxiety, talk to your health care provider or a mental health counselor about coping strategies.
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