Pregnancy and COVID-19: What are the risks?

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If you are pregnant, you recently delivered a baby or you are breast-feeding, you’re probably concerned about the impact of coronavirus disease 2019 (COVID-19) on you and your baby. Here’s what you need to know.

Risks during pregnancy

The overall risk of COVID-19 to pregnant women is low. However, pregnancy increases the risk for severe illness and death with COVID-19. Pregnant women who have COVID-19 appear more likely to develop respiratory complications requiring intensive care than women who aren’t pregnant, according to the Centers for Disease Control and Prevention (CDC). Pregnant women are also more likely to be placed on a ventilator.

In addition, pregnant women who are Black or Hispanic appear to be disproportionately affected by infection with the COVID-19 virus. Pregnant women who have underlying medical conditions, such as diabetes, also might be at even higher risk of severe illness due to COVID-19.

Some research suggests that pregnant women with COVID-19 are also more likely to have a premature birth and cesarean delivery, and their babies are more likely to be admitted to a neonatal unit.

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. Call your health care provider ahead of time to tell him or her about your symptoms and possible exposure before going to your appointment.

If you have COVID-19 and are pregnant, your treatment will be aimed at relieving symptoms and may include getting plenty of fluids and rest, as well as using 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

Community efforts to control the spread of the COVID-19 virus might affect your access to routine 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. To make the most of any virtual visits, prepare a list of questions ahead of time and take detailed notes. Also, consider researching your options for online childbirth classes.

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 24 to 48 hours before your arrival at the hospital. You might be screened again before entering the labor and delivery unit. If you have symptoms or 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 hospitalization 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, it’s recommended during hospitalization after childbirth that you wear a cloth face mask and have clean hands when caring for your newborn. Keeping your newborn’s crib by your bed while you are in the hospital is OK, but it’s also recommended that you maintain 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.

Postpartum guidance

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, especially 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.

Breast-feeding considerations

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 transmit the virus to the baby through respiratory droplets during breast-feeding.

If you have COVID-19 or are waiting for test results due to symptoms, take steps to avoid spreading the virus to your baby. This includes washing your hands before touching your baby and, if possible, wearing a face mask during breast-feeding. 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, you may choose to get a COVID-19 vaccine. Getting a COVID-19 vaccine during pregnancy can protect you from severe illness due to COVID-19.

While further research is needed, early findings suggests that getting a COVID-19 vaccine during pregnancy poses no serious risks. The findings are based on data from the CDC’s coronavirus vaccine safety monitoring system.

Also, there is currently no evidence that any COVID-19 vaccines cause fertility problems.

If you have concerns, talk to your health care provider about the risks and benefits.

Keep in mind that the mRNA COVID-19 vaccines don’t alter your DNA or cause genetic changes.

What you can do

If you haven’t had a COVID-19 vaccine, take steps to reduce the risk of infection. Avoid close contact with anyone who is sick or has symptoms and keep about 6 feet of distance between yourself and others beyond your household. Wear a face mask in indoor public spaces and outdoors where there is a high risk of COVID-19 transmission, such as at a crowded event or large gathering. 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.

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.