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 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. 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.
It isn't yet known how frequently COVID-19 causes problems during pregnancy or affects the health of the baby after birth. Some research suggests that pregnant women with COVID-19 are more likely to have a premature birth 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 are tested for the virus that causes COVID-19, if testing supplies are available. 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 whether the use of virtual prenatal care is an option for you, if it's available in your area, and how it works. Ask your health care provider 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 during the visit. 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, though restrictions might change as infection rates of COVID-19 in your area change. Your hospital stay will likely be shorter than routine.
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. Research suggests that only about 2% to 5% of infants born to women with COVID-19 near the time of delivery test positive for the virus in the days after birth.
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, 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.
It isn't yet known if the COVID-19 virus can be transmitted through breast milk. Limited research has shown no evidence of the virus in the breast milk of women with COVID-19. 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 a symptomatic person under investigation for having the virus, 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.
What you can do
There is no vaccine available to prevent infection with the COVID-19 virus at this time. To reduce your 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 cloth face mask in public and at work. Limit contact with others as much as possible. Instead, consider sharing moments with friends and family via photos, videos or videoconferencing. 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.
Nov. 05, 2020
See more In-depth
- Pregnancy & breastfeeding: Information about coronavirus disease 2019. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prepare/pregnancy-breastfeeding.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fspecific-groups%2Fpregnancy-faq.html. Accessed March 23, 2020.
- Rasmussen SA, et al. Coronavirus disease 2019 (COVID-19) and pregnancy: What obstetricians need to know. American Journal of Obstetrics and Gynecology. 2020; doi:10.1016/j.ajog.2020.02.017.
- Schwartz DA. An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: Maternal coronavirus infections and pregnancy outcomes. Archives of Pathology & Laboratory Medicine. 2020; doi:10.5858/arpa.2020-0901-SA.
- Novel coronavirus 2019 (COVID-19): Practice advisory. The American College of Obstetricians and Gynecologists. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/03/novel-coronavirus-2019. Accessed March 23, 2020.
- Coronavirus disease 2019 (COVID-2019): How to protect yourself. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html. Accessed March 23, 2020.
- Interim considerations for infection prevention and control of coronavirus disease 2019 (COVID-19) in inpatient obstetric healthcare settings. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html. Accessed March 23, 2020.
- McIntosh K, et al. Coronavirus disease 2019 (COVID-19). https://www.uptodate.com/contents/search. Accessed March 23, 2020.
- Butler Tobah YS (expert opinion). Mayo Clinic. March 25, 2020.
- Zeng L, et al. Neonatal early-onset infection with SARS CoV-2 in 33 neonates born to mothers with COVID-19 in Wuhan, China. JAMA Pediatrics. 2020; doi:10.1001/jamapediatrics.2020.0878.
- Zeng H, et al. Antibodies in infants born to mothers with COVID-19 pneumonia. JAMA. 2020; doi:10.1001/jama.2020.4861.
- Barbieri RL. COVID-19 obstetric practice recommendations. NEJM Journal Watch. Accessed May 22, 2020.
- FAQs: Management of infants born to mothers with suspected or confirmed COVID-19. American Academy of Pediatrics. https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/faqs-management-of-infants-born-to-covid-19-mothers/. Accessed Aug. 3, 2020.
- Allotey J, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: Living systematic review and meta-analysis. BMJ. 2020; doi:10.1136/bmj.m3320.
- Coronavirus disease 2019 (COVID-2019): People with certain medical conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html#pregnancy. Accessed Nov. 4, 2020.