COVID-19 and pregnancy: Your questions answered

It’s understandable to feel stressed by the news and the ongoing Omicron surges. You might be feeling especially anxious if you’re pregnant or the parent of a young child, and we hope that Ovia Health is able to provide you with some of the support and advice that you need. 

What you should know about COVID-19 and pregnancy

Here’s the latest from the Ovia Health Clinical Team, including answers to your questions and some practical guidance.

If I’m pregnant and I get COVID-19, will the infection be worse?

It’s possible. Public health experts are still collecting and reporting information about COVID-19 and pregnancy. An updated report including data from 2020 through mid-2021 from the CDC [1] indicates pregnant people and recently pregnant people (within 42 days of giving birth) are at higher risk for significant complications from COVID-19 than their non-pregnant peers. This means that while overall risk for severe illness is low, there is an increased risk of hospitalization, intubation and mechanical ventilation, blood clots, and requiring intensive care. There is also an increased risk of adverse pregnancy outcomes, including preterm birth and possibly an increased risk of pregnancy loss when compared to pregnant women who did not get COVID-19. 

These risks are especially true for Black and Hispanic pregnant people who have an increased risk of preterm birth regardless of COVID-19. This is due to racism and inequities within and outside of the healthcare system. Therefore, pregnant, recently pregnant, and breastfeeding people should take extra precautions to prevent getting exposed to COVID-19. Please follow guidance from public health experts to reduce your risk.

What can I do to prevent infection?

The CDC recommends that everyone who is ages 5 and older – including those who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future – get the COVID-19 vaccine. They also recommend that everyone 5 and older get a booster shot. Recent research shows that boosters may be more critical for pregnant people, who have a higher risk of breakthrough Covid infection due to suspected immune system changes. 

Prevention is no different for pregnant people than it is for anyone else. Follow the advice that you receive from your local health department, from the CDC, and from your healthcare provider. Avoid going to public places if you think or know you have COVID-19, to prevent spreading it to others. 

Everyone in areas with substantial or widespread transmission of the virus should wear masks when indoors and practice social distancing. Being vaccinated has been shown to provide protection against severe COVID-19 disease, however, you can still get sick and pass the illness on to vulnerable people who aren’t vaccinated or cannot be vaccinated (like newborns).

Importantly, vaccines are available and free for all people ages 5 years and older in the U.S., and as mentioned above, recommended for pregnant people. For more information on vaccines head here

Should I go back to the office?

If you’ve been able to work from home since the beginning of the pandemic, you may now be back in the office, or gearing up to head back to the office soon. Some employers are continuing to offer hybrid or remote policies. If you’d like to start a conversation with your employer about accommodations at work, talk to your provider about what they would recommend based on your circumstances and the community risk in your area. 

Is hand sanitizer safe in pregnancy?

Yes, Yes, YES. The CDC reports [3] that handwashing with soap and water is more effective than hand sanitizer. However, you can’t take the sink in your car or on a walk or to the grocery, so make sure you use hand sanitizer regularly in addition to handwashing. Furthermore, it’s often much easier to wipe hand sanitizer on your children’s hands than it is to get them properly washed, so consider this regular habit as well.

If I get COVID-19, will I pass it to my fetus?

The most recent research on the topic says that transmitting COVID-19 while pregnant is very rare – for moms in North America, the rate was about 0.1%. This does not include the risk of passing it to your newborn during routine care postpartum. However, studies show that people who tested positive for COVID-19 during pregnancy are more likely to have complications, such as preterm birth [6]. There is no evidence that cesarean delivery reduces the risk of infection, so this is not recommended.

What about during and after birth?

It is extremely important that you call your healthcare provider before you go to the hospital if you think you have COVID-19 or think you might have been exposed. Once at the hospital, your provider knows what to do to reduce the risk that your baby (and the healthcare professionals who care for you) will become infected.

Keep in mind that testing positive for COVID when in labor may cause changes to your birth plan and hospital stay. Some providers continue to recommend families follow as many isolation precautions as possible in the last weeks of pregnancy to avoid this.

What is the risk to my baby? And what about the risk to my other children?

The good news is that children seem to be at less risk of becoming really sick with COVID-19 than adults are, and the same seems to be true of babies[7]. And current evidence suggests that babies are not likely to get COVID-19 from their mothers as long as preventative steps are taken such as wearing a mask around your baby, washing your hands for 20 seconds prior to holding your baby, and others listed here. You should still do everything you can to reduce the risk of exposure. Children with certain underlying conditions are at risk for complications from COVID-19, so it is important to keep them safe and communicate with their pediatrician.

Is breastfeeding safe if I think I have COVID-19?

There are many benefits to breastfeeding for parents and babies. It appears unlikely that COVID-19 can be transmitted through breast milk, though antibodies can be passed along! 

If you test positive for COVID (or if you think you have COVID) there are relevant CDC guidelines for newborn care. In-hospital, the CDC recommends discussing with your provider the risks and benefits of caring for your newborn while sick. Outside of the hospital, they recommend having a healthy caregiver with low risk of severe COVID care for your baby. If this is not possible, wash your hands frequently — and always before touching your baby — and wear a mask when you are within 6 feet of your baby or another person. If you do have a caregiver who lives at home with you, they should also wear a mask whenever caring for your baby.

We know that with other illnesses, you pass antibodies to your baby through your breast milk. Antibodies are what your body makes to help fight off illness. The research into COVID antibodies in breastmilk is really encouraging and suggests that antibodies are passed through breast milk after infection or vaccination. More research is ongoing to determine how long antibodies are present after infection or vaccination. 

How do I do my part to prevent the spread of COVID-19 to others?

If you have a cough, a fever, a cold, or other respiratory symptoms, or if you think you might have been exposed to COVID-19, please call your healthcare provider or the hospital before you show up for an appointment or to the emergency room. 

This way, your healthcare provider will be ready to take great care of you without exposing others. In general, if you have these symptoms or think you might have been exposed to COVID-19, make sure to do your part and practice social distancing: staying six feet away from others, not going to crowded spaces, and paying particular attention to stay away from the elderly, those with compromised immune systems, and yes, other pregnant people. (Obviously, you can’t stay six feet away from your child, as every parent of a sick kid knows, so just do your best and don’t worry too much if “best,” isn’t “perfect.”) The CDC states those who are fully vaccinated but exposed to a known case of COVID-19 should get tested for COVID 5 days after exposure and wear a mask around others until 10 days after their exposure. That said, these recommendations are changing often, so be sure to check the most recent guidelines

What about my prenatal visits? Should I still attend all of my visits?

The short answer is yes, particularly for visits that involve an ultrasound, fetal testing, or are in the third trimester. For other visits, the answer is maybe, and depends on your health status and your provider’s practice. When in doubt, call your healthcare provider and ask, and consider asking them if it would be reasonable to do your prenatal visit by video or telephone. If you go, remember to wear a mask and handwash/sanitize after touching all of those doors/chairs/surfaces.

Though you may be nervous about going into the hospital, it’s important to reach out to your provider if something is not feeling right.

What if I’m trying to conceive and not yet pregnant?

There’s no evidence that COVID-19 or any similar viruses impact conception or cause birth defects if you are sick when you conceive.

Should pregnant people get the COVID-19 vaccine?

Deciding whether or not to get a vaccine is a personal choice. Multiple, well-respected clinical organizations including the CDC and ACOG (the American College of Obstetricians and Gynecologists) ACNM (American College of Nurse-Midwives) recommend the vaccine to people who are trying to conceive, pregnant, and breastfeeding [11].

The first clinical trials for the COVID-19 vaccines manufactured by Pfizer-BioNTech, Moderna, and Johnson & Johnson did not include participants who were known to be pregnant or breastfeeding. This is typical for pharmaceutical research. Recent studies, however, have included pregnant people and show that there is no increased risk for this group and that vaccines given in any trimester do not negatively impact pregnancy outcomes. In addition, vaccinating or boosting in the second or third trimester may offer additional protection to your newborn.

Additionally, none of these COVID-19 vaccines contain “live” virus. This means you cannot get COVID-19 from the vaccines. In general, vaccines that do not contain “live” viruses are safe during pregnancy and do not have increased risks for infertility, miscarriage, fetal anomalies, or stillbirth. Side effects for the COVID-19 vaccines include pain at the site of injection, fever, fatigue, and chills. These typically go away after a couple of days. These side effects are normal and expected and are indicators of your immune system doing its job to learn to protect you from the virus. There have been very rare reports of unexpected, adverse reactions from the vaccines. A severe allergic reaction called anaphylaxis can happen in very rare cases and the Johnson & Johnson vaccine has been linked with rare cases of dangerous blood clots [5]. The incidences of these adverse events is so low, getting vaccinated remains safer than potentially getting infected with COVID-19. [12]. The CDC recommends women under 50 be aware of this risk and know that there are mRNA vaccine options that do not carry this same risk.

The CDC is also recommending pregnant people reach out to the experts at Mother to Baby for more information: https://mothertobaby.org/. Your midwife, doctor, or other healthcare professional is also a great resource for more information about the COVID-19 vaccine. Ultimately, you are the one who knows what is best for your body and your family.

Should I get the COVID-19 booster shot while pregnant?

Yes. All those over age 5 are now eligible for a booster shot, and for pregnant people the booster may add an additional layer of protection against high rates of breakthrough infection in pregnancy.

Reviewed by the Ovia Health Clinical Team
Updated June 8, 2022

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