COVID-19 and pregnancy: Your questions answered

It’s understandable, in this time of uncertainty due to the coronavirus (COVID-19) pandemic, to feel stressed by the news and the rising number of cases. You might be feeling especially anxious if you’re pregnant, and we hope that Ovia Health is able to provide you with some of the support and advice that you need. 

Here’s the latest from Dr. Adam Wolfberg — OB-GYN and Chief Medical Officer at Ovia Health — including answers to your questions, practical advice, and a call for how we can all help prevent the spread of coronavirus.

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

Probably not. Based on our experience with other coronaviruses and with the flu (influenza), it’s possible that the disease could be worse, however early experience with this COVID-19 pandemic suggests that pregnancy doesn’t make the infection worse. Public health experts are collecting and reporting information about COVID-19 and pregnancy, but these efforts are still in the early stages. A June 2020 report from the CDC[1] suggests that pregnant people are at higher risk for significant complications from COVID-19 than their non-pregnant peers. This is especially true for Black and Hispanic women. Therefore, pregnant and breastfeeding people should take extra precautions to prevent getting exposed to COVID-19. I suggest following guidance from public health experts.

What can I do to prevent infection?

Prevention is no different for pregnant women then it is for others, so follow the advice that you receive from your local health department, from the CDC, and from your healthcare provider. Wear a mask if you think or know you have COVID-19, to prevent spreading it to others. Masks are advised for everyone over 2 years old in public places in addition to keeping 6 feet of distance between people. Your town or state may have additional guidance and rules.

Should I work from home?

Working from home is a good way to avoid catching (or spreading) COVID-19, and many businesses that are able to have employees work from home are advocating this approach. If it’s possible for you to work from home, it is advisable. For many of you, working from home is impossible, so do the best you can to observe infection-reducing practices.

Is hand sanitizer safe in pregnancy?

Yes, Yes, YES. The CDC reports[2] 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?

There are a few scientific reports suggesting that COVID-19 crosses the placenta and can infect your fetus[3], although there is more evidence to suggest that COVID-19 is not transmitted from mother to fetus. Still, there is very little published research[4] on this topic. Other similar viruses (influenza, SARS) do not infect the fetus during pregnancy, so at this point, I am feeling reassured that this form of transmission is not a major concern. There is no evidence that cesarean delivery reduces the risk of infection, so this is not recommended.

What about during and after delivery?

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. 

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 if they are infected with COVID-19 than adults are, and the same seems to be true of babies[5]. You should still do everything you can to reduce the risk of exposure.

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

There is no evidence that breast milk contains COVID-19, however, we’re concerned that your baby could become infected through droplet exposure (cough, sneeze, etc.) while breastfeeding. Therefore, it’s not clear whether it’s safer to wear a mask while breastfeeding or to pump and bottle-feed (with breast milk) if you think you may have COVID-19[6]. This is a topic to discuss with your healthcare provider. Either way, hand-washing and use of masks is recommended.

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 women. (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.”)

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 how your health status and your provider’s practice. When in doubt, call your healthcare provider and ask, and consider asking her/him 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.

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.

Don’t forget the flu.

At this point, the influenza virus still poses a risk to pregnant folks, so make sure you receive your flu vaccine. The good news is that measures to prevent the spread of COVID-19 also work to reduce the risk of catching any virus or bacterium.

Updated December 4, 2020

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