What is COVID-19?

COVID-19 is a new illness that affects the lungs and breathing. It is caused by a new coronavirus. Symptoms include fever, cough, and trouble breathing. It also may cause stomach problems, such as nausea and diarrhea, and a loss of your sense of smell or taste. Symptoms may appear 2 to 14 days after you are exposed to the virus. Some people with COVID-19 may have no symptoms or only mild symptoms.

How does COVID-19 affect pregnant and recently pregnant women?

Researchers are still learning how COVID-19 affects pregnant and recently pregnant women. Current reports suggest that pregnant and recently pregnant women have a higher risk for more severe illness from COVID-19 than nonpregnant women. Reports note that:

• Pregnant women who have COVID-19 and show symptoms are more likely than nonpregnant women with COVID-19 and symptoms to need care in an intensive care unit (ICU), to need a ventilator (for breathing support), or to die from the illness. Still, the overall risk of severe illness and death for pregnant women is low.
• Pregnant and recently pregnant women with some health conditions, such as obesity and gestational diabetes, may have an even higher risk of severe illness, similar to nonpregnant women with these conditions.
• Pregnant women who are Black or Hispanic have a higher rate of illness and death from COVID-19 than other pregnant women, but not because of biology. Black and Hispanic women are more likely to face social, health, and economic inequities that put them at greater risk of illness. To learn more about these inequities, see this page from the Centers for Disease Control and Prevention (CDC).

How can COVID-19 affect a fetus?

Remember that researchers are learning more about COVID-19 all the time. Some researchers are looking specifically at COVID-19 and its possible effects on a fetus. Here’s what they know now:

• Researchers have found a few cases of COVID-19 that may have passed to a fetus during pregnancy, but this seems to be rare.
• Researchers have studied COVID-19 infection, preterm birth, and stillbirth. Some studies suggest there may be an increased risk of preterm birth and stillbirth for women with COVID-19. Other studies have not found this to be true. But information is still limited. Researchers are continuing to study these outcomes to better understand the effects of COVID-19 before birth.

After birth, a newborn can get the virus if they are exposed to it.

Should I get a COVID-19 vaccine during pregnancy?

Yes, you should get a COVID-19 vaccine during pregnancy. ACOG recommends that all pregnant women be vaccinated against COVID-19. Getting a vaccine could help both you and your fetus. Remember that pregnant women have a higher risk of severe illness from COVID-19 than nonpregnant women. The vaccines are very effective at preventing COVID-19 infection, severe illness, and death.

A growing amount of data confirms that COVID-19 vaccines are safe during pregnancy. Scientists have compared the pregnancies of women who have received COVID-19 vaccines and women who have not. The reports show that these women have had similar pregnancy outcomes. Data do not show any safety concerns.

If you are pregnant and want to know more about the vaccines, you can talk with your obstetrician–gynecologist (ob-gyn) or other health care professional. This conversation is not required to get a vaccine, though it may be helpful. You can discuss your risk of getting COVID-19 and your risk of severe illness if you get sick.

Should breastfeeding women get a COVID-19 vaccine?

Yes, we recommend that breastfeeding women get a COVID-19 vaccine. There is no need to stop breastfeeding if you want to get a vaccine. When you get vaccinated, the antibodies made by your body may be passed through breastmilk and may help protect your child from the virus.

Should I get a COVID-19 vaccine if I am trying to get pregnant?

Yes, if you are planning or trying to get pregnant, you should get a COVID-19 vaccine. There is no evidence that the COVID-19 vaccines cause infertility. You also do not need to delay getting pregnant after you get a vaccine.

Some COVID-19 vaccines will require two doses. If you find out you are pregnant after you have the first dose, you should still get the second dose.

How will COVID-19 affect prenatal and postpartum care visits?

It is important to keep your prenatal and postpartum care visits. Call your ob-gyn or other health care professional to ask how your visits may be changed. Some women may have fewer or more spaced out in-person visits. You also may talk more with your health care team over the phone or through an online video call. This is called telemedicine or telehealth. It is a good way for you to get the care you need while preventing the spread of disease.

If you have a visit scheduled, your care team’s office may call you ahead of time. They may tell you about telemedicine or make sure you do not have symptoms of COVID-19 if you are going in to the office. You also can call them before your visits if you do not hear from them.

How can I manage stress, anxiety, and depression?

Some pregnant and postpartum women may be feeling fear, uncertainty, stress, or anxiety because of COVID-19. Reaching out to friends and family during this time may help. Phone calls, texts, and online chats are safe ways to stay connected.

There also are treatment and support resources you can access over the phone or online. Talk with your ob-gyn or other health care professional about how to get help if you’re having symptoms like these:

• Feeling sad, hopeless, worthless, or helpless
• Having fear or worry, which may cause a fast heartbeat
• Feeling that life is not worth living
• Having repeated, scary, and unwanted thoughts that are hard to get rid of

If you are in crisis or feel like you want to harm yourself or others, call 911 right away. See the Resources section for other support options, including helplines you can text or call and online support groups for pregnant and postpartum women.

Physical activity also may help your mental health. And it may be useful to focus on your breathing each day, especially if you are feeling anxious. Breathe in for 4 seconds, hold for 7 seconds, and breathe out for 8 seconds. Repeat three times.

What should I do if I am pregnant and diagnosed with COVID-19?

If you are diagnosed with COVID-19, follow the advice from the CDC and your ob-gyn or other health care professional. The current CDC advice for all people with COVID-19 includes the following:

• Stay home except to get medical care. Avoid public transportation.
• Speak with your health care team over the phone before going to their office. Get medical care right away if you feel worse or think it’s an emergency.
• Separate yourself from other people in your home.
• Wear a face mask when you are around other people and when you go to get medical care.

Should I make any changes to my labor and delivery plans?

Talk with your ob-gyn or other health care professional about your birth plan. In most cases, the timing and method of delivery (vaginal birth or cesarean birth) do not need to be changed. Women who are sick probably do not need a cesarean birth.

How can I avoid passing COVID-19 to my baby?

While you are in the hospital or birth center and after you go home, you should take the following steps to avoid passing the infection to your baby:

• Use a face mask or covering when holding your baby, including during feeding. Do not put a mask or covering over the baby’s face.
• Wash your hands before touching your baby.
• Wash your hands before touching any breast pump or bottle parts and clean all pump and bottle parts after use.
• If possible, let someone who is healthy help care for your newborn. They can bottle-feed your breast milk to your baby after you pump. They should wear a mask and keep their hands clean. And they should not be at risk of severe illness from COVID-19.

Please call our office with any concerns or questions. If you have been tested for COVID-19 and have a positive result, please call the OBGYN Reliant Medical Group location where you routinely receive your care.

Information adapted from ACOG FAQ511. Copyright April 2021 by the American College of Obstetricians and Gynecologists: www.acog.org/patient-resources/faqs/pregnancy/coronavirus-pregnancy-and-breastfeeding

CDC website: www.cdc.gov/coronavirus/2019-ncov/index.html