If you are pregnant, you were pregnant in the last 42 days (recently pregnant) or you are breastfeeding, you’re probably concerned about the impact of coronavirus disease 2019 (COVID-19) on you and your baby. You might also have questions about the safety of the COVID-19 vaccines. Here’s what you need to know.

Risks during pregnancy

The overall risk of COVID-19 to pregnant women is low. However, women who are pregnant or were recently pregnant are at increased risk for severe illness with COVID-19. Severe illness means that you might need to be hospitalized, have intensive care or be placed on a ventilator to help with breathing. Pregnant women with COVID-19 are also more likely to deliver a baby before the start of the 37th week of pregnancy (premature birth) and might be at increased risk for problems such as pregnancy loss.

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

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.

 

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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 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.

Breastfeeding 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 breastfeeding.

If you have COVID-19, take steps to avoid spreading the virus to your baby. Wash your hands before breastfeeding and wear a face mask during breastfeeding and whenever you are within 6 feet of your baby. 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, it’s recommended that you get a COVID-19 vaccine. Getting a COVID-19 vaccine can protect you from severe illness due to COVID-19. Vaccination can also help pregnant women build antibodies that might protect their babies. If possible, people who live with you should also be vaccinated against COVID-19.

COVID-19 vaccines don’t cause infection with the COVID-19 virus, including in pregnant women or their babies. None of the COVID-19 vaccines contain the live virus that causes COVID-19.

While further research is needed, early findings suggests that getting an mRNA COVID-19 vaccine during pregnancy poses no serious risks for pregnant women who were vaccinated or their babies. The findings are based on data from the CDC’s coronavirus vaccine safety monitoring system. Also, keep in mind that mRNA COVID-19 vaccines don’t alter your DNA or cause genetic changes.

In addition, vaccines that use the same viral vector as the Janssen/Johnson & Johnson COVID-19 vaccine have been given to pregnant women in each trimester of pregnancy in clinical trials. No harmful effects were found.

It’s also recommended that you get a COVID-19 vaccine if you are trying to get pregnant or might become pregnant in the future. There is currently no evidence that any COVID-19 vaccines cause fertility problems.

If you become pregnant after receiving the first dose of a COVID-19 vaccine that requires two doses, it’s recommended that you get your second shot. Pregnant women may also receive a COVID-19 booster shot. If you have concerns, talk to your health care provider about the risks and benefits.

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. Wear a face mask when recommended. 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. If those who live with you or come to visit haven’t been vaccinated against COVID-19, they should take the same precautions.

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.