It’s understandable to feel stressed about getting sick while pregnant. You might be feeling especially anxious if you’re pregnant or the parent of a young child. 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 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. Research indicates that 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 the 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 compounded for Black pregnant people, who have long experienced nearly twice the risk of preterm birth when compared to white people. Many studies have demonstrated that race is likely an independent risk factor when it comes to healthcare outcomes like preterm birth, separate from other risk factors like income or education. That race-related risk may stem from chronic stresses of societal racism as well as the race-related inequalities that have been identified within the healthcare system.
Pregnant parents who test positive for COVID-19 should be offered a discussion about the medication Paxlovid. You can read more about that here.
What can I do to prevent infection?
The CDC recommends that everyone ages 6 months 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 6 months and older get a seasonal 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 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).
Should I go back to the office?
If you’ve been able to work from home for a while, 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 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 a 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 suggest 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 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-19 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?
Children seem to be at less risk of becoming really sick with COVID-19 than adults are, but infants make up the bulk of serious cases and hospitalizations in children under 17. 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 having them sleep 6 feet away from you. 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-19, this may impact the care of your newborn. In-hospital, the CDC recommends discussing with your provider the risks and benefits of caring for your newborn while sick. Mildly ill people generally room in and care for their newborns. If you are seriously ill, this may not feel like a physically possible or safe option. Once you are home, wash your hands frequently — and always before touching your baby. Wear a mask when you are within 6 feet of your baby or another person. If you have a caregiver who lives 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.
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 or 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. Consider asking them if it would be reasonable to do your prenatal visit by video or telephone. It’s often required, and always advisable, to wear a mask in healthcare settings. Frequent handwashing or sanitizing is also important.
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?
Multiple well-respected clinical organizations, including the CDC, ACOG (the American College of Obstetricians and Gynecologists) and the 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 Novavax did not include participants who were known to be pregnant or breastfeeding. This is typical for pharmaceutical research. Recent studies have included pregnant people and show that there is no increased risk 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 a “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 of 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. The incidences of these adverse events are so low that getting vaccinated remains safer than potentially getting infected with COVID-19. [12].
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 the age of 6 months are now eligible for a seasonal booster shot. 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 December 2023
Sources:
Dara D. Mendez, Vijaya K. Hogan & Jennifer F. Culhane “Institutional racism, neighborhood factors, stress, and preterm birth”. Ethnicity & Health. 19:5, 479-499. October 18, 2013.
Jasmine D. Johnson et al., “Racial Disparities in Prematurity Persist Among Women of High Socioeconomic Status,” American Journal of Obstetrics & Gynecology 2. 2(3), 100104. Nov 10, 2020
James W. Collins Jr et al., “Very Low Birthweight in African American Infants: The Role of Maternal Exposure to Interpersonal Racial Discrimination,” American Journal of Public Health. 94(12), 2132–2138. December 2004.
Braveman Paula, et al. “Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes” Frontiers in Reproductive Health. Vol. 3. 684207 September 2, 2021.
