Pregnancy and COVID-19: What are the risks?

You may wonder how coronavirus disease 2019 (COVID-19) could affect your risk of illness, birth plan or time bonding with your baby. You also might have questions about the safety of the COVID-19 vaccines. Here's what you need to know.

COVID-19 risks during pregnancy

Pregnant people seem to catch the virus that causes COVID-19 at about the same rate as people who aren't pregnant. Also, pregnant people usually get better without needing care in the hospital. But pregnancy is a factor that raises the risk of severe COVID-19. That risk stays higher for at least a month after giving birth.

And the risk continues to go up if a pregnant person has other health issues linked to severe COVID-19. Examples of these health issues are obesity, diabetes, high blood pressure or lung disease.

Being very sick with COVID-19 means that a person's lungs don't work as well as they should. Severe or critical COVID-19 is treated in the hospital with oxygen and other medical help to treat damage throughout the body. Severe COVID-19 can lead to death.

Pregnant people with severe COVID-19 also may be more likely to develop other health problems as a result of COVID-19. They include heart damage, blood clots and kidney damage. Moderate to severe symptoms from COVID-19 have also been linked to higher rates of preterm birth, high blood pressure or preeclampsia.

These risks may shift as the virus that causes COVID-19 changes. Risks also may change as disease prevention and treatment evolve. But risks are lowered significantly when a pregnant person gets the COVID-19 vaccine.

Preventing COVID-19 during pregnancy and breastfeeding

The Centers for Disease Control and Prevention recommends getting a 2024-2025 COVID-19 vaccine if:

• You are planning or trying to get pregnant.
• You are pregnant now.
• You are breastfeeding.

Staying up to date on your COVID-19 vaccine helps prevent severe COVID-19 illness. It also may help a newborn avoid getting COVID-19 if you are vaccinated during pregnancy.

People at higher risk of serious illness can talk to a healthcare professional about additional COVID-19 vaccines or other precautions. It also can help to ask about what to do if you get sick so you can quickly start treatment.

While you’re pregnant, it’s important for you and those in your household to:

• Test for COVID-19. If you have COVID-19 symptoms, test for the infection. If you are exposed, test five days after you came in contact with the virus. In the United States, the Food and Drug Administration, also known as the FDA, approves or authorizes the tests. On the FDA website, you can find a list of the tests that are validated and their expiration dates. You also can check with your healthcare professional before buying a test if you have any concerns.
• Keep some distance. Avoid close contact with anyone who is sick or has symptoms, if possible.
• Wash your hands. Wash your hands well and often with soap and water for at least 20 seconds. Or use an alcohol-based hand sanitizer with at least 60% alcohol.
• Cover your coughs and sneezes. Cough or sneeze into a tissue or your elbow. Then wash your hands.
• Clean and disinfect high-touch surfaces. For example, clean doorknobs, light switches, electronics and counters regularly.

Try to spread out in crowded public areas, especially in places with poor airflow. This is important if you have a higher risk of serious illness.

The CDC recommends that people wear a mask in indoor public spaces if you're in an area with a high number of people with COVID-19 in the hospital. They suggest wearing the most protective mask possible that you'll wear regularly, that fits well and is comfortable.

COVID-19 and prenatal care

Unlike earlier in the pandemic, in-person prenatal visits typically are not disrupted by COVID-19.

If you test positive for COVID-19, your healthcare professional will want to discuss your options with you. That might mean a virtual or in-person appointment to figure out how to best keep track of your health. It may help to know that in most cases, the COVID-19 infection doesn't spread to the unborn baby.

If you test positive for COVID-19 and have symptoms, your healthcare team will monitor you closely. A healthcare professional may ask about your symptoms, review your other medical conditions and determine your risk of serious illness. You may be offered medicine to block the infection from getting worse. Treatment with these medicines may be a pill that you swallow, or a liquid given through a needle into a vein.

You also may be asked to use a device to monitor your oxygen level, called a pulse oximeter.

After the infection, your healthcare professional may plan on extra imaging tests to make sure the unborn baby is growing as expected.

COVID-19 and giving birth

If you test positive for COVID-19 close to when you give birth, you may not need to change your birth plan.

But it's also possible that your healthcare professional will suggest a change in timing or delivery options for your safety. People who also are managing high blood pressure linked to pregnancy or preeclampsia are more likely to be monitored in the hospital if they get COVID-19.

After the baby is born, research suggests it's safe for your baby to stay with you even if you have COVID-19. If you are too ill to care for your baby, your healthcare professional may suggest the baby stay in another hospital area.

To limit your baby's exposure to the virus, wear a well-fitting face mask and have clean hands when caring for your newborn. Stay a reasonable distance from your baby when not feeding, if possible.

Breastfeeding and COVID-19

If you have COVID-19 but feel well enough, there is no need to stop breastfeeding or stay separate from your baby. To avoid spreading the infection, wash your hands before breastfeeding. Also, wear a well-fitting face mask whenever you are in close contact with your baby.

If you're pumping breast milk, wash your hands before touching any pump or bottle parts and follow instructions for pump cleaning. If you need care in the hospital, you may be able to keep pumping.

COVID-19 concerns after giving birth

Staying healthy can be a big concern for new parents. Worry about COVID-19 illness for yourself or your newborn may be an added burden. But it is typical for newborns to get their first illness during their first year of life. In fact, your baby may have mild illness regularly during this first year as the baby comes in contact with the world.

If you find that worry over COVID-19 or other illness is affecting your or your baby's health, talk to your healthcare professional.

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