If you are pregnant, you recently delivered a baby or you are breast-feeding, you're probably concerned about the impact of coronavirus disease 2019 (COVID-19) on you and your baby. Here's what you need to know.
Risks during pregnancy
Currently, it isn't clear if pregnant women have a greater chance of getting sick from the COVID-19 virus or if they are more likely to experience serious illness. However, pregnant women are at greater risk of severe illness from other respiratory infections, such as the flu. Potentially, pregnant women could be at increased risk of infection with the COVID-19 virus.
It also isn't known if COVID-19 causes problems during pregnancy or affects the health of the baby after birth. There have been a small number of reported problems, such as premature birth, in babies born to mothers who tested positive for COVID-19 during pregnancy. But these problems might not be related to the mother's infection.
In a small study of infants born to mothers infected with COVID-19, none of the infants tested positive for COVID-19 and the virus wasn't found in the amniotic fluid or placenta. However, a report of 33 infants born to mothers with COVID-19 pneumonia showed that three newborns tested positive for the virus two days after birth, despite precautions taken to prevent infection. In another study of six infants who were born to mothers with mild symptoms of COVID-19, the newborns had no symptoms of COVID-19 and tested negative for it. But there was evidence that some of the infants' immune systems responded to COVID-19 before birth. Further research is needed to determine the impact of the virus on babies during pregnancy and after birth.
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 are tested for the virus that causes COVID-19, if testing supplies are available. Call your health care provider ahead of time to tell him or her about your symptoms and possible exposure, including travel, 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
Community efforts to control the spread of the COVID-19 virus might affect your access to routine prenatal care. Talk to your health care provider about whether the use of virtual prenatal care is an option for you, if it's available in your area, and how it works. Ask your health care provider 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 during the visit. 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.
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 24 to 48 hours 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, though restrictions might change as infection rates of COVID-19 in your area change. Your hospital stay will likely be shorter than routine.
If you have COVID-19 or are waiting for test results due to symptoms, contact with your baby after delivery will likely be affected. It isn't known whether newborns who have COVID-19 are at increased risk of severe complications. But there is concern that newborns could become infected with the COVID-19 virus after birth if they come into contact with infected respiratory droplets. Infants born to mothers who have COVID-19 may be cared for in a separate room, with visits limited only to a healthy parent or caregiver.
Health care facilities also may temporarily room mothers who have COVID-19 or are under investigation for having the virus separately from their babies until transmission-based precautions are completed. Your health care team will discuss the risks and benefits of temporary separation and what steps might be involved.
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 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.
It isn't yet known if the COVID-19 virus can be transmitted through breast milk. Limited research has shown no evidence of the virus in the breast milk of women with COVID-19. The bigger concern is whether an infected mother can transmit the virus to the baby through respiratory droplets during breast-feeding.
If you have COVID-19 or are a symptomatic person under investigation for having the virus, take steps to avoid spreading the virus to your baby. This includes washing your hands before touching your baby and, if possible, wearing a face mask during breast-feeding. 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.
What you can do
There is no vaccine available to prevent infection with the COVID-19 virus at this time. To reduce your 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 beyond your household. Limit visitors. Instead, consider sharing moments with friends and family via photos, videos or videoconferencing. 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.
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.