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Patient education: COVID-19 and pregnancy (The Basics)

Patient education: COVID-19 and pregnancy (The Basics)

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What is COVID-19? — COVID-19 stands for "coronavirus disease 2019." It is caused by a virus called SARS-CoV-2. The virus first appeared in late 2019 and quickly spread around the world.

The virus that causes COVID-19 mainly spreads when an infected person coughs, sneezes, sings, talks, or just breathes near other people. A person can be infected and spread the virus to others, even without having any symptoms.

Most people who get COVID-19 will not get severely ill. But some do.

This article has information for people who are pregnant. More general information about COVID-19 is available separately. (See "Patient education: COVID-19 overview (The Basics)".)

What are the symptoms of COVID-19? — Symptoms usually start 4 or 5 days after a person is infected with the virus. But in some people, it can take up to 2 weeks for symptoms to appear. Many people never show symptoms at all.

When symptoms do happen, they can include:

Fever

Cough

Trouble breathing

Feeling tired

Shaking chills

Muscle aches

Headache

Sore throat

Runny or stuffy nose

Problems with sense of smell or taste

Some people have digestive problems like nausea or diarrhea.

Pregnant people with COVID-19 can have any of the above symptoms or no symptoms.

For most people, symptoms will get better within a few days to weeks. But in others, COVID-19 can lead to serious problems like pneumonia, heart problems, or even death.

Are pregnant people at high risk for severe symptoms? — Experts are still studying COVID-19 and pregnancy. From what they know so far, pregnant people do not seem more likely than other people to get the infection.

However, compared with females of the same age who are not pregnant, pregnant people with COVID-19 seem to be more likely to get very sick and need to stay in the ICU. ("ICU" is short for "intensive care unit.") In pregnant people, the risk of getting very sick or dying is highest in those who are age 35 or older, or have certain health conditions like obesity, high blood pressure, or diabetes. But most people recover before having their baby, and do not need to stay in the hospital.

What should I do if I have symptoms? — If you have a fever, cough, trouble breathing, runny nose, or other symptoms of COVID-19, call your doctor, nurse, or midwife. They can tell you what to do and whether you need to be seen in person.

If I am pregnant and get infected, can I pass the virus to my baby? — Experts think it might be possible for a baby to get the infection while still in the uterus. But this seems to be very uncommon. And when it does happen, most babies do not get very sick.

It is also possible to pass the virus to the baby during childbirth or after the baby is born. If you have COVID-19 when you give birth, there are ways to lower this risk.

Can COVID-19 cause problems with pregnancy? — From what experts know so far, most people who get COVID-19 during pregnancy will not have serious problems. But problems can happen if the mother becomes seriously ill.

Pregnant people who get COVID-19 might have an increased risk of preterm birth. This is when the baby is born before 37 weeks of pregnancy. This seems to be more of a risk in people who get very sick and have pneumonia. Preterm birth can be dangerous, because babies who are born too early can have serious health problems.

Getting COVID-19 during pregnancy might also increase the risk of stillbirth. This is when a baby dies before it is born. The risk of preterm birth is much higher than the risk of stillbirth.

How is COVID-19 treated? — Most people with mild illness will be able to stay home while they get better. Mild illness means you might have symptoms like fever and cough, but you do not have trouble breathing. Ask your doctor, nurse, or midwife about ways to relieve these symptoms.

People with serious symptoms or other health problems might need to go to the hospital. If you need to be treated in the hospital, the doctors and nurses will also monitor your baby's health.

In certain cases, doctors might recommend medicines to prevent or treat severe illness. But some of these medicines are not safe to take if you are pregnant.

Can COVID-19 be prevented? — The best way to prevent COVID-19 is to get vaccinated.

In the United States, the first vaccines became available in late 2020. Since then, experts have been studying their safety in people who are pregnant or breastfeeding. Thousands of pregnant people have gotten the vaccine without any problems. The vaccine does not increase the risk of miscarriage (pregnancy loss) or harm the baby. Based on the available evidence, experts recommend that pregnant people get the vaccine. They also recommend getting a "booster" shot for extra protection. Ask your doctor, nurse, or midwife about the best time to get the booster shot.

Vaccines work very well to prevent serious illness and death from COVID-19. Because pregnant people seem to be at high risk for getting very sick if they do get infected, vaccination is especially important. There is also evidence that people who are vaccinated have a lower risk of problems that affect the baby, like stillbirth or needing to be hospitalized in the first 6 months of life. More information about COVID-19 vaccines and boosters is available separately. (See "Patient education: COVID-19 vaccines (The Basics)".)

You can also protect yourself and others by wearing a face mask in some situations (figure 1) and washing your hands often.

Will my regular prenatal appointments change? — Your doctor, nurse, or midwife will work with you to make a plan for your visits during pregnancy. If you live in an area where there are a lot of cases of COVID-19, there will likely be some changes. For example:

If you have any symptoms of COVID-19, you will probably need to wear a medical mask during your appointments.

Your doctor, nurse, or midwife might group certain tests together so you don't need to go in as often.

Your doctor, nurse, or midwife might suggest replacing some visits with a phone or video call.

These changes can feel stressful. It can help to keep in mind that the goal is to help protect you and others.

What will my delivery be like? — Different hospitals and birth centers have different rules to help keep people safe. These might include guidelines for things like wearing a mask and how many visitors you can have. Your doctor, nurse, or midwife will talk to you about what to expect.

You will be checked for fever and other symptoms of COVID-19 when you arrive to give birth. This might happen earlier if you are scheduled to be "induced" or have a cesarean birth ("c-section"). You might be tested for the virus, too.

If you have COVID-19 when you go into labor, the doctors and nurses will take steps to protect others around you. For example, you will need to wear a medical mask. You will still be able to have a vaginal birth, if that is what you planned. You don't need a c-section just because you are sick.

If you have COVID-19, you will still probably be able to stay in the same room as your baby unless you are too sick to care for them or they need special care. You will need to wear a face mask to lower the risk of spreading the infection. You might need to take other precautions, too. These things can be hard. But they are important in order to protect your baby.

What if I want to breastfeed? — Breastfeeding has many benefits for both you and your baby. Even if you have COVID-19, breastfeeding is encouraged. No babies have become very sick in this way.

Whether or not you breastfeed, it's important to be extra careful when feeding or holding your baby. You could pass the virus to your baby through close contact. You can protect your baby by washing your hands often and wearing a face mask while you feed them.

You might choose to pump breast milk for your baby. If you are sick, wash your hands carefully before pumping, and wear a mask while you pump. If possible, have a healthy person clean your pump thoroughly between uses.

If you are planning to breastfeed, experts recommend getting the COVID-19 vaccine if you haven't already. Vaccines work by causing your immune system to make "antibodies," which are proteins that fight against the virus. These antibodies enter your breast milk, which can help protect your baby in addition to protecting you.

How can I take care of my mental health? — It's normal to feel anxious or worried about COVID-19. You can take care of yourself by:

Getting vaccinated and boosted

Getting regular exercise and eating healthy foods

Finding healthy ways to handle stress, like hobbies you enjoy

Finding safe ways to connect with friends and family members

Keep in mind that most pregnant people do not get severely ill from COVID-19. It helps to be prepared, and it's important to do what you can to lower your risk. But try not to panic.

What if I have other questions? — If you have other questions, talk to your doctor, nurse, or midwife. They can help you with questions like:

What symptoms should I be concerned about?

What should I do if I think I was exposed to COVID-19?

What medicines can I use to treat symptoms of COVID-19 while I am pregnant?

Where can I find support if I feel anxious or depressed?

The answers to these questions, and others, will depend on your situation.

Where can I go to learn more? — As we learn more about this virus, expert recommendations will continue to change. Check with your doctor or public health official to get the most updated information about how to protect yourself and your family.

For information about COVID-19 in your area, you can call your local public health office. In the United States, this usually means your city or town's Board of Health. Many states also have a "hotline" phone number you can call.

You can find more information about COVID-19 at the following websites:

United States Centers for Disease Control and Prevention (CDC): www.cdc.gov/coronavirus/2019-ncov/index.html

World Health Organization (WHO): www.who.int/emergencies/diseases/novel-coronavirus-2019

More on this topic

Patient education: COVID-19 overview (The Basics)
Patient education: Recovery after COVID-19 (The Basics)
Patient education: Avoiding infections in pregnancy (The Basics)
Patient education: Acute respiratory distress syndrome (The Basics)
Patient education: Pneumonia in adults (The Basics)
Patient education: Prenatal care (The Basics)
Patient education: Pumping breast milk (The Basics)
Patient education: Preterm labor (The Basics)

This topic retrieved from UpToDate on: Sep 01, 2022.
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