Coronavirus (COVID-19), Pregnancy, and Breastfeeding

COVID-19 is a new illness that affects the lungs and breathing. It is caused by a new coronavirus. Symptoms include fever, cough, and trouble breathing. It also may cause stomach problems, such as nausea and diarrhea, and a loss of your sense of smell or taste. Symptoms may appear 2 to 14 days after you are exposed to the virus.

Current reports show that pregnant women do not have more severe symptoms than the general public. But researchers are still learning how the illness affects pregnant women. Doctors urge pregnant women to take the same steps as the general public to avoid coronavirus infection.

It’s too early for researchers to know how COVID-19 might affect a fetus. Some pregnant women with COVID-19 have had preterm births, but it is not clear whether the preterm births were because of COVID-19. It is not likely that COVID-19 passes to a fetus during pregnancy, labor, or delivery, but more research is needed.

The virus spreads mainly from person-to-person contact. Pregnant women can take the same steps as other people to protect themselves, including:

• washing hands often with soap and water for at least 20 seconds
• cleaning hands with a hand sanitizer that contains at least 60% alcohol if you can’t wash them (rub until your hands feel dry)
• avoiding touching your eyes, nose, and mouth
• staying home as much as possible
• staying at least 6 feet away from other people if you need to go out
• avoiding people who are sick

As of April 3, the CDC says all people, including pregnant women, can wear a cloth face covering when they are in public to slow the spread of COVID-19. Face coverings are recommended because studies have shown that people can spread the virus before showing any symptoms.
Wearing a cloth face covering is most important in places where you may not be able to stay 6 feet away from other people, like a grocery store or pharmacy. It also is important in parts of the country where COVID-19 is spreading quickly. But you should still try to stay at least 6 feet away from others whenever you leave home.
If you have COVID-19 or think you may have it, you should wear a mask while you are around other people. You also should wear a mask if you are taking care of someone who has COVID-19 or has symptoms. You do not need to wear a surgical mask or medical-grade mask (N95 mask).

As the virus spreads, it is a good idea to call your obstetrician-gynecologist (ob-gyn) or other health care professional to ask how your visits may be changed. Some women may have fewer or more spaced out in-person visits. You also may talk more with your health care team over the phone or through an online video call. This is called telemedicine or telehealth. It is a good way for you to get the care you need while preventing the spread of disease.

If you have a visit scheduled, your care team’s office may call you ahead of time. They may tell you about telemedicine or make sure you do not have symptoms of COVID-19 if you are going into the office. You also can call them before your visits if you do not hear from them.

Pregnant women can stay healthy by following the usual recommendations during pregnancy, including:

• Eating healthy meals (see Nutrition During Pregnancy).
• Exercising regularly (see Exercise During Pregnancy, though be mindful to stay at home or away from other people while exercising).
• Getting plenty of sleep.
• Avoiding alcohol and drugs (see Tobacco, Alcohol, Drugs, and Pregnancy).

Some pregnant and postpartum women may be feeling fear, uncertainty, stress,, or anxiety because of COVID-19. Reaching out to friends and family during this time may help. Phone calls, texts, and online chats are safe ways to stay connected.

There also are treatment and support resources you can access over the phone or online. Talk with your ob-gyn or other health care professional about how to get help if you’re having symptoms like these:

• Feeling sad, hopeless, worthless, or helpless
• Having fear or worry, which may cause a fast heartbeat
• Feeling that life is not worth living
• Having repeated, scary, and unwanted thoughts that are hard to get rid of physical activity also may help your mental health. And it may be useful to focus on your breathing each day, especially if you are feeling anxious. Breathe in for 4 seconds, hold for 7 seconds, and breathe out for 8 seconds. Repeat three times.

If you think you may have been exposed to the coronavirus and have a fever or cough, call your ob-gyn or other health care professional for advice.

If you have emergency warning signs, go to the hospital right away. Emergency warning signs include the following:

• Having a hard time breathing or shortness of breath (more than what has been normal for you during pregnancy)
• Ongoing pain or pressure in the chest
• Sudden confusion
• Being unable to respond to others
• Blue lips or face

If you go to the hospital, try to call ahead to let them know you are coming so they can prepare.

If you are diagnosed with COVID-19, follow the advice from the CDC and your ob-gyn or other health care professional. The current CDC advice for all people with COVID-19 includes the following:

• Stay home except to get medical care. Avoid public transportation.
• Speak with your health care team over the phone before going to their office. Get medical care right away if you feel worse or think it’s an emergency.
• Separate yourself from other people in your home.
• Wear a face mask when you are around other people and when you go to get medical care.

Talk with your ob-gyn or other health care professional about your birth plan. In most cases, the timing and method of delivery (vaginal birth or cesarean birth) do not need to be changed. Women who are sick probably do not need a cesarean section.

the safest place for you to give birth in a hospital, hospital-based birth center, or accredited freestanding birth center. Your hospital or birth center may be adjusting their policies. For example, there may be changes to the number of visitors allowed and how long you will stay in the hospital. Check with your hospital and ob-gyn or other health care professional about your birth plan.

Check with your hospital or birth center. They may limit the number of visitors to help prevent the spread of COVID-19. The number of visitors you can have may depend on local and state recommendations and how quickly COVID-19 is spreading in your area.

Your health care team may wear masks or take other steps to reduce the risk of spreading the virus. You and your health care team also may discuss having your newborn stay in a separate room to reduce the risk of infection for the baby. If your health care team thinks a temporary separation is important, you should make this decision together. Talk with your health care team about your options and make a decision that feels right to you.

So far, the virus has not been found in breast milk. But there is not enough information yet on whether women who are sick can pass the virus through breast milk.

Breast milk gives babies protection against many illnesses. It also is the best source of nutrition for most babies. Talk with your ob-gyn or other health care professional about whether to start or continue breastfeeding. You can make this decision together with your family and health care team.

If you have symptoms of COVID-19 or if you have been diagnosed, you can take the following steps to avoid passing the infection to your baby:

• Wash your hands before touching your baby.
• Wear a face mask while breastfeeding if possible.
• Wash your hands before touching any breast pump or bottle parts and clean all pump and bottle parts after use.
• You also can have someone who is not sick feed your breast milk to your baby after you pump.

Talk with your employer about how you can stay safe while doing your job. If remote work is possible, your employer may offer it. If remote work is not possible, your employer should follow guidelines from local and state health departments and the CDC to keep employees safe.

Remember, current reports show that pregnant women do not have more severe illness from COVID-19 than the general public. But people with some health conditions, such as diabetes mellitus or lung disease, have a higher risk of severe illness from COVID-19. Tell your employer if you have a health condition.

Your ob-gyn or other health care professional should continue to be your main resource for all questions about your pregnancy. For the most current information about the coronavirus and COVID-19, check CDC web pages, which are updated often and listed below.

This is a personal choice. You can make the decision based on your health, the potential risks of COVID-19, and other factors.

Researchers are still learning how COVID-19 affects pregnant women. Current reports show that pregnant women do not have more severe symptoms than the general public. But people with some health conditions, such as diabetes mellitus, lung disease, or heart disease, have a higher risk of severe illness from COVID-19.

Based on current research, it is not likely that COVID-19 passes to a fetus during pregnancy, labor, or delivery. But more research is needed on this. After birth, a newborn can get the virus if they are exposed to it.