The world has broken out in panic over the COVID-19 pandemic, also known as coronavirus, and that’s because there’s a lot that we don’t know about this virus. Consequently, there’s a lot we don’t know about how it affects pregnant women and their babies.
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Pregnant Women are at Higher Risk for Contracting Coronavirus
When a woman gets pregnant, her body recognizes that the fetus is a “foreign object” (meaning it wasn’t with the mother at her birth), and to prevent the mother’s body from fighting “foreign object,” her immune system lowers itself to protect the baby.
The lowered immune system makes the mother more likely to get sick, putting her at higher risk.
The Society for Maternal Fetal Medicine confirms that even though very little is known about pregnancy and the coronavirus, pregnant women are at higher risk for contracting the virus. (1)
“It is reasonable to predict that pregnant women might be at greater risk for severe illness, morbidity, or mortality compared with the general population, as is observed with other related coronavirus infections [including severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV)], and other viral respiratory infections, such as influenza, during pregnancy.
Data from MERS-CoV and SARS-CoV, although limited, suggest that infection in pregnancy may be associated with severe infection and adverse neonatal outcomes, including increased risk of miscarriage, fetal growth restriction, and preterm birth.” But again, data specific to COVID-19 are not yet available. (1)
Pregnant women with chronic illnesses such as heart, lung, or kidney disease should take extra precaution.
Hard Facts about Coronavirus
1. COVID-19 is a respiratory virus, just like the seasonal flu, and that means there’s currently no cure for it. As with any virus, a doctor can prescribe medicine to treat symptoms, but the body has to fight off and eliminate the virus itself.
2. Those most likely to get infected are age 60 and above and have two or more chronic diseases or conditions (like diabetes, hypertension, etc.)
3. COVID-19 is most commonly spread from an infected person to others through:
— airborne droplets from coughing and sneezing.
— close contact such as touching and shaking hands.
— touching an infected surface.
— touching your nose, mouth, or eyes before washing your hands.
4. Symptoms are fever, cough, and shortness of breath.
5. Currently there is no antiviral medication approved to treat COVID-19, and no vaccine is available.
Why Health Matters
Being healthy in pregnancy is important for you, your baby, labor and delivery, and recovery. In a time like this, although your health can’t prevent you from contracting a virus, your health can determine how you recover if infected.
It can be the difference of sick for days or sick for weeks, mild symptoms or severe symptoms causing other complications, recovering at home or hospitalization, or life or death.
Remember, those most likely to get infected, and die, already have preexisting health problems.
Here are a few tips to be healthier, no matter how healthy you are.
1. While social distancing and quarantining, walk in place or around the house during commercial breaks.
2. Eat plenty of fruits, vegetables, nuts, and seeds. You don’t have to feel like a vegan, but these foods are great for pregnancy and have a variety of nutrients that build your immune system. If you’d like to know more, see How to Eat for Pregnancy.
3. Take a quality prenatal vitamin. Just because your prenatal vitamin says it contains 100% of each nutrient, that doesn’t mean you’re actually getting 100% of each nutrient, or that the type of nutrients are worthwhile. To learn more, read about How to Choose a Prenatal Vitamin.
How the Coronavirus Affects Pregnancy
Little information is known about how COVID-19 affects pregnancy because there have been so few pregnant women infected with the virus. However, there is some data available, and confident conclusions can be drawn for the questions that still remain.
If you contract COVID-19 while pregnant, you should receive care and monitoring similar to any critically ill pregnant woman. Your doctor will decide which measures are best based on the circumstances in your pregnancy, but you’re likely to have routine ultrasounds to monitor the baby’s growth.
Though there’s not enough data available for COVID-19, adverse neonatal outcomes are associated with the flu, including low birth weight and preterm birth. (1) This is not to say that the baby is directly effected by the flu, but that the baby is effected as a result of the mother being sick and under stress.
Can a Pregnant Woman Pass COVID-19 to Her Baby?
No evidence currently shows that COVID-19 passes to a pregnant woman’s amniotic fluid or cord blood, meaning the baby remained virus-free. Although this was tested in less than 10 infants, the findings are in line with other common respiratory viral illnesses in pregnancy. (1)
Miscarriage due to Coronavirus
The evidence on the risk of miscarriage or congenital anomalies due to COVID-19 is inadequate. However, data from the SARS epidemic suggests no increased risk of fetal loss or congenital anomalies associated with infection early in pregnancy. (1)
Preterm Delivery due to Coronavirus
Preterm delivery has been associated with COVID-19, HOWEVER, the data shows that some cases were likely due to reasons unrelated to COVID-19.
Since this finding is based on so few pregnancies, the data is inconclusive.
In all cases, no neonatal deaths were reported. (1)
How Does COVID-19 Affect Labor & Delivery?
The type of delivery (vaginal, medicated, c-section, etc.) has nothing to do with whether or not the baby will get infected.
If a pregnant woman is infected with COVID-19 and recovers in her first or second trimester, labor and delivery will not be affected.
“For [pregnant] women infected in the third trimester who recover, it is reasonable to attempt to postpone delivery (if no other medical indications arise) either until a negative testing result is obtained, or quarantine status is lifted…” The reason for this is to avoid transmission to the baby after the baby is born, since mother and child have such close contact. (1)
If an infected mother gives birth, the CDC recommends separating the mother and baby until the mother’s transmission-based precautions are discontinued. (2)
If physical separation is undesired or not an option, the CDC recommends physical barriers between the mother and baby, like a curtain or six or more feet of separation. (2)
Please note that these are recommendations, and that ultimately the mother has the final say-so in the matter.
Induction and COVID-19
“In general, COVID-19 infection itself is not an indication for delivery.” (1) That means that you cannot be induced based solely on being infected.
Can COVID-19 Infected Moms Breastfeed?
In nine women tested, no traces of the virus were found in the breastmilk, so yes, infected moms can breastfeed.
It’s vital to take precautions while breastfeeding or bottle feeding, like washing hands, wearing a mask, and/or covering the baby.
If you express breastmilk through a pump, be sure to wash and disinfect all parts of the breast pump when finished.
Yes, due to their lowered immunity. Pregnant women with chronic illnesses are at even higher risk.
The data isn’t sufficient, but the data from the SARS (a similar virus) epidemic suggests no increased risk of fetal loss or congenital anomalies associated with infection early in pregnancy.
No. No traces of the virus were found in amniotic fluid or cord blood.
Yes, but it’s necessary for the mom to wear a mask and take whatever precautions are available, such as washing her hands and/or covering the baby.
Nothing can prevent you from catching a virus, but certain measures can significantly reduce your risk: stay away from large crowds and infected people, wash your hands, minimize touching your face, and wear a mask to cover your nose and mouth when in public.
It is unknown at this time.