Coronavirus Disease (COVID-19): What You Need to Know About Its Impact on Moms and Babies

Pregnant people have a higher risk of severe illness or death from COVID-19 compared with pregnant people without COVID-19. Pregnant people with COVID-19 are more likely to be admitted to the hospital or the intensive care unit (ICU).

Pregnant people with COVID-19 have a higher risk of preterm birth. They may also have a higher risk of other pregnancy complications, such as preeclampsia/eclampsia, severe infections, blood clots, bleeding problems after birth, heart problems and cesarean (C-section) birth.

Research shows that the symptoms of COVID-19 may be worse for pregnant people who are older, who are affected by obesity or who have pre-existing conditions like high blood pressure, lung disease, diabetes or gestational diabetes.

Recent research shows that babies of pregnant people with COVID-19 may have more complications before and after birth.

Pregnant people and those living with them must take steps to protect themselves from COVID-19. Get the COVID-19 vaccine as soon as it’s available to you. Pregnant and breastfeeding people who want to get the COVID-19 vaccine may choose to do so. If you are not fully vaccinated, you can protect yourself by taking these steps:

Pregnant people who experience social and health disparities are at a higher risk of getting COVID-19. They may also be at a higher risk of complications if they get COVID-19.

Most newborns born to people who have COVID-19 won’t get the virus. Some do, but we still don’t know if they got it before, during or after birth.

Have close contact with other people (closer than 6 feet)

Spend more time with other people

Spend time in crowds (more than 10 people)

Spend time in indoor spaces, especially if they don’t get a lot of fresh air

The virus spreads between people who are in close contact with one another (within about 6 feet) for a total of 15 minutes or more within a 24-hour period.

Droplets can be large and visible or smaller and unseen. Small droplets also can form particles when they dry very quickly in the airstream.

Respiratory droplets cause infection when they are inhaled or deposited on mucous membranes, such as those that line the inside of the nose and mouth.

As the respiratory droplets travel further from the person with COVID-19, the concentration of these droplets decreases.

With passing time, the amount of infectious virus in respiratory droplets also decreases.

Some infections are spread by exposure to small droplets and particles that contain the virus and can linger in the air for minutes to hours. This means that people who are further than 6 feet apart can sometimes become infected. People who are infected but do not show symptoms can spread the virus to others.

Pregnancy

Cancer

Chronic kidney disease

COPD (chronic obstructive pulmonary disease)

Down Syndrome

Heart conditions, such as heart failure, coronary artery disease or cardiomyopathies

Obesity (BMI of 30 or higher less than 40)

Severe Obesity (BMI of 40 or higher)

Sickle cell disease

Smoking

Type 2 diabetes mellitus

Weakened immune system from solid organ transplant

Anxiety disorders and related problems

Asthma (moderate to severe)

Cerebrovascular disease (affects blood vessels and blood supply to the brain)

Cystic fibrosis

High blood pressure

Lipid metabolism disorders (conditions in which your body has too much lipids, a type of fat)

Liver disease

Neurologic conditions, such as dementia

Overweight (BMI of more than 25 but less than 30)

Pulmonary fibrosis (having damaged or scarred lung tissues)

Thalassemia (a type of blood disorder)

Type 1 diabetes

Weakened immune system from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines

Difficulty breathing or shortness of breath

Constant pain or pressure in the chest

Unable to wake or stay awake

If you start feeling confused

Bluish lips or face

Stay home except to get medical care. If you’re seeking medical care, don’t go to work, school, or public areas and avoid using public transportation or taxis (including ride-share services).

Call the medical facility before you arrive. Be sure to tell the staff that you have or may have COVID-19. This will help them take steps to keep other people from getting infected or exposed. Put on a mask before you enter the facility.

Separate yourself from other people who live in your home. Stay in a specific room and away from other people and pets who live in your home. Use a separate bathroom, if possible.

Wear a facemask to cover your nose and mouth when you are around other people, even at home. The CDC says you may use a scarf or a bandana to cover your nose and mouth if a facemask is not available.

Clean your hands often. Wash your hands with soap and water for at least 20 seconds. Always wash your hands after blowing your nose, coughing or sneezing; going to the bathroom; and before eating or preparing food. Try not to touch your eyes, nose or mouth.

Cough or sneeze into a tissue or into your arm. Throw used tissues in the trash. Be sure to wash your hands with soap and water for at least 20 seconds after using a tissue. You also can use alcohol-based hand sanitizers that contain at least 60% alcohol. Use enough hand sanitizer so that it takes at least 20 seconds for your hands to dry.

Don’t share personal household items. Use hot, soapy water or a dishwasher to wash dishes and utensils. Don’t share towels or bedding with other people or pets who live in your home. Wash these items thoroughly after each use.

Clean and disinfect objects in your isolation area every day. This includes areas you frequently touch and the bathroom you use. Your caregiver should clean other parts of the home outside of your isolation area. These include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets and bedside tables. Use a regular household cleaning spray or wipe. See the CDC’s complete disinfection guide for more information.

10 days since symptoms first appeared and

24 hours with no fever without the use of fever-reducing medications and

Other symptoms of COVID-19 are improving.

You might need to stay home longer than 10 days and up to 20 days after symptoms first appeared.

You may require testing to determine when you can be around others.

Talk to your health care provider for more information. If testing is available in your community, it may be recommended by your provider. Your provider will let you know if you can be around other people again based on the results of your testing.

Your doctor may work with an infectious disease expert or your local health department to determine if testing is necessary before you can be around others.

You should stay home for 14 days after the last time you were in contact with that person.

Your local health department sets guidelines for when quarantine can be shorter. This may include:

You had COVID-19 in the last 3 months, have recovered and continue not to have COVID-19 symptoms.

You have been fully vaccinated against COVID-19 and you don’t have symptoms.

Pregnant people have a higher risk of severe illness or death from COVID-19 compared with pregnant people without COVID-19. Pregnant people with COVID-19 are more likely to be admitted to the hospital or the intensive care unit (ICU).

Recent research shows that there may be an increased risk of preterm birth and other complications among pregnant people with COVID-19. If you’re affected by preterm labor and COVID-19, your doctor will consider the risks and benefits of medicines called corticosteroids. These medicines are sometimes used in pregnant people to help prevent preterm birth. But research suggests that certain people taking corticosteroids may be a higher risk for severe illness with COVID-19.

In addition to preterm birth, data suggests that pregnant people with COVID-19 may have a higher risk for pregnancy complications such as preeclampsia/eclampsia, severe infections, blood clots, bleeding problems after birth, heart problems and cesarean (C-section) birth.

Research shows that the symptoms of COVID-19 may be worse for pregnant people who are older, who are affected by obesity or who have pre-existing conditions like high blood pressure, lung disease, diabetes or gestational diabetes.

Recent research shows that babies of pregnant people with COVID-19 may have more complications before and after birth.

High fevers caused by any infection during the first trimester of pregnancy can increase the risk of certain birth defects.

Because of the COVID-19 crisis, you may experience increased depression and anxiety during and after pregnancy. Be sure to tell your provider about any thoughts or feelings that you may have.

Newborns. Most newborns who have tested positive for COVID-19 had mild or no symptoms and have recovered fully. However, there are some reports of newborns who became very sick.

Children. Most children who have COVID-19 have mild or moderate symptoms. Based on limited data, the risk of serious problems in children with COVID-19 appears to be low. Children who have certain medical conditions, such as asthma; chronic lung disease; diabetes; genetic, neurologic or metabolic conditions; heart disease since birth; weakened immune system; multiple chronic conditions that affect many parts of the body; or obesity may be at higher risk of getting very sick from COVID-19. The CDC and others are investigating a rare but serious medical condition associated with COVID-19 in children called multisystem inflammatory syndrome in children (MIS-C). We do not yet know what causes MIS-C and who is at increased risk for developing it. Learn more about MIS-C.

Don’t skip your prenatal or postpartum care appointments. Visit your healthcare provider for all recommended appointments or ask your health care provider for virtual prenatal visits and off-hour visits for ultrasounds and lab testing.

Make sure that you have at least a 30-day supply of your medicines.

Get recommended vaccinations, including the flu vaccine. You may choose to get the COVID-19 vaccine, talk to your provider if you have questions.

Talk to your health care provider about how to stay healthy and take care of yourself during the COVID-19 pandemic. This includes maintaining a healthy weight before and during pregnancy and managing any chronic health condition such as diabetes.

If you don’t have a provider, contact your nearest community health center or health department.

Call your provider if you have any questions related to your health.

Seek care immediately if you have a medical emergency.

Call your hospital or birth center and ask them about any restrictions they have on the number of support persons (e.g. doula, spouses, family) allowed in the room during labor and delivery.

Update your Birth Plan by using our template here. Additional versions of this Birth Plan are available in Chinese Simplified, Chinese Traditional, Hindi, Hmong, Vietnamese, Arabic, Farsi, HYE (Armenian), Korean, Punjabi, Russian, Somali, Tagalog, Mixtec. (Translated documents are courtesy of Anthem.)

If you are in labor and you have, or think may have COVID-19, call the hospital before you go so the staff can properly prepare and protect your baby and others from being infected.

Babies born to people who have COVID-19 are tested for the virus whether they have signs of infection or not.

CDC says that the risk of your newborn getting COVID-19 from you is low. Decide with your health care provider if your baby should stay in your room with you or not. You can reduce the chances of your baby becoming infected by keeping 6 feet distance when not directly caring for your baby, and by washing your hands thoroughly and wearing a facemask when you have contact with your baby.

Your provider may recommend that you stay in a separate room from your newborn if you are very sick with COVID-19 and cannot care for your baby safely.

Your providers may suggest other precautions, like keeping a curtain between you and your baby or placing the newborn in an incubator while in the hospital.

If your isolation period for COVID-19 has ended, you should still wash your hands before caring for your newborn, but you don't need to take the other precautions. You most likely won't pass the virus to your newborn or any other close contacts after your isolation period has ended.

So far, the virus that causes COVID-19 has not been found in the breast milk of people with COVID-19.

Breast milk is the best food for babies in the first year of life. It helps them grow healthy and strong and protects them from infections and illness.

Breast milk has antibodies that help protect your baby from many illnesses. Antibodies are cells in the body that fight off infection. Breastfed babies have fewer health problems than babies who aren’t breastfed.

Research shows that the breast milk of people with COVID-19 may contain antibodies.

Use a facemask to cover your face and nose

Wash your hands and breast thoroughly before and after touching your baby

Properly clean your breast pump and the surfaces you touch

If rooming-in, keep your newborn 6 feet away from you when you’re not directly caring for your baby

Take care of yourself. We are living through a public health emergency. Research shows that the pandemic has created a lot of stress, anxiety, loneliness and depression for pregnant people and new parents around the world. Caring for a new baby during a pandemic while also feeling sore, tired and stressed can be a lot to handle. But there are several things you can do to care for yourself:

At least three COVID-19 vaccines have been approved for emergency use authorization by the U.S. Food and Drug Administration (FDA) and several more are under development.

The Advisory Committee on Immunization Practices (ACIP) has recommended that one of the vaccines currently approved for emergency use can be used in people ages 12 and older for the prevention of COVID-19, and the other two vaccines can be used in people ages 18 and older.

Two of the current vaccines use mRNA technology. They do not contain a live virus.

The third vaccine uses viral vector technology. It contains a harmless version of a type of virus called an adenovirus. The adenovirus used in the vaccine cannot cause an infection. There have been some reports of a rare type of blood clot in a very small number of people receiving the vaccine in the U.S., particularly in women under age 50. This risk has not been seen in the mRNA vaccines. The CDC and FDA have determined that this risk is very low and the vaccine is safe and effective in preventing COVID-19.

All of the current vaccines give the body’s cells instructions that help the immune system fight COVID-19.

Pregnant and breastfeeding people were not included in the original COVID-19 vaccine trials, although some participants became pregnant while in the trial. Trials are now testing the vaccine in pregnant people.

Recent research shows that the mRNA vaccines are very effective in reducing the risk of COVID-19 for fully vaccinated people. In rare cases when people who are fully vaccinated with an mRNA vaccine get COVID-19, they may have a milder, shorter illness or even no symptoms.

So far, research has shown that the mRNA vaccines are safe and effective in pregnant people. As of now, there’s no evidence that the antibodies your body makes after getting the COVID-19 vaccine can cause any problem with pregnancy.

The FDA and CDC have systems in place to monitor safety in pregnant people who get the COVID-19 vaccine. You can enroll in safety monitoring systems such as the CDC’s V-safe program, which is a smartphone-based, after-vaccination health checker.

According to the CDC, the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM), pregnant and breastfeeding people may choose to get the COVID-19 vaccine.

Recent research has shown that pregnant people who get the mRNA COVID-19 vaccine in the third trimester of pregnancy can pass protective COVID-19 antibodies to their babies. Researchers continue to study the best vaccination timing for passing antibodies to babies. Studies also have shown that the breast milk of people who get the vaccine may contain COVID-19 antibodies.

As of now, there’s no evidence that the COVID-19 vaccine can affect fertility. The American College of Obstetricians and Gynecologists (ACOG) recommends COVID-19 vaccination for all people who are eligible to get the vaccine and are considering a future pregnancy.

There’s no need to delay pregnancy after getting the vaccine.

Experts believe that the benefits of pregnant people getting the COVID-19 vaccine outweigh any potential concerns.

Talk to your provider if you have any concerns about getting the COVID-19 vaccine. It is your decision.

With the two mRNA vaccines, you need 2 doses. A second shot a few weeks after your first shot is needed to get the most protection.

It’s best to avoid getting other vaccines for at least 2 weeks before and 2 weeks after getting the COVID-19 vaccine, unless your provider says that another vaccine is necessary during that time.

After you get the vaccine, you may have some side effects. Side effects may feel like you have the flu and may affect your ability to do daily activities, but they should go away in a few days. This is a normal sign that your body is building protection.

So far, millions of doses of the COVID-19 vaccines have been given in the U.S. Some people have had no side effects. Many people have had mild side effects. The CDC reports that severe reactions are rare.

Talk with your provider about the benefits and risks of getting the COVID-19 vaccine.

Take breaks from watching or listening to the news stories or going on social media to help reduce anxiety.

Keep in touch with people you care about and who care about you. Tell your partner, family and friends how you’re feeling.

While COVID-19 has changed a lot about our daily lives, you can still keep a routine. Every day, take a shower, eat healthy foods and regular meals, drink plenty of water and get a good night’s sleep.

Know you’re not alone. Share your story and talk to other NICU families online. Click here to learn more.

Bond with your baby. Some of the most important ways you can begin to bond with your baby are holding them, providing skin-to-skin care and feeding them. Other ways of bonding include singing, talking or reading softly and gently touching your baby. Ask your NICU staff about the best way to bond with your baby right now.

If you have or may have COVID-19, you may not be able to be with your baby. Temporary separation may be needed to avoid getting your baby sick. Call them and ask about what rules they have to protect your baby from getting COVID-19. If you and your baby are able to be together, wash your hands thoroughly and wear a facemask before and while spending time with your baby to reduce the chances of getting your baby infected. If you can’t be in the NICU ask the NICU staff about ways to connect with your baby during this time.

If you are temporarily separated from your baby and you want to breastfeed, you can express breast milk for your baby. Talk with your NICU about any rules you need to follow. If you are able to provide breast milk you can use a breast pump to express your breast milk. Wash your hands thoroughly before touching the pump and bottle parts, and clean all parts after each use. A healthy caregiver can feed the breast milk to your baby.

Be honest with them. Your older children may have a lot of questions but may not know how to ask them. Tell them what’s going on with you and with their baby in words they can understand.

Calm your children’s worries. Some children are scared that their parents will love them less now that the new baby is here. Tell your children that you love them very much and describe what makes them special. If they’re old enough, you can talk with them about COVID-19 and how it’s affecting your family’s routine. Recent research shows that children and teens under 18, possibly may not be more likely to get COVID-19 if they attend daycare or school in-person. The CDC has a checklist to help you plan for in-person school.

Create an activity that will help them feel part of their sibling’s care. Below are some activities your children can do at home to help care for the baby while they’re in the NICU. Ask your NICU staff before bringing any items into the NICU: