Coronavirus Disease (COVID-19): What You Need to Know About Its Impact on Moms and Babies
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What We Know About Covid-19
Coronavirus disease 2019, also called COVID-19, is a new disease caused by a new coronavirus. COVID-19 is now a pandemic because this disease has spread to the U.S. and around the world. COVID-19 is spreading easily between people. Based on what we know at this time, pregnant people are at increased risk for getting sicker from COVID-19 compared to non-pregnant people. Public health and medical groups are closely monitoring the COVID-19 pandemic and providing regular updates.
Based on what we know at this time:
Pregnant people have a significantly higher risk of severe illness or death from COVID-19 compared with non-pregnant people. According to recent data, there is an increased risk for deaths in pregnant people with COVID-19 than non-pregnant people. Recent CDC data showed that symptomatic pregnant women with COVID-19 had a 70% higher risk of death compared to non-pregnant women.
Research shows that the symptoms of COVID-19 may be worse for pregnant people who are older, have a higher body mass index (BMI) or have pre-existing conditions like high blood pressure, diabetes or gestational diabetes.
Although some pregnant people with COVID-19 have no symptoms, a recent study shows that some pregnant people with COVID-19 may have symptoms for up to eight weeks or longer.
People who are infected with the virus that causes COVID-19 may have a higher risk of pregnancy complications, such as preterm birth, preeclampsia, emergency cesarean (C-section) delivery or pregnancy loss.
Pregnant people with COVID-19 also may have a higher risk of developing blood clots and heart issues, including slow heart rate.
Having children living in the home may make pregnant people at higher risk of getting COVID-19.
How it spreads:
Learn how the virus spreads and take measures to stay as safe as possible. The best way to protect yourself is to avoid the virus.
The virus is thought to spread mainly from person-to-person.
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.
Important to remember that people who are infected but do not show symptoms can also spread the virus to others.
Through respiratory droplets produced when an infected person coughs, sings, breathes, sneezes or talks.
These droplets can range in size from larger droplets (some of which are visible) to smaller droplets. Small droplets also can form particles when they dry very quickly in the airstream.
Infections occur mainly through exposure to respiratory droplets when a person is in close contact with someone who has COVID-19. 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. Larger droplets fall out of the air due to gravity. Smaller droplets and particles spread apart in the air.
With passing time, the amount of infectious virus in respiratory droplets also decreases.
Some infections can be spread by exposure to virus in small droplets and particles that can linger in the air for minutes to hours. These viruses may be able to infect people who are further than 6 feet away from the person who is infected or after that person has left the space.
This kind of spread is referred to as airborne transmission and is an important way that infections like tuberculosis, measles, and chicken pox are spread.
There is evidence that under certain conditions, people with COVID-19 seem to have infected others who were more than 6 feet away. These transmissions occurred within enclosed spaces that had inadequate ventilation. Sometimes the infected person was breathing heavily, for example while singing or exercising.
Important to remember that people who are infected but do not show symptoms can also spread the virus to others.
The latest information on the spread of COVID-19 in the U.S. can be found here.
Who is at risk of getting COVID-19
Everyone who is exposed to the virus that causes COVID-19 is at risk of being infected. The risk of getting COVID-19 is higher for people who:
Live in places where there is ongoing community spread.
Have close contacts with people who have COVID-19.
Have traveled to places where community spread is happening.
Provide health care to patients who have COVID-19.
Early research indicates that those with a vitamin D deficiency may have an increased risk of being infected but more research is needed.
Who is at a higher risk for severe illness?
Adults of any age with the following conditions are at increased risk of severe illness from the virus that causes COVID-19:
Cancer
Chronic kidney disease
COPD (chronic obstructive pulmonary disease)
Heart conditions, such as heart failure, coronary artery disease or cardiomyopathies
Weakened immune system from solid organ transplant
Obesity (BMI of 30 or higher less than 40)
Severe Obesity (BMI of 40 or higher)
Sickle cell disease
Smoking
Type 2 diabetes mellitus
Based on what we know at this time, adults of any age with the following conditions might be at an increased risk for severe illness from the virus that causes COVID-19:
Asthma (moderate to severe)
Cerebrovascular disease (affects blood vessels and blood supply to the brain)
Cystic fibrosis
High blood pressure
Weakened immune system from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines
Neurologic conditions, such as dementia
Liver disease
Overweight (BMI of more than 25 but less than 30)
Pregnancy
Pulmonary fibrosis (having damaged or scarred lung tissues)
Thalassemia (a type of blood disorder)
Type 1 diabetes
COVID-19 is more likely to be severe among people who live in nursing homes or long-term care facilities, and among Black, Hispanic and Native American people, although more research is needed in this area. Additionally, recent studies suggest that COVID-19 symptoms are more severe among pregnant people than non-pregnant people. They are more likely to be admitted to the hospital or the intensive care unit (ICU). Pregnant people with COVID-19 also may be more likely to need a ventilator to breathe compared with non-pregnant people. According to recent data, there is an increased risk for deaths in pregnant people with COVID-19 than non-pregnant people.
If you think you may have been exposed to COVID-19, contact your health care provider.
Symptoms:
Mild symptoms to severe illness can appear within 2-14 days of being infected and include:
Fever
Chills
Cough
Shortness of breath or difficulty breathing
New loss of smell or taste
Fatigue
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea
Research has found that some pregnant people don’t have any symptoms of COVID-19, despite testing positive for the virus. More research is needed.This list does not include all of the possible symptoms. We will continue to update this list as we learn more. See the COVID-19 symptoms self-checker from the CDC.
Preventing Infection:
There’s no vaccine approved yet for COVID-19, but there are ways to protect yourself and your family from exposure to the virus. The best way to prevent getting sick is to avoid being exposed to the virus.
You should:
Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing or sneezing. If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
It’s especially important to wash before eating or preparing food or touching your face, and after:
Using the restroom
Leaving a public place
Blowing your nose, coughing or sneezing
Handling your mask
Changing a diaper
Caring for someone who is sick
Touching animals or pets
Avoid close contact:
Avoid close contact inside your home, especially with people who are sick. If possible, maintain 6 feet between the person who is sick and other household members.
Outside your home, put 6 feet of distance between yourself and people who don’t live in your household. Remember that some people without symptoms (asymptomatic) may be able to spread virus, so stay at least 6 feet (about 2 arms’ length) from other people.
Avoid crowded indoor spaces, like restaurants, bars and cafes.
Keeping distance from others is especially important for people who are at higher risk of getting very sick.
Changing a diaper
Caring for someone who is sick
Touching animals or pets
Use face coverings:
Cover your mouth and nose with a mask when around others. You could spread COVID-19 to others even if you do not feel sick. Masks offer some protection to you and are also meant to protect other people in case you are infected.
Everyone should wear a mask in public and when around people who don’t live in your household, especially when social distancing is difficult.
Masks should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or unable to take off the mask without help.
Do not use a mask meant for a healthcare worker, like a surgical mask or N95 respirator.
Continue to keep about 6 feet between yourself and others. The mask is not a substitute for social distancing.
See CDC’s information on how to create homemade cloth face covering.
Cover coughs and sneezes:
Always cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow and do not spit.
Throw used tissues in the trash.
Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not available, clean your hands with a hand sanitizer that contains at least 60% alcohol.
Clean and disinfect:
Clean and disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets and sinks.
If surfaces are dirty, clean them. Use detergent or soap and water prior to disinfection.
Then, use a household disinfectant. Most common EPA-registered household disinfectants will work.
Monitor your health daily:
Be alert for symptoms. Watch for fever, cough, shortness of breath, or other symptoms of COVID-19.
This is especially important if you are running essential errands, going into the office or to work, or in places where it may be difficult to keep a physical distance of 6 feet.
Take your temperature if symptoms develop. Don’t take your temperature within 30 minutes of exercising or after taking medications that could lower your temperature, like acetaminophen.
Follow CDC guidance if symptoms develop.
Keep up with your routine vaccines. Vaccines are an important part of protecting your health. Receiving some vaccines while you’re pregnant, like the influenza (flu) and Tdap vaccines, can help protect you and your baby. Talk with your provider about which vaccines you should get.
Eating a diet rich in nutrients also may help boost your immunity. A recent study recommends that pregnant people take micronutrient supplements and/or eat a variety of foods, including fresh vegetables and fruits, beans (legumes), grains (like high-fiber cereal), dairy products (like milk, yogurt and cheese), lean meat, fish, poultry and eggs.
What to do if infected:
If you have a fever or cough, you may have COVID-19. Call your health care provider and ask what you should do. You may also want to review the CDC’s self-checker tool.
Monitor your symptoms. If you get any of the followings signs, get medical care right away:
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
According to the CDC, most people have mild illness and may be able to recover at home. If you have mild symptoms, follow these recommendations to care for yourself and avoid spreading the disease to others:
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 cloth mask to cover your nose and mouth or a mask when you are around other people, even at home. CDC says you may use a scarf or a bandana to cover your nose and mouth if a mask 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 CDC’s complete disinfection guide for more information.
When can you be around others after having COVID-19?
If you think or know you had COVID-19 and had the symptoms of the virus, you can be around others after:
At least 10 days since symptoms first appeared and
At least 24 hours with no fever without fever-reducing medication and
Other symptoms of COVID-19 improving. However, loss of taste and smell continue for weeks or months after you recover. You do not need to continue to isolate if that is those symptoms continue but all others improve.
Most people do not require testing to decide when they can be around others. However, if your healthcare provider recommends testing, they will let you know when you can be around others again based on your test results.
If you tested positive for COVID-19 but had no symptoms:
If you continue to have no symptoms, you can be with others after 10 days have passed since you had a positive viral test for COVID-19. Most people do not require testing to decide when they can be around others. However, if your healthcare provider recommends testing, they will let you know when you can be around others again based on your test results.
If you develop symptoms after testing positive, follow the advice above for “if you think or know you had COVID-19 and had symptoms.”
If you were severely ill with COVID-19 or have a severely weakened immune system (immunocompromised) due to a health condition or medication:
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 healthcare 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.
If you’ve been around a person with COVID-19, you should stay home for 14 days after the last time you saw that person. However, if you had close contact with someone with COVID-19 and had COVID-19 in the last 3 months, have recovered and continue not to have COVID-19 symptoms, you do not need to stay at home.
Research shows that a person who has had and recovered from COVID-19 may have low levels of virus in their bodies for up to 3 months after diagnosis. This means that if you recovered from COVID-19 and are retested within 3 months of your first infection, you may continue to have a positive test result.
If you have recovered from COVID-19 and have new symptoms of the virus, you may need an evaluation for reinfection, especially if you’ve had close contact with someone infected with COVID-19. You should isolate yourself from other and call your provider to be evaluated.
What Pregnant and Breastfeeding People Need to Know
Check out COVID-19 Things to know if you're pregnant fact sheet. (English, PDF)
Additional versions of this fact sheet are available in Chinese Simplified, Chinese Traditional,
Hindi, Hmong, Vietnamese. Arabic
Farsi, HYE (Armenian),
Korean, Punjabi, Russian,
Somali, Spanish, and Tagalog, Mixteca Baja.
Translated documents are courtesy of Anthem.
Can you give COVID-19 to your baby during pregnancy?
It’s not clear whether a pregnant woman with COVID-19 can transmit the virus to her baby. Early data had suggested that babies born to mothers who were infected with the virus did not test positive for COVID-19. Recent data published in the Journal of American Medical Association (JAMA) and other journals suggest that transmission during pregnancy may be possible.
After birth, a newborn can become infected after being in close contact with an infected person, including the baby’s mom or other caregivers. A small number of babies have tested positive for the virus shortly after they were born. However, it is not clear whether these babies became infected before, during or after birth.
Read more from CDC about pregnancy and COVID-19.
The CDC recommends testing all newborns for COVID-19 who are born to people with COVID-19 (confirmed or suspected).
What complications can I or my baby have if I get COVID-19 during pregnancy?
What do we know:
Recent studies suggest that COVID-19 symptoms are more severe among pregnant people than non-pregnant people. They are more likely to be admitted to the hospital or the intensive care unit (ICU). Pregnant people with COVID-19 also may be more likely to need a ventilator to breathe compared with non-pregnant people.
Recent research shows that some pregnant people with COVID-19 do not experience fever or muscle aches like most other people with the virus do. More research is needed on this topic.
According to the CDC, there may be an increased risk of preterm birth and pregnancy loss among pregnant people with COVID-19.
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.
Breastfeeding
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.
If you have COVID-19 and you choose to breastfeed:
Use a cloth (or facemask—if available) to cover your face and nose.
Wash your hands and breast thoroughly before and after touching your baby.
Constantly clean surfaces you touch.
Properly clean your breast pump.
You can also use a breast pump to express your breast milk. Wash your hands thoroughly before using the pump. A healthy caregiver can feed the breast milk to your baby.
What do we know about COVID-19 and babies
Recent data shows that compared with adults, symptoms of COVID-19 are less severe in babies and children. However, among babies and children, babies younger than one year of age are at a higher risk of getting very sick from COVID-19.
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 chronic lung disease, asthma, heart conditions or issues with their immune systems may be at higher risk of getting very sick from COVID-19. CDC and partners 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.
How can you protect your pregnancy and future baby
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
Talk to your health care provider about how to stay healthy and take care of yourself during the COVID-19 pandemic.
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.
How can you get ready for labor and delivery
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.
If you have or may COVID-19, how can a hospital protect your baby after birth?
Your baby will be tested for COVID-19, whether he has signs of infection or not.
Your health care provider may recommend that you stay in a separate room from your newborn or at least 6 feet apart until the risk of spreading the infection is over.
If you and your baby are not separated, you can reduce the chances of your baby being infected by washing your hands thoroughly and wearing a facemask before each feeding.
Your providers may suggest other precautions, like keeping a curtain between you and your baby.
Dealing with stress
Take care of yourself. We are living through a public health emergency that is creating a lot of stress, fear and anxiety in families across the U.S. For new moms, caring for a new baby while feeling sore, tired and stressed can be a lot to handle. But there are several things you can do to care for yourself:
Take periodic breaks from watching or listening to the pandemic 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 members and friends how you’re feeling.
While COVID-19 has changed the way daily life looks for us, there are things you can do to help 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 are not alone. Staying connected with friends and family in a virtual way is important. Reach out, share your story and talk to other expecting and new moms online. Visit share.marchofdimes.org to learn more.
What Families with a Baby in the NICU Need to Know
Each hospital has specific rules about who and how many people can be in the NICU at one time. Ask the NICU staff about these rules and make sure you follow them.
Practice social distancing any time you are outside of the NICU and only leave your home for essential needs. Inside the hospital, practice social distancing with other adults as much as possible.
Take care of yourself. COVID-19 is a public health emergency that is creating a lot of stress, fear and anxiety in families across the U.S. The stress of having a baby in the NICU may be increased by the public health emergency and possible restrictions on being with your baby. But there are several things you can do to care for yourself:
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 the way daily life looks for us, 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. Reach out, 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 (also known as kangaroo 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.
How to help older children cope
You may wonder how you’re going to help your children cope when you’re having trouble coping yourself. You may also wonder how you will find time for your other children when your baby needs you, too. There are a lot of things you can do to help your older children:
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 brother or sister 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.
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:
Color pictures to put up near the baby’s bed.
Pick a favorite photo of themselves or the family to have near the baby’s bed.
Put together a photo album of pictures of the baby.
Create a storybook about the birth of their baby brother or sister.
Help get the nursery ready for when the baby comes home.
Stay In-The-Know
Find the latest information about COVID-19:
Follow March of Dimes and Nacersano online for the latest updates and share the information with friends and family. Check out @MarchofDimes and find us on Facebook.
Learn more about the disease and advice for pregnant people and families on our blog at newsmomsneed.org.
Stay up-to-date on upcoming events at marchforbabies.org or by calling us at 888-663-4637.
March of Dimes follows the COVID-19 guidelines and recommendations from the CDC. You can view real-time updates on the disease, guidance for pregnant people and travel advisories at here.
External Resources
Mom and Baby COVID-19 Intervention and Support Fund
March of Dimes established the Mom and Baby COVID-19 Intervention and Support Fund to address the urgent need for research, advocacy and education to protect moms, babies and families from COVID-19 and the unknown future effects of the virus.
Learn more about how you can support The Fund.
Help Protect Moms and Babies from COVID-19
Through the Mom and Baby COVID-19 Intervention and Support Fund, March of Dimes is addressing the urgent need to protect moms, babies and families from COVID-19.
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