Patient Education - COVID 19 & PREGNANCY

Are pregnant people at high risk for severe symptoms?

Experts do not yet know a lot about COVID-19 and pregnancy. From what they know so far, pregnant people do not seem more likely than other people to get the infection.

One study found that pregnant people with COVID-19 might be more likely to get very sick and need to stay in the intensive care unit ("ICU"). In pregnant people, the risk of getting very sick is highest in those who are age 35 or older, obese, or have high blood pressure or diabetes. But most people recover before having their baby, and do not need to stay in the hospital. Pregnant people are not at higher risk of dying from COVID-19 than other people of similar age.

What should I do if I have symptoms?

If you have a fever, cough, trouble breathing, 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. They will also tell you if you should be tested for the virus that causes COVID-19.

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 (womb). 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.

How is COVID-19 treated?

There is no known specific treatment for COVID-19. 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.

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.

Doctors are studying several possible treatments for COVID-19. In certain cases, doctors might recommend medicines that seem to help some people who are severely ill. They also might recommend being part of a clinical trial. A clinical trial is a scientific study that tests new medicines to see how well they work. But some medicines are not safe to take if you are pregnant.

Fever is a common symptom of COVID-19. If you are pregnant and get a fever, ask your doctor, nurse, or midwife what to do. Acetaminophen can be used to treat a fever and is generally safe to take during pregnancy.

Can COVID-19 be prevented?

There is not yet a vaccine to prevent COVID-19. But there are things you can do to reduce your chances of getting it. In general, it's a good idea to be extra careful about hand washing and avoiding sick people when you are pregnant.

To help slow the spread of COVID-19:

• Practice "social distancing. "This means keeping people, even those who are healthy, away from each other. It is also sometimes called "physical distancing." The goal is to slow the spread of the virus that causes COVID-19.
  Avoiding large groups and events is an important part of social distancing. But even small gatherings can be risky, so it's best to stay home as much as you can. When you do need to go out, try your best to stay at least 6 feet (about 2 meters) away from other people.
• Wear a cloth face mask when you need to go out. Experts in many countries recommend doing this. It is mostly so that if you are infected, even if you don't have any symptoms, you are less likely to spread the infection to other people. It might also help protect you from others who could be infected, although experts are still studying this.
  You can use a cloth or homemade mask to cover your mouth and nose. These work best if they have several layers of fabric. When you take your cloth mask off, make sure you do not touch your eyes, nose, or mouth. And wash your hands after you touch the mask. You can wash the cloth mask with the rest of your laundry.
• Wash your hands with soap and water often. This is especially important after being out in public. Make sure to rub your hands with soap for at least 20 seconds, cleaning your wrists, fingernails, and in between your fingers. Then rinse your hands and dry them with a paper towel you can throw away.
• If you are not near a sink, you can use a hand sanitizing gel to clean your hands. The gels with at least 60 percent alcohol work the best. But it is better to wash with soap and water if you can.
• Avoid touching your face with your hands, especially your mouth, nose, or eyes.
• Avoid traveling if you can. Some experts recommend not traveling to or from certain areas where there are a lot of cases of COVID-19. But any form of travel, especially if you spend time in crowded places like airports, increases your risk. If lots of people travel, it also makes it more likely that the virus will spread to more parts of the world.

Will my regular prenatal appointments change?

Your doctor 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:

• Your partner might not be able to join you for appointments
• If you have any symptoms of COVID-19, you will probably need to wear a medical mask during your appointments
• Your doctor might group certain tests together so you don't need to go in as often
• Your doctor 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?

You will be checked for fever and other symptoms of COVID-19 when you get to the hospital or birth center. This will happen earlier if you are scheduled to be "induced" or have a cesarean delivery ("c-section"). You might be tested for the virus, too. Even if you feel healthy, you should cover your nose and mouth with a cloth mask before going to the hospital. You can also expect to wear a mask during labor and delivery.

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 if possible. You will probably 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, your doctor or nurse might suggest staying apart from your baby until you get better. This will depend on how sick you are, whether your baby has been tested for the virus, and other factors. If you do hold your baby, 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. It is not known if the virus that causes COVID-19 can be passed to a baby through breast milk.

If you are sick, you might want to have another healthy adult feed your baby. If that is not possible, it's important to be extra careful when feeding or holding your baby, whether or not you breastfeed. Even though experts do not know if the virus can be spread through breast milk, you could pass it 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.

What can I do to cope with stress and anxiety?

It's normal to feel anxious or worried about COVID-19. If you are pregnant, you might feel sad about having to cancel celebrations and stay away from relatives and friends.

You can take care of yourself by trying to:

• Take breaks from the news
• Get regular exercise and eat healthy foods
• Try to find activities that you enjoy and can do in your home
• Stay in touch with your friends and family members

Keep in mind that most 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 and help slow the spread of the virus. But try not to panic.

What if I have other questions?

If you have other questions, talk to your doctor. 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.