COVID-19 & Pregnancy: All Your Questions, Answered

Nearly 30% of couples delayed pregnancy because of the coronavirus pandemic, according to a 2020 survey by the Guttmacher Institute. While this hesitation is likely due to many reasons, one of them may be the confusion and unanswered questions surrounding the impact of COVID-19 on conception and pregnancy. 

Are you considering having a child soon but aren’t sure if you should delay because of the pandemic? Our pharmacists picked some of the most common—and important—questions you may have to help you in your decision. Read on below for the answers. 

Does being pregnant mean you could face more serious side effects if you contract COVID-19? 

There was some confusion regarding this question earlier on in the pandemic. However, researchers are now more certain that pregnant women are indeed at higher risk for severe COVID than non-pregnant women. Pregnancy also increases the likelihood that you will need ICU care or ventilation if infected with COVID-19. Chronic conditions such as obesity, diabetes, and high blood pressure can also raise infection levels

Beyond impacting the mother, COVID-19 can also negatively impact the baby. COVID-19 often is accompanied by a high fever, which can increase the likelihood of birth defects during the first trimester of pregnancy.

This increased risk means you should take more serious safety measures to prevent infection in the first place. Follow the standard advice such as wearing a protective mask, staying at least six feet away from others, and washing your hands frequently. But you may also want to try to stay at home as much as possible, even if your state is relaxing its stay-at-home measures. You can reduce the frequency of common errands by using grocery delivery services and switching to an online pharmacy. 

Can I pass COVID-19 to the fetus? 

More research is still needed to answer this question. However, doctors believe that it is very rare to pass COVID-19 to the fetus based on placenta testing and anecdotal reports. The CDC states that it is “uncommon” for mothers who were COVID-19 positive during pregnancy to pass the virus to their newborn. Cases of severe COVID-19 in newborns are rare, and most newborns who do catch the virus have mild or no symptoms. Signs of a COVID-19 infection in a newborn include:

  • Fever
  • Lethargy
  • Runny nose
  • Cough
  • Vomiting
  • Diarrhea
  • Poor feeding
  • Shallow breathing

Contact a healthcare provider if your baby exhibits these symptoms. If they have trouble breathing, call 911 or seek emergency care immediately. 

What happens if I get COVID-19 right before giving birth? 

The American Academy of Pediatrics (AAP) has released a set of guidelines for women who become infected with COVID-19 right before birth. They suggest that you and your baby can still share a room, but that you should keep at least 6 feet away from your baby as much as possible. Additionally, they recommend you wear a mask and wash your hands frequently when taking care of your newborn. While there is little research on the potential transmission of COVID-19 through breastmilk, medical experts appear to think it is unlikely

Once you leave the hospital, it is ideal to have someone who is uninfected and low-risk for COVID-19 to take care of your baby until you are no longer contagious. However, if you are unable or do not want to use another caretaker, then continue to take extra precautions around your baby such as washing your hands and wearing a mask. Do not put a face covering of any kind on a baby.

Should I delay getting pregnant because of COVID-19? 

At this time, there is no official guidance from health officials suggesting that you delay conception. That means this is really a personal decision for you to decide. Although waiting may mean delaying adding a new member to your family, there are a few reasons why some couples have chosen to delay. Medically speaking, you might be at an increased risk of infection. Additionally, the nature of the pandemic might mean you can’t celebrate milestones (such as a baby shower) with friends and family or have relatives involved with childcare. 

Is it safe to get the COVID-19 vaccine if I’m pregnant? What if I’m trying to conceive? 

Both the Centers for Disease Control (CDC) and the American College of Obstetricians and Gynecologists (ACOG) recommend the COVID-19 vaccine for women who are pregnant or planning on conceiving. That’s because pregnancy increases your risk for a more severe COVID-19 infection. 

While it’s true that pregnant women were not specifically included in the Moderna and Pfizer-BioNTech vaccine trials, the vaccines are considered safe for these populations. Medical experts overall consider the high likelihood of risks associated with COVID-19 infection for pregnant women to far outweighs the low likelihood of the vaccine posing any sort of risk. In other words, you’re better off betting on the vaccine than taking the chance of getting COVID-19. 

Although both  Moderna and Pfizer-BioNTech plan on further researching their vaccines in pregnant patients, it’s not uncommon that this population is studied last. Given the sensitive nature of childbearing, pregnant women are typically not included in studies. A small number of participants did become pregnant while in the vaccine trials (both in the placebo and vaccinated groups), and they did not experience any negative side effects. There were four adverse pregnancy outcomes, but they all happened to patients in the placebo group who did not receive the vaccine. 

Once you receive the COVID-19 vaccine, it is considered safe to try conceiving straight away. You do not need to delay. One important note though: fever is a known (and normal!) side effect of the vaccines. However, fevers need to be controlled during pregnancy. If you are pregnant and experience a fever from the vaccine, ACOG recommends taking acetaminophen (not ibuprofen). This is an over-the-counter fever and pain reliever that is safe during pregnancy. 

It’s also recommended that you get the flu vaccine and Tdap (whooping cough) vaccine. As always, speak with your OBGYN and/or doctor directly if you have any concerns. 

Does the COVID-19 vaccine affect IVF? 

One study suggests that having a fever can interfere temporarily with IVF treatments, and fever is a known symptom of COVID-19. However, this study was small, and much more research is still needed. Both the American Society for Reproductive Medicine (ASRM) and the American College of Obstetricians and Gynecologists (ACOG) have stated that women who are trying to conceive should still get the COVID-19 vaccines when available to them. 

What doctor visits should be in-person and which ones can be virtual?

Prenatal care is still very important for the health of both your baby and yourself. At the same time, you want to limit exposure to the virus. Prenatal care will look different due to COVID-19, but the exact ratio of in-person versus virtual visits will depend on your specific doctor’s safety procedures and what trimester you are in. 

Generally speaking, doctors have converted as many visits into virtual meetings as possible to limit the risk for both yourself and the doctor. Your first visit will most certainly be in person. After that, most early prenatal checkups can happen virtually (except for a few appointments, such as a blood draw or an anatomy scan at 19 weeks). Childbirth and breastfeeding classes have also been moved online in most cases. 

In later trimesters as more blood work or ultrasounds are needed, you’ll need to go in person. It’s important to note that no matter the COVID-19 risk, you should immediately call your doctor for guidance or visit an emergency room if you notice the following warning signs

  • Blurred vision
  • Decreased fetal movement
  • Elevated blood pressure
  • Increased swelling in the arms, legs, or face
  • Severe abdominal pain
  • Severe headache
  • Vaginal bleeding

You should also seek medical attention if you notice any COVID-19 symptoms, including fever, cough, shortness of breath, chills, severe fatigue, loss of taste or smell, or sore throat. 

What’s it like to give birth during COVID-19? 

The ACOG still recommends hospitals and hospital-based birthing centers as the safest places to give birth, even during COVID-19. That being said, many hospitals have developed additional safety measures in order to limit risk to you, other patients, and healthcare staff. Depending on the hospital, visitors might be limited. The amount of time you can stay in the hospital after given birth might also be shortened.  You’ll need to call your specific hospital in order to learn their policy. 

While we are a year into the pandemic at this point, there is still a lot more research needed to fully understand the effects of COVID-19 on pregnancy. If you have any other questions or concerns, feel free to reach out to one of our pharmacists or talk with your doctor directly.

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