COVID While Pregnant

What happens if you’re pregnant and get COVID-19?

If you’re pregnant and get COVID-19 (SARS-CoV-2), your overall risk for becoming severely ill is low. Even so, studies show that people who are pregnant are more likely to get seriously ill from COVID-19 than people who aren’t pregnant.

Even though medicine has come a long way since the COVID-19 pandemic, getting a positive COVID test can still cause you stress and worry. It’s normal to have even more stress and worry if you get COVID-19 while you’re pregnant. You’re adjusting to all the physical and emotional changes pregnancy brings, but now you have the added concerns about what COVID means for your pregnancy and how you can stay healthy. It might help to remind yourself that healthcare providers know more about the virus than they once did, and they’re learning more every day.

It’s important to contact your pregnancy care provider if you think you have symptoms of COVID-19 or get a positive at-home COVID test. They can best help you manage your symptoms and determine if you need to seek emergency care.

What are the risks of being pregnant with COVID-19?

If you’re pregnant, you’re at risk for severe complications from COVID due to changes in your respiratory system and immune system during pregnancy. Severe complications are any symptoms that require hospitalization, intensive care or being on a ventilator to help you breathe.

Your immune system works to protect both you and the fetus from illness. Some parts of your immune system get weaker because it’s giving some of your protection to the fetus, which can make you more susceptible to certain infections. Changes to your respiratory system like your diaphragm shifting upward and needing more oxygen can also lead to shortness of breath, even without having COVID in pregnancy.

Most pregnant people have mild symptoms of COVID and a low risk of severe complications. But studies suggest that if you have moderate or severe COVID-19 during pregnancy, your risk of the following complications may increase:

• Preeclampsia.
• Blood clotting disorders.
• Heavy bleeding right after giving birth.
• Preterm birth (delivering a baby before 37 weeks).
• Low birth weight (delivering a baby weighing less than 5 pounds, 8 ounces or 2.5 kilograms).
• Fetal growth restriction (the fetus isn’t growing at the average growth rate for its age).
• Fetal brain damage or respiratory issues (this is rare).
• Stillbirth (researchers are still determining the exact risk).

The complications tend to be highest in the third trimester (beginning at 29 weeks). But the actual overall chance of having a severe complication during pregnancy due to COVID is still quite low — less than 1%.

Can COVID cross the placenta?

The chances of transmitting COVID to the fetus are low. While it’s possible for the virus to cross the placenta, it’s rare. Factors like the gestational age of the fetus and how sick you become with the virus may play a role in transmission.

Studies from the National Institutes of Health (NIH) show that only a handful of babies have COVID-19 at birth, and it’s not fully known if they got the virus before, during or just after birth. Like adults, most newborns with COVID have mild symptoms and recover fully.

Who is more at risk for COVID while pregnant?

You may be at a higher risk for severe illness due to COVID if you’re pregnant and:

• Have a medical condition like diabetes, high blood pressure or heart disease.
• Have overweight or obesity.
• Have limited or no access to medical care for financial, social or other reasons.

Are the symptoms of COVID-19 the same during pregnancy?

Yes, the symptoms are the same. Most symptoms start as mild and flu-like, but they can become severe.

Mild symptoms of COVID-19 during pregnancy could include:

• Fever.
• Chills.
• Cough and nasal congestion.
• Headache and body ache.
• Fatigue.
• Loss of taste and smell.

You should seek emergency medical attention if you have any of the following severe symptoms:

• Trouble breathing.
• Pain or pressure in your chest.
• Confusion.
• Inability to wake up or stay awake.

What causes COVID-19?

A virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19. Coronaviruses are a family of viruses that can cause respiratory illness in humans. You get it from a person who already has the virus. This can happen in two ways:

• You breathe in respiratory droplets from someone who has the virus. For example, a person coughs or sneezes near you and you breathe in those particles.
• You touch a contaminated surface and then touch your nose, eyes or mouth. The virus can survive for short periods on surfaces like doorknobs, countertops and railings.

How is COVID diagnosed during pregnancy?

A COVID-19 diagnosis in pregnancy is the same process as a diagnosis when you’re not pregnant. Your healthcare provider may diagnose COVID based on symptoms and likelihood of exposure to the virus. A laboratory test that involves swabbing your nasal fluid is the only way to definitively diagnose COVID-19.

What should I do if I test positive for COVID while pregnant?

If you took an at-home COVID-19 test, the first thing you should do is contact your healthcare provider and let them know what symptoms you have. Your provider may diagnose COVID based on your symptoms and results of the at-home test, or they may order a laboratory test to confirm the diagnosis.

What can I do to treat COVID-19 if I’m pregnant?

Treatment for COVID-19 depends on the severity of your symptoms. If your symptoms are mild, your pregnancy care provider may recommend:

• Resting.
• Drinking extra fluids.
• Taking an over-the-counter (OTC) pain reliever like acetaminophen. Don’t take ibuprofen.
• Using a humidifier or inhaling steam to relieve congestion.
• Taking medication containing dextromethorphan to reduce coughing.

Sometimes, your provider will recommend medication to help treat COVID-19 during pregnancy:

• Antiviral medications, which typically come in a pill that you swallow. An example of an antiviral drug is Paxlovid™ (nirmatrelvir/ritonavir).
• Monoclonal antibody therapy. This type of therapy is intravenous (IV), which means you get it through a needle in your arm.

Ask your provider if they recommend a blood pressure monitor or pulse oximeter (pulse ox) to monitor your oxygen levels at home. They can let you know what symptoms are serious and what to do if you experience them.

If your symptoms become severe, your provider may recommend treatment in a hospital where you can receive extra care. While your chances of hospitalization are low, your risk of hospitalization is higher than a person who isn’t pregnant. This is mainly because your risk of serious complications is higher and your provider is acting out of caution to protect you and the fetus.

What can I do to avoid getting COVID while pregnant?

You can take the same precautions during pregnancy as you normally would to avoid getting COVID-19. Some of the actions you can take include:

• Getting the COVID-19 vaccine. This is the most effective way to protect yourself from the virus. Vaccination is safe and effective during pregnancy. Get the flu vaccine (and other vaccines your provider recommends), too.
• Washing your hands frequently. If you can’t wash your hands, use hand sanitizer with at least 60% alcohol.
• Avoiding contact with sick people.
• Maintaining distance from people at crowded, indoor events. Other precautions can include wearing a mask or staying away from large events entirely.
• Avoiding touching your eyes, nose and mouth unless you know your hands are completely clean.
• Disinfecting doorknobs, electronic devices, counters and other high-touch surfaces frequently.
• Attending your prenatal appointments. Your provider can monitor your health and the fetus’s growth and guide you on managing health risks to your pregnancy.

Healthcare providers also know that having a high fever during pregnancy (especially in first 12 weeks) increases your risk of pregnancy complications. That’s also why it’s important to protect yourself from all types of illness during pregnancy, not just COVID-19.

Should I be worried about COVID-19 during pregnancy?

You might feel worried if you get COVID during pregnancy. On top of the usual pregnancy changes, you’re likely feeling sick and wondering if COVID will affect your delivery.

While there are risks, it’s important to know that most pregnant people who get COVID-19 experience mild symptoms and fully recover. Talk to your healthcare provider about your concerns and what severe symptoms to watch out for.

Can COVID during pregnancy cause birth defects?

Research is still ongoing about the effects of COVID-19 on a fetus. But most studies show that birth defects (congenital disorders) due to COVID-19 are rare.

How do I take care of myself if I have COVID while pregnant?

It’s important to communicate with your healthcare provider and follow their advice. They can assess your symptoms and let you know what symptoms require immediate medical attention.

Remember, taking care of yourself is your top concern. Be sure to get plenty of rest and drink a lot of water. If you live with others, try to isolate yourself until you feel better.

When should I see my healthcare provider?

Contact your healthcare provider if symptoms of COVID-19 don’t improve after several days. Most cases of COVID are mild and symptoms go away slowly with time and lots of rest. Ask your healthcare provider what symptoms to watch out for or what to do if you don’t feel better.

When should I go to the ER?

You may need to go to the nearest ER if you have any of the following symptoms:

• Severe fever (higher than 103 degrees Fahrenheit or 39 degrees Celsius).
• Diarrhea and vomiting.
• Trouble breathing.
• Chest pains.
• Disorientation or confusion.
• Blue-tinged lips (cyanosis).
• Confusion, lethargy or having trouble staying awake.

What questions should I ask my healthcare provider?

Finding out you have COVID while pregnant can be scary and it’s natural to have lots of questions. Some of the questions you may want to ask your pregnancy care provider are:

• Is my baby at risk for getting COVID because I have it while pregnant?
• What symptoms are considered severe?
• What symptoms mean I should go to the ER?
• What are the potential complications of having COVID while pregnant?
• Do I have to quarantine or stay away from other family members?
• Will my birth plan be affected by having COVID?

A note from Cleveland Clinic

Being pregnant with COVID can be scary and overwhelming, to say the least. But it may help to know that studies show most pregnant people who get COVID experience mild symptoms and recover fully. While it’s true that you may be at a higher risk for complications from COVID-19, the chances of your baby being born sick or having lasting effects are very low. If you do test positive for COVID, know that your healthcare team will give you the best possible care, and the best thing you can do is focus on taking care of yourself.