Pregnant With COVID? Here's What to Do
Learn what the agencies that serve pregnant people say about birth plans, breastfeeding and when to call your doctor if you test positive.
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You've done everything to prevent getting COVID-19 during your pregnancy, including getting vaccinated and boosted, and wearing a mask even when others around you have dropped theirs. But still, you've tested positive from the most contagious form of the virus circulating in this phase of the pandemic. What do you do?
Take care of yourself and stay relaxed, first of all. While it's true COVID-19 does cause more severe disease in people who are pregnant compared to people of the same age who aren't -- and the risk of pregnancy and birth complications is higher in women who are sick -- the risk of severe illness is still low overall, especially for those who are fully vaccinated, according to the US Centers for Disease Control and Prevention.
Experts aren't entirely sure why pregnancy can raise a person's risk of developing severe COVID-19, but there are a few ideas. Changes in the body that occur during pregnancy could increase someone's chances of becoming severely ill with a respiratory disease like COVID-19. It may also be because a person's immune system is naturally depressed during pregnancy to prevent their body from rejecting the growing fetus, Dr. Ella Speichinger, an OB-GYN at University of Missouri Health Care, told CNET in May.
But the pandemic, like your growing belly, is changing by the day. Here's what the experts say now about catching COVID-19 during pregnancy.
Read more: Perinatal Depression: What It is and How to Cope
I tested positive while pregnant. Now what?
The CDC says that people who are pregnant and have COVID-19 symptoms should contact their health care provider within 24 hours. For most parents-to-be who have COVID-19, advice on what to do when sick will be similar to the advice for other people: Stay home, isolate from other people in your house and take care of yourself by resting and staying hydrated.
But to be safe, call your doctor if you have symptoms or test positive to see if they recommend you be seen or if they recommend any treatment. A long list of health conditions (pregnancy and being postpartum are two of them) can increase someone's risk of severe COVID-19, including hospitalization and death. If you're pregnant and also have a medical condition, such as diabetes (including gestational diabetes), asthma, high blood pressure, or if you have a high BMI, your doctor may recommend additional treatment.
Some research shows that high fever, during the first trimester especially, could cause problems in fetal development. If you run a fever from COVID-19, your doctor may recommend you take acetaminophen or a fever-reducing medication.
While not all treatments were directly studied for use in pregnant people, your doctor may recommend one if the benefits of treating COVID-19 for you and your baby outweigh the unknowns.
"We can provide treatment for COVID-19 in pregnancy," Dr. Jeanne Sheffield, a maternal-fetal medicine expert at Johns Hopkins University, said in a 2021 post. "Several of the medications currently in use are also being used for our pregnant women, and early studies have shown they can provide some benefit."
COVID-19 treatments available and believed to be effective against the omicron variant include Paxlovid, a monoclonal antibody therapy and remdesivir. Molnupiravir, a prescription antiviral pill that works differently than Paxlovid, is not recommended for pregnant people or anyone trying to conceive because of a potential for fetal harm seen in some animal reproduction studies.
According to the CDC, COVID-19 is unlikely to be passed through breast milk. However, your doctor may recommend pumping because close contact can spread the virus.
Giving birth and breastfeeding with COVID: Can COVID pass through breast milk?
According to the American College of Obstetrics and Gynecologists, you most likely won't need to change your birth plan if you test positive for COVID-19 before delivery, but talk with your OB-GYN or provider. Being sick with COVID-19 is "not a reason by itself" to need a cesarean section, the agency says.
If you give birth with COVID-19, the ACOG notes that, according to current reports, the risk of a baby getting COVID-19 does not change based on whether the baby stays in your room or in a separate room. Isolating your baby in another room may be encouraged, however, if you are very ill or if your baby is at high risk of getting very sick. (All newborns are at higher risk, but some may be born premature or have another health condition.)
Can COVID-19 pass through breast milk? It isn't likely, say the CDC and ACOG. But the ACOG recommends letting someone who isn't sick care for your newborn, if possible, and bottle feed your baby your breast milk to avoid passing them the infection.
Read more: Crib, Bassinet or Pack 'N Play: Where Should Your Baby Sleep?
Can I pass COVID to my baby during pregnancy?
The ACOG says that there are some reports of COVID-19 being passed to a baby because their parent was sick during pregnancy, but these reports are rare.
Impacts of COVID-19 on the pregnant person and their baby mostly center on delivery, as women with COVID-19 are more likely to give birth preterm or experience a stillbirth than women who don't have COVID-19.
The risks of COVID-19 for both the parent and child may be reduced if the parent was vaccinated before or during their pregnancy, however, as seen in a growing number of studies on pregnancy, COVID-19 and the vaccines.