COVID-19 and Pregnancy

COVID-19 is a viral infection that was first identified towards the end of 2019. It is usually spread through close contact with an infected person.

Most pregnant women are no more likely to get COVID-19 than other healthy adults.

Some pregnant women do have an increased risk of catching the virus, for example if you have diabetes or are overweight (Body Mass Index over 25). 

Many women do not experience symptoms when infected with COVID-19. Symptoms you may experience include:

• high temperature (fever),
• shivering (chills)
• a new continuous cough
• loss of taste and/or smell
• shortness of breath
• tiredness and muscle aches
• headache
• sore throat
• blocked or runny nose
• loss of appetite and diarrhoea.

More severe infection can cause pneumonia and serious complications including life-threatening breathing difficulty, sepsis, blood clots, heart problems and death.

To confirm a diagnosis of COVID-19, you will need to take a test. This can be done at home, or at the hospital. For the most up to date information on testing, see the NHS information on testing for COVID or contact your healthcare professional. 

Most pregnant women who test positive for COVID-19 have no symptoms or only a mild cold or flu-like illness.

• You may have a higher chance of severe infection if you:
  •    have high blood pressure,
  •    have diabetes,
  •    are overweight (Body Mass Index over 25),
  •    are older than 35,
  •    have another medical condition,
  •    are from a minority ethnic group,
  •    live in an area of social disadvantage.

If you have COVID-19 infection in pregnancy, you are more likely to develop severe illness and need hospital care, compared to someone who is not pregnant. The risk of severe infection is highest in women who get COVID-19 in the last three months of pregnancy (after 28 weeks).You are more likely to need care in an Intensive Care Unit. 

You are also more likely to need an emergency caesarean birth compared to a pregnant woman without COVID-19.

What about ‘Long COVID’?

At present, it is not known whether pregnancy has any effect on the chance of developing ‘long COVID’ after having had COVID-19 infection. 

If you have COVID-19 during pregnancy:

• Your baby does not have a higher chance of having a problem with their physical development (congenital anomaly.
• Your baby may not grow as well as they should, especially if you have other conditions which can affect your baby’s growth. If you have had COVID-19, you may be offered extra scans during pregnancy to monitor your baby’s growth.
• Your chance of stillbirth (your baby dying before birth) is increased from up to 5 per thousand to around 10 per thousand compared to a woman who does not have COVID-19 during pregnancy. This is not always related to how severe your COVID-19 infection is. However, stillbirth is still a rare event.
• You may have a higher chance of a late miscarriage (after 20 weeks).
• Your baby has a higher chance of being born early (prematurely). This is usually because your healthcare professionals recommend that your baby needs to be born to help with your treatment. Babies who are born prematurely may have a range of health problems, which tend to be more serious the earlier they are born.

If you have COVID-19 during pregnancy or at the time you give birth, the chance of your baby catching the virus is very low. It is safe for you to have skin-to-skin contact with your baby after they are born. Even if your baby does catch COVID-19 infection soon after birth, they usually remain well.

The most effective way to protect yourself is to be vaccinated.

• Vaccination dramatically reduces your chance of needing hospital admission and developing severe infection.
  Being vaccinated against COVID-19 will:
• Reduce your chance of having COVID-19 infection.
• Reduce your chance of having severe infection which requires admission to hospital.
• Reduce your chance of having very severe infection needing intensive care. Almost all pregnant women who are admitted to intensive care units have not been vaccinated.
• Protect your baby from catching COVID-19 and needing admission to hospital with COVID-19 in the first 6 months of their life.

There are also simple things you can do in your daily life that will help reduce the spread of COVID-19 and other respiratory infections:

• Let fresh air in if meeting others indoors.
• Practise good hygiene:
  •    wash your hands
  •    cover your coughs and sneezes
  •    clean your surroundings frequently
  •    Think about wearing a face covering if you are in close contact with other people or in crowded places.

If you work, your employer is required to carry out a pregnancy risk assessment for you as an individual to ensure your working environment is safe for you.

If you think you might have COVID-19 you need to follow the current NHS advice which applies to everyone.

Try to stay at home and avoid contact with other people. Take extra care to avoid close contact with anyone who is at higher risk of getting seriously ill from COVID-19.

Speak to your healthcare professional or maternity team – they will advise you what to do. 

If you have mild symptoms, you will be advised to stay at home. To look after yourself at home, try to keep well hydrated and mobile. You may be advised to have treatment to prevent you getting blood clots if you are at higher risk of this. Your maternity team will assess your risk and arrange this if needed.
You can go back to your normal activities when you feel better.

If you feel your symptoms are worsening or if you are not getting better, this may be a sign that you are developing a more severe infection that requires hospital admission and specialised care. You should contact your maternity team, GP, or use the NHS 111 online service (or NHS 24 in Scotland) for further information and advice. In an emergency, call 999.

Seek medical advice as early as possible if you have any questions or concerns about you or your baby. This advice is important for all pregnant women, but particularly if you are at higher risk of becoming seriously unwell. 

It is important that you still attend your appointments and scans. If you have an appointment scheduled, tell your maternity unit that you think you have COVID-19 before attending. Your appointment may be rearranged or carried out by phone or video. If you have a scan appointment, depending on the reason for the scan, it may be rearranged, or you may need to attend at a different time to reduce contact with others.

• Oxygen
• Steroids
• Help with your breathing, which in severe illness, can mean admission to the intensive care unit for extra support.  
• Specific medications and antibody treatment.

•  Wash your hands. 
• Try to avoid coughing or sneezing on your baby. 
• Consider wearing a mask or face covering while feeding.