Pregnancy is an exciting — and stressful — time. Your mind races with a zillion questions and concerns ranging from mild (but not silly — there are no silly questions when you’re pregnant) to very serious.
A common question is how illness affects the baby while you’re pregnant. You should always let your doctor know if you develop a fever during pregnancy because certain viruses may affect your baby’s health. Examples include:
- cytomegalovirus (CMV)
- varicella-zoster
- Zika virus
- rubella
- parvovirus B19
- herpes
- HIV
In 2019, a new virus hit the world scene and spread rapidly: a novel coronavirus, responsible for the respiratory disease COVID-19. With Zika virus and its risks of birth abnormalities still fresh on many people’s minds, pregnant women may have added another worry to their growing lists.
And in 2020, the World Health Organization (WHO) declared the global outbreak of COVID-19 a “public health emergency of international concern.” Those are some scary words.
COVID-19 is still a new disease that hasn’t been well studied. How it affects pregnant women and their developing babies isn’t fully known. And that’s nerve-wracking.
But before you panic, read on. Here’s what you need to know about the new coronavirus if you’re pregnant or planning to become pregnant.
Coronaviruses are a family of viruses that circulate in both humans and animals and can cause everything from the common cold to more serious respiratory illnesses.
In late 2019 a new coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), surfaced in humans in Wuhan, China. Experts aren’t exactly sure how the virus originated or spread, but they suspect it may have transferred to humans from contact with an animal.
The virus causes a respiratory disease called COVID-19.
COVID-19 is mainly a respiratory disease. Symptoms typically appear between 2 and 14 days after exposure to the new coronavirus. Data from people who acquired COVID-19 in China found a median incubation period of 4 days. The most common symptoms — whether you’re pregnant or not — are:
- dry cough
- fever
- shortness of breath
- fatigue
- sore throat
- headache
Call your doctor if you have any of these symptoms and are pregnant. You might need to be seen, and maybe even tested, but it’s important to give your doctor advance warning before going into the office so the staff can take precautions to protect their own and other patients’ health.
The virus hasn’t been extensively studied, so no one can say for sure.
But the Centers for Disease Control and Prevention (CDC) notes that pregnant women are more susceptible than others to all kinds of respiratory infections, such as the flu. This is partly because pregnancy changes your immune system and partly because of the way pregnancy impacts your lungs and heart.
Even so, as of March 2020, there’s no concrete evidence suggesting that pregnant women are more prone to COVID-19 than other people, says a 2020 study. And even if they do get the infection, the researchers go on to point out, they’re no more likely than others to get severe complications of the disease, like pneumonia.
Treatment for COVID-19 is similar to the treatment of other respiratory illnesses. Whether you’re pregnant or not, doctors advise:
- taking acetaminophen (Tylenol) for a fever of 100.4°F (38°C) or higher
- staying well hydrated with water or low-sugar drinks
- rest
If Tylenol doesn’t bring down your fever, you have difficulty breathing, or you start vomiting, call your doctor for further guidance.
Again, because the virus is so new, there’s little data to go on. But experts can pull from the past. The CDC notes that pregnant women who have gotten other, related coronaviruses have a greater chance of having worse outcomes than pregnant women who don’t get these infections.
Things like miscarriage, preterm birth, stillbirth, and having a more severe infection have all been observed in pregnant women with other coronaviruses. And a high fever in the first trimester of pregnancy, regardless of its cause, can lead to birth defects.
OK, take a deep breath. We know that sounds super scary. But all the news isn’t dire, especially when we look at pregnant women who have delivered while sick with this particular virus.
According to a WHO report that looked at a small sampling of pregnant women with COVID-19, the overwhelming majority didn’t have severe cases. Of the 147 women studied, 8 percent had severe COVID-19 and 1 percent were critical.
The Royal College of Obstetricians and Gynaecologists reports that while some Chinese women with coronavirus symptoms have given birth to preterm babies, it’s unclear whether the babies were born early because of the infection or because doctors decided to risk a premature delivery because the moms-to-be were unwell. They’ve also seen no evidence that this particular coronavirus causes miscarriage.
Judging from the women who have given birth while infected with this coronavirus, the answer is probably that it’s unlikely — or more accurately, that there’s no definitive evidence that it does.
COVID-19 is a disease that’s mainly passed from person to person through droplets (think the coughs and sneezes of infected people). Your baby can only be exposed to such droplets after birth.
In one tiny study looking at nine pregnant Chinese women infected with the new coronavirus in the last trimester of pregnancy, the virus didn’t show up in samples taken from their amniotic fluid or cord blood or in throat swabs of the newborns.
However, in one slightly larger study , three newborns born to women with COVID-19 did test positive for the virus. The other 30 newborns in the group tested negative, and researchers aren’t sure whether the babies who tested positive really contracted the virus in utero or if they got it shortly after delivery.
Whether you deliver your baby vaginally or via cesarean will depend on a lot of factors, and not just whether you have COVID-19.
But experts say a vaginal delivery is favorable to a cesarean delivery, provided you’re eligible for a vaginal delivery and aren’t recommended for a c-section due to other factors. Performing surgery on a body already weakened with a serious virus might cause additional complications, they note.
In the few studies that have been done on breastfeeding women with the coronavirus, the answer appears to be no. But experts caution that more research needs to be done before they can definitively say there’s no risk.
The CDC says if you’re a new mom who has COVID-19 (or suspects you might), talk to your doctor about the pros and cons of breastfeeding. If you do decide to breastfeed, you can help limit your baby’s exposure to the virus by:
- wearing a face mask
- washing your hands thoroughly before touching your baby; be sure to get under your nails and into the webbing of your fingers
- washing your hands thoroughly before handling a breast pump or bottle
- considering having someone who is well give the baby a bottle of expressed breast milk
No doubt you’ve heard them before, but they bear repeating:
- Wash your hands for 20 seconds with soap and water. In a pinch, use hand sanitizer with at least 60 percent alcohol. And skip the baby wipes — they don’t disinfect.
- Stand 6 feet away from people.
- Avoid touching your face, especially your mouth, eyes, and nose.
- Stay out of large crowds. In fact, the more you can limit your exposure to people, the better.
- Take care of yourself. Eat well. Get enough rest. Exercise if your doctor says it’s OK. A healthy body is better able than a run down one to ward off all kinds of diseases.
Like swollen ankles and constipation, worry is a constant companion when you’re pregnant. But it’s important to keep perspective.
This new coronavirus is serious business, but, pregnant or not, you’re not a sitting duck.
While much still needs to be learned about the virus, the little research that’s out shows that pregnant women with COVID-19 are no more likely than others to have severe disease. And the virus is not likely to be passed along to their babies during pregnancy or childbirth, according to limited data we have so far.
As the saying goes, it pays to be prepared, not scared. Simple steps like thorough hand washing and limiting your time in crowds can go a long way in protecting you and your baby.
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Pregnancy