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Covid-19 and Pregnancy
What you need to know about coronavirus disease 2019 (COVID-19) and pregnancy:
Pregnancy increases your risk for severe COVID-19 illness. COVID-19 can also lead to preterm delivery of your baby. Most babies who become infected with the new virus do not develop serious effects, but some do. It is important for you and your baby to stay safe during pregnancy and delivery.
Signs and symptoms of COVID-19 in newborns:
The following signs and symptoms may be from COVID-19, but they are also common in newborns. Your newborn's healthcare provider may recommend testing to confirm or rule out COVID-19. Your newborn may need a second test if the first is negative.
- Not moving arms or legs much, or being too sleepy to feed
- A runny nose or cough
- Fast breathing, or trouble breathing
- Vomiting, diarrhea, or not feeding well
If you think you, your baby, or someone in your home may be infected:
Do the following to protect others:
- If emergency care is needed, tell the operator about the possible infection, or call ahead and tell the emergency department.
- Call a healthcare provider for instructions if symptoms are mild. Anyone who may be infected should not arrive without calling first. The provider will need to protect staff members and other patients.
- The person who may be infected needs to wear a face covering while getting medical care. This will help lower the risk of infecting others. Coverings are not used for anyone who is younger than 2 years, has breathing problems, or cannot remove it. The provider can give you instructions for anyone who cannot wear a covering.
Call your local emergency number (911 in the US) or go to the emergency department if:
- You have trouble breathing or shortness of breath at rest.
- You have chest pain or pressure that lasts longer than 5 minutes.
- You become confused or hard to wake.
- Your lips or face are blue.
- You have a fever of 104°F (40°C) or higher.
Call your doctor if:
- You have signs or symptoms of COVID-19. Try to call within 24 hours of when you start to feel sick.
- You do not have symptoms of COVID-19 but had close physical contact within 14 days with someone who tested positive.
- You have questions or concerns about your condition or care.
How the 2019 coronavirus spreads:
The virus spreads quickly and easily. The virus can be passed starting 2 days before symptoms begin or before a positive test if symptoms never begin. The following are ways the virus is thought to spread, but more information may be coming:
- Droplets are the main way all coronaviruses spread. The virus travels in droplets that form when a person talks, coughs, or sneezes. The droplets can also float in the air for minutes or hours. Infection happens when you breathe in the droplets or get them in your eyes or nose. Close personal contact with an infected person increases your risk for infection. This means being within 6 feet (2 meters) of the person for at least 15 minutes over 24 hours.
- Person-to-person contact can spread the virus. For example, a person with the virus on his or her hands can spread it by shaking hands with someone.
- The virus can stay on objects and surfaces for a short time. You may become infected by touching the object or surface and then touching your eyes or mouth.
- An infected animal may be able to infect a person who touches it. This may happen at live markets or on a farm.
Protect yourself and your baby while you are pregnant:
If you have COVID-19 during your pregnancy, healthcare providers will monitor you and your baby closely. Work with your healthcare provider or obstetrician. If you do not have either, experts recommend you contact a local community health center or health department. The best way to prevent infection is to avoid anyone who is infected, but this can be hard to do. An infected person can spread the virus before signs or symptoms develop, or even if signs or symptoms never develop. The following can help keep you and your baby safe:
- Wash your hands throughout the day. Use soap and water. Rub your soapy hands together, lacing your fingers. Wash the front and back of each hand, and in between your fingers. Use the fingers of one hand to scrub under the fingernails of the other hand. Wash for at least 20 seconds. Rinse with warm, running water for several seconds. Dry your hands with a clean towel or paper towel. Use hand sanitizer that contains alcohol if soap and water are not available. If you must go out, wash your hands before you leave your home and when you get home. Wash your hands after you put items away. Be careful about what you touch while you are out.
- Protect yourself from sneezes and coughs. Turn your face away and cover your mouth and nose if you are around someone who is sneezing or coughing. This helps protect you from the person's droplets. Cover your mouth and nose with a tissue when you need to sneeze or cough. Use the bend of your arm if you do not have a tissue. Throw the tissue away. Then wash your hands or use hand sanitizer.
- Make a habit of not touching your face. If you get the virus on your hands, you can transfer it to your eyes, nose, or mouth and become infected.
- Follow worldwide, national, and local social distancing guidelines. Social distancing means staying far enough away physically from others that the virus cannot spread from one person to another. If you must go out, avoid crowds and large gatherings. Gatherings or crowds of 10 or more individuals can cause the virus to spread. Avoid places such as parks, beaches, sporting events, and tourist attractions. For events such as parties, holiday meals, religious services, and conferences, attend virtually (on a computer), if possible.
- Wear a face covering (mask) around anyone who does not live in your home. A covering helps protect the person wearing it from being infected or passing the virus to others. Do not wear a plastic face shield instead of a covering. You can use both together for extra protection. Use a disposable non-medical mask, or make a cloth covering with at least 2 layers. Cover your mouth and your nose. Securely fasten it under your chin and on the sides of your face. A face covering is not a substitute for other safety measures. Continue social distancing and washing your hands often. Do not put a face shield or covering on your newborn. These increase the risk for sudden infant death syndrome (SIDS).
- Stay at least 6 feet (2 meters) away from anyone who does not live in your home. Keep this distance every time you go out of your home and are around another person. Do not shake hands with, hug, or kiss a person as a greeting. Stand or walk as far from others as possible, especially around anyone who is sneezing or coughing. If you must use public transportation (such as a bus or subway), try to sit or stand away from others. Do not go to someone else's home unless it is necessary. Do not go over to visit, even if you are lonely, or the person is. Only go if you need to help him or her.
- Stay safe if you must go out to work. Keep physical distance between you and other workers as much as possible. Follow your employer's rules so everyone stays safe.
- Clean and disinfect high-touch surfaces and objects in your home often. Use disinfecting wipes or make a solution of 4 teaspoons of bleach in 1 quart (4 cups) of water. Clean surfaces and objects in the room where your baby will be sleeping, especially right before you give birth. Wash your hands after you clean and disinfect. Be careful with cleaning products. Read the labels to make sure they are safe to use during pregnancy. Open windows to make sure you have good ventilation.
What you can do to have a healthy pregnancy during the COVID-19 outbreak:
- Keep all prenatal and postnatal appointments. You may be able to have certain prenatal appointments without having to go into the provider's office. Some providers offer phone, video, or other types of appointments. You may also be able to get prescriptions for a few months at a time. This will help lower the number of trips you need to make to the pharmacy for refills. If you do need to go into your provider's office, take precautions. Put a face covering on before you go into the office. Do not stand or sit within 6 feet (2 meters) of anyone in the waiting room, if possible. Do not stand or sit near anyone who is not wearing a face covering.
- Get recommended vaccines. A COVID-19 vaccine is a shot given to help prevent infection caused by the novel coronavirus. The vaccine is not available to you while you are pregnant. Your healthcare provider can give you more information about when a COVID-19 vaccine may be available to you. Get the influenza (flu) vaccine as soon as recommended, usually starting in September or October.
- Take prenatal vitamins as directed. Your prenatal vitamins should contain folic acid. You need about 600 micrograms (mcg) of folic acid each day during pregnancy. Folic acid helps to form your baby's brain and spinal cord in early pregnancy.
- Eat a variety of healthy foods. Healthy foods are important, even if you take a prenatal vitamin. Healthy foods contain nutrients that help keep your immune system strong. Examples of healthy foods include vegetables, fruits, whole-grain breads and cereals, lean meats and poultry, fish, low-fat dairy products, and cooked beans. Do not have raw, undercooked, or unpasteurized food or drinks. Unpasteurized foods are foods that have not gone through the heating process (pasteurization) that destroys bacteria. Your healthcare provider or a dietitian can help you create healthy meal plans.
- Talk to your healthcare provider about exercise. Moderate exercise can help keep your immune system strong. Your healthcare provider can help you plan an exercise program that is safe for you during pregnancy. You may need to exercise at home if you cannot exercise outdoors, such as walking in a park. If you want to do pregnancy yoga or other group activities, be safe. Stay at least 6 feet (2 meters) away from others in the class, and the instructor. Wash your hands before you leave the building. Follow the facility's instructions for preventing infections.
- Try to lower your stress. You may be feeling more stressed than usual because of the COVID-19 outbreak. You may also feel stress from not being able to share your pregnancy with others. For example, you may not be able to have someone with you during prenatal visits or ultrasounds. Talk to your healthcare providers about ways to manage stress during this time. Pick 1 or 2 times a day to watch the news. Constant news watching about COVID-19 can increase your stress levels. Set a sleep schedule to go to bed and wake up at the same times each day.
- Do not smoke cigarettes, drink alcohol, or use drugs. Nicotine and other chemicals in cigarettes and cigars can harm your baby and your health. Alcohol can increase your risk for a miscarriage. Your baby may also be born too small or have other health problems. Certain drugs can be passed to your baby before he or she is born. Some can be passed through breast milk. It is best to quit cigarettes, alcohol, and drugs before you become pregnant and not start again after your baby is born. Ask your healthcare provider for information if you currently use any of these and need help to quit.
Protect your newborn during delivery and while you are in the hospital:
It is not known for sure if an unborn baby can be infected with the virus that causes COVID-19. Some newborns have tested positive for the virus. The newborns may have been infected before, during, or after birth. The greatest risk is for a newborn to be in close contact with an infected person. Your baby may be tested for the virus soon after being born if you have COVID-19. He or she may be tested again before you leave the hospital. This depends on whether your baby has any signs or symptoms of COVID-19. You will be able to make choices for you and your baby during your hospital stay. Talk to healthcare providers about the following:
- Ask about temporary separation if you have COVID-19. Temporary separation means your newborn is moved to a different room from you. You will be able to make the decision if you want to do this. Separation will help lower your newborn's risk for being infected. You will still be able to give your newborn breast milk. You may need to pump the milk from your breasts. Someone who does not have COVID-19 will then feed the pumped milk to your newborn. You may instead choose to have your baby brought to you when you want to breastfeed. Take precautions to keep your baby safe. Wash your hands and the skin around your nipples before you hold your baby. Wear a face covering while you breastfeed.
- Be careful if you have COVID-19 and do not choose temporary separation. Healthcare providers will keep your newborn at least 6 feet (2 meters) away from you as much as possible. Your newborn may be placed in an incubator. The incubator will help protect your newborn from infection. Always wash your hands and put on a face covering when you hold, touch, or have close contact with your newborn.
- Ask about visitors. The facility may not be allowing any visitors to newborns during this time. If you are allowed visitors, you may need to limit how many you can have at a time. Do not allow anyone who has known or suspected COVID-19 to visit. Even without signs or symptoms, the person can infect your newborn or others in the room. All visitors need to wash their hands and put on clean face coverings before entering your room. The face covering needs to stay on during the whole visit. Do not let anyone take the face covering down to make faces at your baby, talk, sneeze, or cough. Do not let anyone kiss you or your baby.
Protect your newborn at home:
- You can choose to continue temporary separation if you have COVID-19. You can do this if an adult who does not have COVID-19 can care for your newborn. Your healthcare provider can give you instructions on how to do this safely at home. Only have close contact with your newborn when needed. Remember to wash your hands and put on a clean face covering first. You may need to continue pumping your breast milk. A healthy adult can feed the pumped breast milk to your newborn. You may instead choose to have your baby brought to you when you want to breastfeed. Take precautions to keep your baby safe. Wash your hands and the skin around your nipples before you hold your baby. You will also need to wear a face covering while you breastfeed.
- Use face coverings safely. Everyone who has COVID-19 needs to wear a clean face covering while being within 6 feet (2 meters) of your newborn. This includes other children in your home who are 2 years or older. Do not put a face covering or plastic face shield on your newborn. Any covering increases your newborn's risk for sudden infant death syndrome (SIDS). Do not use coverings on children younger than 2 years or on anyone who has breathing problems or cannot remove it.
- Be careful about visitors. Continue precautions you used in the hospital. Do not allow anyone who has known or suspected COVID-19 to come over to see your newborn. Have visitors put on clean face coverings before they enter your home. Have them wash their hands as soon as they come in. The face covering needs to stay on during the whole visit.
- Keep all checkup appointments. You may be able to have some appointments by phone or video meeting. Other appointments will need to be in person, such as for vaccines. Vaccines are normally given to babies at certain ages. Until COVID-19 is under control, your newborn's provider will give you a vaccine schedule. It is important for your newborn to get all recommended vaccines.
What you need to know about breastfeeding:
Breastfeeding for the first 6 months decreases your baby's risk for respiratory (lung) infections, allergies, asthma, and stomach problems. Breast milk also helps your baby develop a strong immune system. Breast milk is considered safe, even if you have COVID-19. Experts currently believe the virus that causes COVID-19 does not spread in breast milk. Do the following to help protect your baby:
- Wash your hands before every breastfeeding or pumping session. Even if you do not have COVID-19, you can transfer the virus from your hands to your baby or the pump. Use soap and water to wash your hands whenever possible. Use hand sanitizer that contains alcohol if soap and water are not available.
- Clean and sanitize your breast pump after each use. Follow the manufacturer's directions for cleaning and sanitizing the pump. It is important not to use it until it is clean and sanitized.
- If you have COVID-19:
- Wear a face covering while you breastfeed or pump. This will help prevent you from passing the virus through droplets when you talk, cough, sneeze, or laugh. The virus can stay on surfaces such as a breast pump for hours to days.
- Have someone who is not infected bottle feed your baby, if possible. Have the person wash his or her hands with soap and water before each feeding. The person can feed your newborn pumped breast milk or formula.
Follow up with your doctor or obstetrician as directed:
Write down your questions so you remember to ask them during your visits.
For more information:
- Centers for Disease Control and Prevention
1600 Clifton Road
Atlanta , GA 30333
Phone: 1- 800 - 232-4636
Web Address: http://www.cdc.gov
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