FAQ: COVID-19 and Pregnant Patients

Where can I get up-to-date information on COVID-19 in pregnancy?

Reliable sources on this subject include the following:

• American College of Obstetricians and Gynecologists (ACOG)
• California Department of Public Health (CDPH)

I am pregnant. Do I need to take special precautions to avoid COVID-19?

In general, pregnant people experience immune system and physiological changes that make them more vulnerable to viral respiratory infections. Pregnant patients are at risk for more severe illness from a COVID-19 infection.

Patients who are pregnant or trying to conceive should follow the same precautions as people who are not pregnant:

• Wash your hands often with soap and water for at least 20 seconds each time.
• If soap and water aren't available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.
• Avoid touching your eyes, nose and mouth with unwashed hands.
Don't go to work if you're sick. Cover your mouth and nose with a tissue when you cough or sneeze and throw the tissue in the trash. Then wash your hands with soap and water. Clean and disinfect frequently touched objects and surfaces.
• Depending on COVID-19 transmission patterns in your area, wearing a mask can help protect you. If you wear a mask, choose one that is well-fitting and multilayered. Don't use a mask with a valve; these masks allow droplet release, so they don't protect people near you.

Do pregnant people who get a COVID-19 infection have an increased risk of adverse pregnancy outcomes?

Since the onset of the pandemic, we have collected information on adverse pregnancy outcomes and COVID-19. Early pregnancy loss due to COVID-19 infection has not been observed (unlike with other related coronaviruses, such as SARS and MERS). There's also no evidence that COVID-19 causes birth defects, and there's no data suggesting that the virus routinely crosses the placenta and harms the newborn.

There is evidence, however, that pregnant patients with COVID-19 are more likely to experience severe illness. They're more likely to be hospitalized and admitted to the intensive care unit than patients who aren't pregnant. We also know that COVID-19 infection during pregnancy can increase the risk of preterm birth and stillbirth.

I am pregnant and have COVID-19. Is there treatment available?

Antiviral treatments are available to reduce the risk of severe COVID-19. Paxlovid (nirmatrelvir/ritonavir) is an oral antiviral medication that is recommended for patients at higher risk of developing more severe disease, including pregnant patients. The treatment must be started within 5-7 days of symptom onset to be effective. Contact your health care provider promptly after diagnosis.

Can a pregnant person pass the virus to the baby during pregnancy or delivery?

There have been reported cases of COVID-19 transmission between parent and fetus during pregnancy, but this is very rare. More commonly, a person with an active COVID-19 infection during delivery can pass the virus to the infant during close contact after birth. The COVID-19 virus has not been detected in breast milk and breastfeeding should continue if possible, while taking hygiene precautions.

Can I get a COVID-19 vaccine or booster if I'm pregnant or trying to get pregnant?

Leading public and professional health organizations strongly recommend vaccination if you are pregnant, planning to be pregnant, or lactating. Pregnancy increases the risk of severe complications from COVID-19, and the protection provided by the vaccine helps to keep parent and baby healthy. Multiple studies have shown that the COVID-19 vaccine has no adverse effect on fertility, miscarriage or other pregnancy outcomes. The COVID-19 vaccine may cause mild menstrual irregularities for one or two cycles after vaccination. Maternally transferred immunity after the COVID-19 vaccine has been shown to protect the newborn from infection for up to 6 months of age, until they are eligible for the infant vaccine.

Pregnant patients should get the most up-to-date booster formulation to maximize protection against actively circulating variants.

Guidance on the COVID-19 vaccine and pregnancy is available from the California Department of Public Health.