We know that everyone has been following the news about the worldwide spread of COVID-19 and that there are many questions and concerns about what this outbreak will mean during pregnancy locally. The brief comments below reflect both the limited knowledge and expert opinions as of March 20, 2020. Please note: most advice for pregnant women is similar to the advice for the general population in the United States.

The best sites for staying up to date are:

Q: Are pregnant women more susceptible to infection or at increased risk for severe illness, morbidity or mortality with COVID-19?

A: We do not currently know if pregnant women have a greater chance of getting sick from COVID-19 than the general public nor whether they are more likely to have serious illness as a result. Pregnant women experience changes in their bodies that may increase their risk of serious infection. Studies during outbreaks of other related coronavirus infections (SARS-CoV, MERS-CoV) as well as influenza have demonstrated that pregnant women are more susceptible to severe illness. However, so far, limited data from China do not show a greater risk for acquisition or severity of COVID-19 in pregnant women compared to other adults. Data from nine women in their third trimester with COVID-19 suggest that severe infection near the end of pregnancy may impact timing and route of delivery.

Q: Can pregnant women pass COVID-19 to their fetus during pregnancy?

A: In a small, published case series of pregnant women with COVID-19, the virus was not found in newborns or samples of amniotic fluid or breast milk. Although information is limited about intrauterine transmission for other coronaviruses (MERS-CoV and SARS-CoV), maternal to fetal transmission has not been reported for these infections either. Transmission of COVID-19 from mother to the newborn after birth, through infectious respiratory droplets, is a concern and there have been very few cases reported of newborns as young as a few days old with infection. To reduce the risk of this transmission, temporarily separating a mother who has suspected or confirmed COVID-19 from her baby may be recommended by the health care team.

Q: I am pregnant and a health care worker. Can I work with patients who are potentially infected with COVID-19?

A: Pregnant health care workers, as all health care workers, should be aware of and follow all updated infection control guidelines for their health care facilities to keep themselves and others safe in the health care environment. 

Q: I am pregnant and planning to travel this spring/summer. Should I cancel my trips?

A: Given the rapid spread of COVID-19 in the U.S. and around the globe, all patients, including pregnant women, are advised to avoid all travel domestically and internationally at this time. 

Always review the latest information and CDC advisories before embarking on any trip.

Q: I am pregnant and concerned about going to crowded places (public transportation, restaurants, work meetings). Should I avoid such social settings?  

A: The CDC and local health authorities now recommend that all individuals practice social distancing to limit their own exposures and to decrease the spread of the illness. As such, all people, including pregnant women, should avoid any gatherings, practice good hand hygiene and avoid touching the face. 

Visit the CDC site for steps you can take to prevent illness.

Q: I was in a crowded grocery store near a person that was coughing. Should I be tested for COVID-19?

A: No testing is indicated in this situation. The COVID-19 tests are currently only recommended for patients based on severity of symptoms and potential exposures. Testing guidance is evolving rapidly and indications for testing are likely to expand in the coming weeks. 

Q: I am pregnant and have fever, cough, myalgias, sore throat and headache. Could this be COVID-19?

A: While the data on new cases in Massachusetts is evolving quickly, at the time of this document, influenza and other respiratory viruses may still be more likely than community-acquired COVID-19. During pregnancy, appropriate diagnosis of and treatment for influenza remains of utmost importance.

Please call your OB office to report your symptoms. Your OB provider will work with the hospital’s infection control and infectious diseases consultants to determine if you need to be tested for COVID-19. They will provide instructions to you on where testing can be arranged, if needed.

Q: The office just called to delay my routine prenatal care appointment. How will my pregnancy be monitored for complications?

A: During the ongoing COVID-19 events, the Department of OB/GYN at Mass General is committed to keeping all our patients safe. Now, and in accordance with the hospital and public health recommendations, we are focused on essential care in the office and hospital settings. This allows us to promote recommended social distancing and focus our resources on those with urgent needs. We will defer appointments for those who are pregnant to when it is safe for your pregnancy. While we have eliminated some routine in person visits, we are working toward opportunities to check up on you and assess your pregnancy with calls or virtual/electronic visits where appropriate. Many appointments during pregnancy will still be held in person. We want to reassure you that we are always open 24/7 for all urgent care in the OB/GYN office, on Labor and Delivery and in the hospital. If you have an urgent question or concern, please call the OB office number which will be available day and night.

Q: If I develop symptoms of COVID-19 around the time of delivery, what can I do to protect my baby?

A: Transmission from mother to the newborn after birth, via contact with infectious respiratory secretions, is a concern. To reduce the risk of this transmission, temporarily separating a mother who has suspected or confirmed COVID-19 from her baby may be recommended by the health care team. This will be discussed in detail with you and your family at the hospital where you will have a chance to ask questions of both your OB provider and the baby’s newborn team. Mothers can still express breast milk and this milk should be fed to the newborn by a healthy caregiver.

At this time, there are no recommendations to separate asymptomatic women from their babies even if there has been a possible COVID-19 exposure. However, these recommendations could change as guidelines are rapidly evolving and hopefully testing will become more widely available for exposed individuals. 

Q: If I develop COVID-19 will I still be able to breastfeed?

A: Breast milk is the best source of nutrition for most infants. Although much is unknown about COVID-19, limited data to date has not identified coronavirus in the breast milk. A mother with confirmed or suspected COVID-19 should take all precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask, if possible, while feeding at the breast. If expressing breast milk with a manual or electric breast pump, you should wash your hands before touching any pump or bottle parts and follow recommendations for proper pump cleaning after each use. If possible, the infant should be fed the expressed breast milk by a healthy care giver.

Additional References

  • Mass General Coronavirus hotline: 617-724-7000
  • Mass General Obstetrics Program: 617-724-2229
  • Partners COVID-19 FAQs

This content was prepared by Ilona Goldfarb, MD, for the Department of Obstetrics and Gynecology. (Updated 3/20/2020)