As the COVID-19 pandemic continues to have a significant impact on daily life inside and outside of the hospital, there are many questions and concerns about what this outbreak means during pregnancy. The brief comments below reflect both available data and expert opinions as of 4/12/2020. Most advice for pregnant women regarding COVID-19 is similar to the advice for the general population in the United States.
The best sites for staying up to date are:
- CDC – guidance for higher risk populations
- Massachusetts Department of Public Health
- Mass General Coronavirus News and Information
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 and early experience at Mass General do not show a greater risk for acquisition or severity of COVID-19 in pregnant women compared to other adults.
Q: Can pregnant women pass COVID-19 to their fetus during pregnancy?
A: In all published case series of pregnant women with COVID-19 so far, the virus was not been 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 a few cases reported of newborns as young as a few days old with infection. To reduce the risk of this transmission, mothers who are infected themselves or with symptoms that suggest infection will need to pay close attention to hand hygiene and wearing a mask when caring for their infant. While in our hospital, mothers with suspected or confirmed COVID 19 will stay in the same room with their babies but the health care team will help to arrange the room so that the baby can be six feet away from the mother. When possible, whether in the hospital or at home, care should be provided to the infant by a healthy caregiver.
Learn more from the CDC >
Q: I am pregnant and a health care worker. Can I work with patients who are potentially infected with COVID-19?
A: Although information is still limited, pregnant women do not appear to be at higher risk of severe disease related to COVID-19. 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. Some facilities may want to consider limiting exposure of pregnant health care personnel to patients with confirmed or suspected COVID-19 infection, especially during higher-risk procedures (eg, aerosol-generating procedures), if feasible, based on staffing availability.
In order to promote further physical distancing and reduce as much as possible the risk for symptoms or infection at the time of delivery, pregnant women may consider stopping work at 37 weeks or at an earlier point if based on their individual circumstances their obstetric provider feels that delivery is anticipated earlier.
Q: I was in a 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 symptoms and potential exposures. Testing guidance is evolving rapidly and indications for testing are likely to expand in the next weeks. Your obstetric and/or primary care provider can guide you in evaluating symptoms and exposures and need for testing.
Q: I am pregnant and have fever, cough, myalgias, sore throat and headache. Could this be COVID-19?
A: 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, 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 physical distancing and focus our resources on those with urgent needs. We will defer some appointments for those who are pregnant, when doing so is safe for your pregnancy. In place of some deferred in person visits, we have begun using virtual/electronic visits where appropriate. It is important to understand that 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 which will be available day and night.
Q: I have heard that some hospitals are testing all women for COVID-19 who arrive to the hospital for labor—even women without any symptoms. Will I be tested when I arrive at Mass General?A: With guidance from infection control specialists and our colleagues in other states, Mass General, along with all our partner hospitals, will begin testing all women arriving to Labor and Delivery. This means that some patients who have no symptoms will be identified as COVID positive. We believe this will allow us to take the best possible care of all the mothers and babies on the unit.
Q: I have heard that hospitals are restricting visitors. Will I be allowed to bring a support person with me for labor and my postpartum stay?
Despite the many challenges posed by COVID 19, we are committed to helping pregnant women have the best labor and delivery experience possible—which includes having a support person in the room during labor. Given the ongoing pandemic, and in line with current hospital policy and needs to protect the health of our staff, the person who comes to support you must be free from symptoms of coronavirus infection.
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.
- Mass General Coronavirus hotline: 617-724-7000
- Mass General Obstetrics Program: 617-724-2229
- Mass General Brigham COVID-19 FAQs
This content was prepared by Ilona Goldfarb, MD, for the Department of Obstetrics and Gynecology.
Date originally published: 3/20/2020
Most recently updated: 4/15/2020
OB/GYN at Mass General
The Department of Obstetrics & Gynecology at Mass General consistently ranks among the best women's health care providers in the country, offering innovative treatments from leading experts in obstetrics, gynecology, infertility, cancer and urogynecology. Learn more about our department.