What happens if I get COVID while pregnant?

It's entirely possible to become infected with COVID-19 while pregnant, especially with new variants emerging all the time. We're still learning about the disease, but we already have a good amount of information about prevention, effects, and treatment during pregnancy. Here's what to know about COVID during pregnancy.

What are the symptoms of COVID in pregnancy?

The symptoms of COVID are the same whether you're pregnant or not. Some people have very mild symptoms, or no symptoms at all. If you do have symptoms, they may include:

• Fever
• Cough
• Shortness of breath (beyond the beyond normal shortness of breath in pregnancy)
• Loss of smell or taste
• Chills
• Body or muscle aches
• Sore throat
• Runny nose
• Nausea or vomiting
• Diarrhea

Go to the emergency room or call 911 if you have:

• Difficulty breathing
• Pain or pressure in your chest
• Sudden confusion
• Unresponsiveness
• Blue lips or face

Learn more about pregnancy symptoms you should never ignore.

What if get COVID while pregnant?

The first step if you test positive is to call your healthcare provider for advice. It's a good idea to also call your provider if you've been exposed to the virus and develop symptoms, such as a fever or cough, even if you haven't tested positive. They'll give you instructions about what to do.

In addition to calling your provider, here are some other steps to take if you have COVID:

• Keep your distance from others as much as you can, including your family members at home.
• Follow the current CDC recommendations for isolatingOpens a new window. The Centers for Disease Control and Prevention recommends isolating for at least 5 days depending on your symptoms. If, after 5 days, you've been fever-free for 24 hours (without using fever-reducing medicine), and your symptoms are improving, you can end isolation. If your symptoms aren't improving, continue to isolate until you're fever free for 24 hours and your symptoms are getting better. If you never had symptoms, you can end your isolation period 5 days after you receive a positive test. However, if you had moderate illness (you experienced shortness of breath or difficulty breathing) or severe illness (you were hospitalized), it's recommended you isolate for 10 days. It's a good idea for everyone, regardless of when your isolation period ends, to wear a mask for 10 days out in public and at home.
• Stay home, except for necessary medical care. Call ahead and wear a mask if you go in for appointments.
• Take good care of yourself by drinking plenty of water to stay hydrated and getting plenty of rest to help your body fight the infection.
• If you're running a fever, take acetaminophen to reduce it. Also, many over-the-counter remedies are safe to take in pregnancy for congestion and cough. Ask your provider about medication that's safe to take while pregnant.
• Get a pulse oximeter (you can find them at most drug stores or through online retailers) and check your oxygen levels a few times a day. Call your doctor if you routinely measure under 94 percent.

Although most pregnant women who get COVID will have mild symptoms and go on to have healthy pregnancies, they do have an increased risk for severe illness.

A studyOpens a new window published in BMJ Global Health looked at data collected from over 13,000 pregnant women. The researchers concluded that having COVID-19 during pregnancy increases the risk of death, intensive care admission, mechanical ventilation, pneumonia, and blood clots among pregnant women.

The risk of getting very sick is highest in pregnant women who are 35 or older, or have certain health conditions such as obesity, high blood pressure, or diabetes. Complications are especially likely for unvaccinated expecting moms, as they're more likely to develop a serious case of COVID. (Learn more about getting the COVID vaccine during pregnancy.)

If you test positive for COVID, talk to your provider right away. They can recommend treatments that are safe during pregnancy and can help reduce your risk of becoming seriously ill.

Can I take Paxlovid during pregnancy?

Yes, you can take Paxlovid during pregnancy and while breastfeeding. Paxlovid (Ritonavir-boosted Nirmatrelvir) is an oral antiviral medication used to treat mild to moderate COVID-19 symptoms in adults with a high risk of the disease progressing. (Pregnant women fall into this category.) It's given for 5 days and is effective if started within 3 to 5 days of the beginning of symptoms. Most pharmacies have Paxlovid, but you'll need a prescription.

Remdesivir (Veklury) is another FDA-approved antiviral medication that has shown to be effective at treating moderate to severe COVID-19 infection. It's most effective when started within 7 days of first noticing symptoms. Remdesivir is most commonly given to hospitalized patients, intravenously, for 5 days. It can also be given daily in the outpatient setting, intravenously, for 3 days. Studies show that it's effective and safe to take during pregnancy and while breastfeeding.

(Another oral antiviral medication for use in COVID patients is called Molnupiravir, but it's not recommended for use in pregnancy.)

What if I get COVID in my third trimester?

If you get COVID in your third trimester, you'll want to talk with your doctor or midwife about what will happen if you deliver while you still have COVID (see below).

While the COVID virus rarely transfers to a baby during pregnancy, the chance may be higher if the mother has an active infection at the time of delivery, according to MotherToBabyOpens a new window, a service of the Organization of Teratology Information Specialists.

"However," MotherToBaby explains, "most infants who test positive soon after delivery have only mild or no symptoms, and fully recover from the virus. Severe illness may be more likely in infants who are born preterm or have other health problems."

What happens if I have COVID when it's time to deliver?

Most babies born to mothers with COVID do just fine, though there are increased risks. According to the study published in BMJ Global Health, babies born to women infected with COVID were more likely to be admitted to the neonatal intensive care unit (NICU) and to be born premature.

According to another studyOpens a new window of more than 342,000 pregnant women published in the American Journal of Obstetrics & Gynecology, having COVID-19 at the time of birth is associated with higher rates of preterm birth, preeclampsia, stillbirth, and emergency C-section delivery.

If you have COVID when you're getting close to your delivery date, review your birth plan with your healthcare provider. While you may need to make some changes in terms of visitors and your postpartum stay, in most instances you won't need to change other plans. The timing and method of delivery – whether you're having a vaginal birth or C-section, for example – can usually stay the same.

Staff will likely place you in an isolated area if you have COVID, and providers will take safety precautions, such as wearing masks or other protective equipment. If you already know you have COVID-19 before you go to the hospital or birth center, call ahead to let them know so you can be cared for effectively while taking the safety of other patients and medical staff into consideration. If they don't have COVID, your support person can likely stay with you, though they probably won't be able to come and go as normal.

After delivery, unless you're very sick or your baby's at high risk of getting very sick, your baby can stay in your room with you, though the crib may be kept at least 6 feet away from you as much as possible.

Could I give COVID to my baby during pregnancy or delivery?

It's unlikely. While some newborns (rarely) have tested positive for COVID-19 shortly after birth, most babies born to mothers who had COVID-19 during pregnancy don't get the virus themselves.

Transmission of COVID-19 through the placenta appears to be very rare and limited to cases where the mother was extremely ill with what doctors call a "large viral load" at the time of delivery. Newborns who tested positive shortly after birth may have had the virus transmitted during an active infection in the mother during or after birth, most likely through respiratory droplets.

There are now hundreds of documented cases where the virus wasn't transmitted to the baby during pregnancy or delivery. The risk is particularly low if steps are taken to prevent spread of the infection, such as wearing a mask and washing your hands frequently when caring for your baby.

Even when newborns do test positive for COVID-19, most have mild or no symptoms. If you have COVID prior to delivery or during, your baby will have some protection by the transfer of maternal antibodies across the placenta before delivery and through breast milk after delivery if you breastfeed.

Still, a newborn can get the virus if they're exposed to it, so it's important to take the following precautions after delivery if you have COVID:

• Wash your hands before touching your baby
• Wear a face mask while holding your baby. (Don't put a mask or any covering on your baby's face, though.)
• Keep your baby at least 6 feet away from you as much as possible
• Ask someone who's healthy to help care for your baby. Have them wear a mask and keep their hands washed.

Keep taking these precautions until:

• you've been fever-free for 24 hours without taking any fever medication
• it's been at least 5 days since your symptoms started, and
• all of your symptoms have improved

If you don't have symptoms, wait at least 5 days after your positive test result, but restart the clock if you develop symptoms within 10 days of being tested.

Contact your baby's doctor if your baby develops any signs or symptoms of COVID-19, including:

• Fever
• Lethargy
• Runny nose or nasal congestion
• Cough
• Vomiting
• Diarrhea
• Poor feeding
• Pink eye (conjunctivitis)

Get immediate medical attention – go to the ER or call 911 – if your baby has shallow breathing or difficulty breathing.

Will I be able to breastfeed my baby if I test positive for COVID-19?

Yes, and breastfeeding is recommended, even if you've tested positive for COVID-19. It's still safe and important for your baby to receive breast milk. In addition to providing optimal nutrition, breast milk protects your baby from infections. There's currently no evidence that babies can get COVID-19 through breast milk, but there is good evidence that antibodies – from vaccines, as a response to infection, or both – get passed on to your baby.

If you have COVID, minimizing the risk of transmission when you're near your baby will lower their chances of getting COVID-19. This means washing your hands before touching your baby and wearing a mask while nursing.

Another option is to pump your milk and have someone else bottle feed it to your baby until you're out of the quarantine period. Wear a mask when you pump your milk, and clean the pump well after each use.

How can I avoid getting COVID while pregnant?

Here's how to reduce your risk of getting COVID-19 while you're pregnant:

• Get your COVID vaccine. COVID vaccines are safe for pregnant women, women who are trying to become pregnant, and breastfeeding moms. While you can still get COVID after vaccination, being vaccinated helps protect you from serious illness.

• Wash your hands frequently, with soap and water, for at least 20 seconds. If soap and water aren't available, use a hand sanitizer with at least 60 percent alcohol.
• Attend your prenatal visits. If COVID-19 is currently spreading in your area, your provider may offer telemedicine or telehealth options (a visit over the phone or via online video call) to limit possible exposure to the virus.
• Follow the current guidelinesOpens a new window from the CDC on wearing a mask. When COVID-19 hospital admission level is medium or high in your area, consider wearing a mask for greater protection. You might also consider wearing a mask when COVID is spreading along with the flu. Well-fitting disposable surgical masks and KN95s offer good protection, and NIOSH-approved respirators (including N95s) offer the best protection.
• Limit interactions with people who might have been exposed to or infected with COVID-19, including people within your household, as much as possible.
• To limit your exposure, avoid crowded areas, especially indoors. Keep in mind that others can easily be carriers for COVID, even if they don't have the illness.
• Do everything you can to say healthy during your pregnancy, including eating healthy meals and snacks, exercising regularly, and getting plenty of rest.

Learn more:

• COVID symptoms in babies and children
• How to have a healthy pregnancy and baby
• Is it safe to take cold medicine while pregnant?
• Common pregnancy aches and pains