COVID-19 & pregnancy: What you need to know

pregnant woman reading an iPad while lounging on her bed

If you’re pregnant, planning to get pregnant, or have a newborn, you may have questions or concerns about how COVID-19 could affect you and your baby. 

First, it’s important to get the COVID-19 vaccine and booster. Being pregnant increases the risk for severe COVID-19. And having COVID-19 during pregnancy increases your risk for giving birth prematurely.1 The good news is that the COVID-19 vaccines are safe and effective for pregnant people. Getting vaccinated is the best way to protect yourself and your baby.

To help keep you informed and prepared, we’ve outlined what you can expect from your prenatal and postnatal care, as well as what we know about COVID-19’s effect on pregnancy and newborn care. We’ve also shared our recommendations on the COVID-19 vaccine for pregnant and breastfeeding parents. As always, your health and safety are our top priority, and we’re here to support you and your family.

  

  

COVID-19 vaccine for pregnant and breastfeeding parents


 

Yes. Evidence shows that the benefits of receiving a COVID-19 vaccine outweigh the risks for pregnant people.1 The Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists both recommend that pregnant individuals get vaccinated against COVID-19. 

There are many reasons why pregnant people should get a COVID-19 vaccine:

  • Being pregnant increases the risk for becoming severely ill from COVID-19. These risks are higher among pregnant Latina and Black people.1,2
  • Pregnant people with COVID-19 are at increased risk for complications like preterm labor.1
  • Getting vaccinated during pregnancy builds antibodies that can be passed to your baby. Those antibodies might protect your baby from COVID-19.1

If you’re pregnant or breastfeeding, you can receive any FDA-authorized COVID-19 vaccine available to you. The CDC has found no safety concerns for pregnant people or their babies. There is also no evidence that COVID-19 vaccines can cause fertility problems.1 However, all women under 50 should be aware of the rare risk of thrombosis with thrombocytopenia syndrome (TTS) after receiving the Johnson & Johnson vaccine, and know that other FDA-authorized COVID-19 vaccines are available.

Talk with your care team if you have any concerns about getting the COVID-19 vaccine.

Yes. Pregnant people are at increased risk of severe illness, death, and pregnancy complications from COVID-19, and we encourage them to get COVID-19 vaccine boosters if they meet the criteria laid out by the Centers for Disease Control and Prevention (CDC). For pregnant people (and others with certain underlying conditions) who are at least 18 years of age and completed a two-dose vaccination series from Pfizer or Moderna, the CDC recommends that they may receive a booster if at least six months have passed since they completed the vaccination series. For pregnant people (and all others) who are at least 18 years of age and received a one-dose Johnson & Johnson vaccine, the CDC recommends a booster if at least two months have passed since they were vaccinated. Any of the COVID-19 vaccines can be used for booster vaccination, regardless of the vaccine product used for primary vaccination.
Vaccination of pregnant people builds antibodies that can be passed to the baby. Those antibodies might protect the baby from COVID-19.1   
We recommend the COVID-19 vaccine for people who are breastfeeding. Research shows that breastfeeding people who’ve been vaccinated against COVID-19 have antibodies in their breastmilk that could help protect their babies.1 You don’t need to delay or stop breastfeeding after getting the vaccine. Talk with your care team if you have concerns.
Visit kp.org/covidvaccine  to request a vaccine appointment at Kaiser Permanente. Please note, we encourage our eligible members to get the COVID-19 vaccine wherever there’s availability. Vaccines are available at no cost. 
In addition to the COVID-19 vaccine, we strongly recommend that all pregnant people receive Tdap and flu vaccinations. You can find a flu shot near you by visiting kp.org/flu .

 

Changes to your prenatal and postnatal care

  

Your safety is our top priority. To give you more options for care, we’ve expanded the availability of virtual visits for prenatal and postpartum care so you can get care from home.

Here’s what you can expect:

  • Your care team will let you know when you should come in for an in-person visit and when it’s appropriate to do a phone or video visit.* This decision will be based on the stage of your pregnancy and your health.
  • If a phone or video visit* is recommended but you’d like to be seen in person due to a health concern, let us know, and we’ll see you in person. 
  • Group care appointments have been changed to either in-person visits for individuals or online visits for groups.
  • Your care team may ask you to take additional steps to monitor yourself at home, such as checking your weight or blood pressure.
  • Your care team will tell you symptoms to watch out for, so you know when to call us or come in immediately for care.

Your prenatal appointments are an important part of your care during pregnancy, and we’ll continue to safely deliver that care as we respond to the pandemic.

*When appropriate and available.

To help prevent the spread of COVID-19, we’ve made changes to our visitor policies. Please understand that our visitor policies may continue to change depending on the spread of COVID-19 in different regions of the U.S. In some locations, visitors may not be allowed at prenatal appointments. To get up-to-date facility and visitor information, visit our Getting care during the COVID-19 outbreak  page, select your region, and scroll to the “Changes to our visitor policy” section.
When you come in for appointments, please adhere to the Centers for Disease Control and Prevention’s COVID-19 safety guidelines  . Wear a mask over your mouth and nose and remain at least 6 feet away from others, when possible.

In most of our facilities, our in-person prenatal education classes are now available online. Your care team can provide you with the online class information and registration links. We also have other online resources available to help you prepare:

To limit the spread of COVID-19, we’re not offering in-person tours of our hospitals and labor and delivery units. However, we do offer virtual tours in English and Spanish. The virtual tours can be viewed from any device with a web browser. To take a virtual tour, visit kp.org/maternity , click on “Find a hospital,” select your region, and the hospital where you plan to give birth, and select “virtual tour.”

If you’re having signs of labor, your water breaks, or you can’t feel the baby move, please call the Labor & Delivery department at your Kaiser Permanente facility for advice, or come to the hospital.

When you arrive at the hospital, someone will ask you about symptoms and possibly take your temperature. If you have a cough, fever, or shortness of breath, let them know.

If you’re healthy and have an uncomplicated birth, we’ll try to get you back to the safety of your home as quickly as possible. If your delivery is by cesarean section, we have protocols developed for early recovery so you can get home faster. Getting you home quickly and safely protects you and your baby.

To help prevent the spread of COVID-19, we’ve made changes to our visitor policies. Please refer to our visitor policy for the latest information at your hospital. To find our visitor policy, visit the Getting care during the COVID-19 outbreak  page, select your region, and scroll to the "Changes to our visitor policy" section.

When it’s time to go to the hospital to have your baby, your care team will take extra precautions to protect you and your newborn: 

  • Depending on the prevalence of COVID-19 in your area, you may be tested for COVID-19 either when you are admitted to the hospital or before a scheduled cesarean or induction.
  • Patients who have COVID-19, or are suspected of having COVID-19, are isolated from other patients to prevent infection of others.
  • Masks are required for all staff and visitors in the hospital.
  • Staff and visitors are welcomed and prescreened by greeters at the entrances of our medical facilities.
  • We’re following infection-control practices to prevent the spread of the virus. This includes your labor and delivery team.
  • Visitors are required to follow the latest visitor policy at their hospital. To find our visitor policy, visit the Getting care during the COVID-19 outbreak page , select your region, and scroll to the “Changes to our visitor policy” section.

We follow the latest guidelines from the Centers for Disease Control and Prevention (CDC), local public health officials, and our infectious disease experts. If you haven’t had a fever or any COVID-19 symptoms for 10 days after a positive test, you’re no longer at risk of infecting anyone else. Once you’ve passed that 10-day isolation window, you should go to all your appointments as instructed. If you’re still within that 10-day window, please let your care team know so they can explore phone or video care* options with you. 

*When appropriate and available

You should bring your baby in for scheduled well-child visits. The American Academy of Pediatrics recommends that you continue well-child visits and immunizations for your baby. These infant preventive visits generally take place in the following order after delivery: 2 to 3 days, 2 weeks, 2 months, 4 months, 6 months, 12 months, and 18 months.

To help keep you and your child safe, we have dedicated areas for pediatric care to limit your exposure to the virus. Before your appointment, you’ll be screened over the phone for COVID-19 symptoms. If you and your child aren’t showing any symptoms, you’ll most likely be scheduled for an in-person visit. However, if any symptoms develop between the time you set up the appointment and the visit, you must reschedule. Also, due to the pandemic, we may ask that only one parent or caregiver come with the child to the appointment. However, for the first month of your baby’s life, another adult may go with you to your well-baby visit.

It’s natural to feel stressed and anxious as we face the challenges of the COVID-19 pandemic. Here are some ways to help manage these feelings:

  • Online self-care resources — You’ll find a range of articles, tips, and audio activities to help you with anxiety, stress, and parenting.
  • Therapy and counseling — Call your care team if stress gets in the way of your daily activities for several days in a row.

If you need additional support managing your stress and anxiety, please tell your care team. We can help connect you to care.

Having healthy relationships and a safe home environment are very important for you and your baby during your pregnancy and after the birth. If you don’t feel safe at home or feel threatened by your partner, please contact us or seek emergency help by calling 911 right away. 

Here are a few ways to get help:

  • For immediate help, contact the National Domestic Violence Hotline. Help is available in over 200 languages over the phone at 1-800-799-SAFE (1-800-799-7233) and via online chat at thehotline.org.
  • Talk to your Kaiser Permanente provider about any violence or relationship issues. For nonurgent issues or support, you can call us 24/7 for advice or email your provider’s office. Your care team will connect you with resources and help you develop a safety plan.
  • Check out the myPlan app and website. Developed by Johns Hopkins University School of Nursing and recommended by providers in Kaiser Permanente’s Family Violence Prevention Program, the app is an online tool to help people who are experiencing abuse in a relationship.
  • Click here to learn more about intimate partner violence, types of domestic abuse, signs of domestic violence, how to get help, and more. 
  • You’ll be screened for intimate partner violence, substance abuse, and depression throughout your pregnancy. All your answers are completely confidential, and you should feel free to answer the questions as honestly as you can.

  

Effects of COVID-19 on pregnancy and newborn care

   

For information on the coronavirus and COVID-19, including signs and symptoms, visit kp.org/coronavirus .
Information on how COVID-19 affects pregnant people is limited. Although the overall risk of severe illness is low, pregnant people have a higher risk of severe illness from COVID-19 compared to nonpregnant people. Pregnant people who have health conditions like diabetes might be at even higher risk of severe illness. You might also be at risk for pregnancy complications such as preterm birth. COVID-19 is uncommon in newborns born to mothers with COVID-19 in pregnancy, but some newborns have tested positive for COVID-19 shortly after birth. We don’t yet know if the virus can be transmitted during pregnancy or if these newborns were infected after birth.3

If a mother tests positive or has symptoms of COVID-19, we may recommend that mother and baby stay in different rooms or maintain a distance of at least 6 feet.  As more information is uncovered about COVID-19 risk factors to newborns, there are still many unknowns. What we currently know:3

  • Newborns can be infected with the virus if they’ve had close contact for long periods of time with someone who has the virus, even if that person is asymptomatic.
  • The majority of newborns who got a positive test for the virus had mild, if any, symptoms and made full recoveries.
  • While some newborns have tested positive for the virus after birth, it’s not clear if they were exposed during pregnancy or during birth.

At this time, there's no information on the long-term health effects on infants with COVID-19 or those exposed to the virus during pregnancy.

In general, COVID-19 tests are only made available when you’re having symptoms of the disease or when you’re about to undergo a hospitalization or procedure. For information on testing, and when you should get a test, visit kp.org/coronavirus .
During your pregnancy, it’s important for you, and those who live or visit with you, to take steps to protect themselves from getting COVID-19. You can follow the CDC’s recommended safety precautions for people with and without the COVID-19 vaccination. Please see the CDC’s safety recommendations for pregnant people .

If you’re pregnant and you have a positive COVID-19 test or have been diagnosed with COVID-19, whether at Kaiser Permanente or at a non– Kaiser Permanente location, you don’t need to come to labor and delivery to be evaluated. Please stay home and isolate from other members of your household as much as possible. See below for when to call Kaiser Permanente or seek medical attention. 

If you took your test at Kaiser Permanente, your care team will receive a copy of your positive test results. If you haven’t been contacted by your ob-gyn department within 72 hours of receiving your positive result, please message your care team through kp.org/getcare to inform them you’re COVID-19 positive. We’ll review your electronic health record to determine the need for any potential next steps or further treatment.

If you took your test at home or outside Kaiser Permanente and it’s positive, please message your care team through kp.org/getcare to inform them you’re COVID-19 positive. We’ll review your electronic health record to determine the need for any potential next steps or further treatment.
 

Treatments

There are outpatient COVID-19 treatments, including new medications, that may be appropriate for some pregnant patients with COVID-19. Your care team will let you know if they are available and if you should receive them. 
 

Supplements

Pregnant patients should continue to take supplements recommended during pregnancy, such as prenatal vitamins and calcium. 

There’s no evidence to support or discredit the use of vitamin C, zinc, or vitamin D.
Melatonin should not be used in pregnancy.  

 

Existing medications recommended in pregnancy

Pregnant patients should continue other medications recommended in pregnancy. 

 

While you’re recovering at home, continue to monitor your illness. If your illness worsens, seek immediate medical care by calling your care team. Tell them you have COVID-19. If you’re told to come to the medical center, please wear your mask and inform the staff immediately that you have COVID-19. 

If you’re less than 20 weeks pregnant, you may be directed to urgent care or the emergency department. 

If you’re 20 weeks pregnant or more, you may be directed to labor and delivery. 

If you develop any life-threatening symptoms, such as trouble breathing, consistent pain in the chest, or bluish lips or face, call 911 and tell them you have COVID-19. If possible, put on your mask before help arrives. 

As with any illness, it’s best to stay isolated until all your symptoms have improved and you feel well. If you have any questions, talk to your care team to confirm whether it’s safe to stop home isolation.

Due to the current risk of COVID-19, the CDC is continually updating its travel recommendations. We recommend you review and consider these recommendations before traveling. Please see the CDC’s coronavirus travel recommendations  for the latest updates.

While you’re eager to introduce your new bundle of joy to your friends and family, it’s more important to keep your baby safe and healthy. Here are some guidelines to follow:

  • To help keep your baby safe, we recommend that you, and others around the baby, get the COVID-19 vaccine.
  • Limit visitors and in-person gatherings, even if people are vaccinated. It’s best to limit the number of people who touch or hold your baby. Instead of in-person visits, consider video calls or sharing pictures online with friends and family.
  • When visitors do come over, whether they’re vaccinated or not, they must wear a mask, wash their hands with soap and water, use hand sanitizer often, and maintain at least 6 feet of distance. 
  • No one with a cough, cold, or fever should visit the baby. 
  • Consider the risks of spreading COVID-19 to you and your baby before you decide to go out for activities other than doctor visits or child care. If you do go out, keep 6 feet of distance between your baby and people who don’t live in your household.

Evidence suggests that breast milk is unlikely to spread the virus to babies, and breastfeeding is considered safe.3

If you have COVID-19, or you’re waiting for test results, take extra care to avoid spreading it to your baby:

  • Wash your hands with soap and water for 20 seconds before touching the baby.
  • Wear a face mask while breastfeeding.
  • If using a breast pump, wash your hands before touching any pump or bottle parts, and follow recommendations for proper pump cleaning after each use.

By taking these important safety precautions, you’ll help keep your baby healthy and still bond during this special time.

We’re still learning about how COVID-19 affects infants and children. While some children and infants have been sick with COVID-19, most illnesses have been among adults. However, some research suggests that infants under 1, and those who have underlying medical conditions, could be at higher risk for becoming seriously ill with COVID-19 compared to other children.4 If you have any questions or concerns, contact your child’s pediatrician.

The most important thing you can do is keep your child home and away from others. Because COVID-19 can have the same symptoms as many viruses, including the flu, you should keep your child away from any high-risk adults (even if you don’t know for sure your child has COVID-19) until they’re symptom-free for 72 hours. This includes keeping your child away from anyone over 65, anyone with chronic medical conditions, and pregnant people, if possible. 

Care for your child as you would for someone with any typical cough or cold. Cold and cough medications aren’t recommended for children under 6. If you’re worried about your child’s illness, or if their symptoms are moderate, severe, or not going away, please call your care team.

If you believe you have an emergency medical condition, call 911 or go to the nearest hospital. For the complete definition of an emergency medical condition, please refer to your Evidence of Coverage or other coverage documents.

Don’t forget to stay up to date on your child’s vaccines, which protect them against a variety of preventable illnesses. This year more than ever, the flu vaccine is an essential way to make sure your child doesn’t get a life-threatening respiratory illness.

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Help coping with COVID-19

Right now, it’s especially important to care for the whole you — mind, body, and spirit. We have many digital tools and articles to help your physical and mental health.

  • Read articles on how to manage lifestyle changes amid the COVID-19 pandemic.

1COVID-19 Vaccines While Pregnant or Breastfeeding,” cdc.gov, accessed October 14, 2021.
 
2Pregnancy and COVID-19: What are the Risks?” MayoClinic.org, accessed October 14, 2021.
 
3COVID-19: Breastfeeding and Caring for Newborns if You Have COVID-19,” cdc.gov, accessed October 15, 2021. 
 
4COVID-19: Frequently Asked Questions,” cdc.gov, accessed October 14, 2021.