Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients
Reviewed by: Lisa Hollier, MD, MPH, FACOG, Baylor College of Medicine, Houston, Texas
Last updated: April 3, 2020 at 7:30 p.m.
Experts are learning more every day about the new coronavirus that causes COVID-19. The American College of Obstetricians and Gynecologists (ACOG) is following the situation closely. This page will be updated as we learn new information for pregnant and breastfeeding women.
Please note that while this is a page for patients, this page is not intended to provide specific medical advice and is for informational reference only. Medical advice should be provided by your physician or other health care professional.
Ob-gyns: Please refer to acog.org/covid19 for ACOG’s latest updates on COVID-19.
COVID-19 is a new illness that affects the lungs and breathing. It is caused by a new coronavirus. Symptoms include fever, cough, and trouble breathing. It also may cause stomach problems, such as nausea and diarrhea, and a loss of your sense of smell or taste. Symptoms may appear 2 to 14 days after you are exposed to the virus.
Current reports show that pregnant women do not have more severe symptoms than the general public. But researchers are still learning how the illness affects pregnant women. Doctors urge pregnant women to take the same steps as the general public to avoid coronavirus.
How can COVID-19 affect a fetus?
It’s too early for researchers to know how COVID-19 might affect a fetus. Some pregnant women with COVID-19 have had preterm births, but it is not clear whether the preterm births were because of COVID-19. It’s also not clear if COVID-19 can pass to a fetus during labor and delivery.
The virus spreads mainly from person-to-person contact. Pregnant women can take the same steps as other people to protect themselves, including
- washing hands often with soap and water for at least 20 seconds
- cleaning hands with a hand sanitizer that contains at least 60% alcohol if you can’t wash them (rub until your hands feel dry)
- avoiding touching your eyes, nose, and mouth
- staying home as much as possible
- staying at least 6 feet away from other people if you need to go out
- avoiding people who are sick
As of April 3, the CDC says all people, including pregnant women, can wear a cloth face covering when they are in public to prevent the spread of COVID-19. Face coverings are recommended because studies have shown that people can spread the virus before showing any symptoms.
Wearing a cloth face covering is most important in places where you may not be able to stay 6 feet away from other people, like a grocery store or pharmacy. It also is important in parts of the country where COVID-19 is spreading quickly. But you should still try to stay at least 6 feet away from others whenever you leave your home.
If you have COVID-19 or think you may have it, you should wear a mask while you are around other people. You also should wear a mask if you are taking care of someone who has COVID-19 or has symptoms. You do not need to wear a surgical mask or medical-grade mask (N95 mask).
As the virus spreads, it is a good idea to call your obstetrician–gynecologist (ob-gyn) or other health care professional to ask how your visits may be changed. Some women may have fewer or more spaced out in-person visits. You also may talk more with your health care team over the phone or through an online video call. This is called telemedicine. It is a good way for you to get the care you need while preventing the spread of disease.
If you have a visit scheduled, your care team’s office may call you ahead of time. They may tell you about telemedicine or make sure you do not have symptoms of COVID-19 if you are going in to the office. You also can call them before your visits if you do not hear from them.
Pregnant women can stay healthy by following the usual recommendations during pregnancy, including:
- Eating healthy meals (see Nutrition During Pregnancy).
- Exercising regularly (see Exercise During Pregnancy, though be mindful to stay at home or away from other people while exercising).
- Getting plenty of sleep.
- Avoiding alcohol and drugs (see Tobacco, Alcohol, Drugs, and Pregnancy).
Being home a lot and avoiding other people can be hard. The above tips for staying physically healthy also can help your mental health. A few other things you can do to stay mentally healthy include:
- Staying connected with your friends and family, over the phone or online.
- Taking breaks from coronavirus news and social media.
- Telling your ob-gyn or other health care professional if you are feeling sad or anxious.
If you or a loved one are feeling overwhelmed, you can call the Disaster Distress Helpline run by the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-985-5990 (TTY 1-800-846-8517). You also can text TalkWithUs to 66746. If you feel like you want to harm yourself or others, call 911 right away. Find more mental health advice and resources from the CDC.
Times of crisis can be very hard for people in abusive relationships. Abuse at home is known as intimate partner violence or domestic violence. Abuse can get worse during pregnancy. If you need help, call the 24-hour, toll-free National Domestic Violence Hotline: 800-799-SAFE (7233) and 800-787-3224 (TTY). Or you can use the live chat option at https://www.thehotline.org/.
The CDC is updating travel recommendations often. See the CDC’s Coronavirus Disease 2019 Information for Travel page for the latest updates.
Other travel recommendations may be in place globally or locally as the virus continues to spread. Check with your local or state health department for information about travel in your area.
If you think you may have been exposed to the coronavirus and have a fever or cough, call your ob-gyn or other health care professional for advice.
If you have emergency warning signs, call 911 or go to the hospital right away. Emergency warning signs include the following:
Having a hard time breathing or shortness of breath (more than what has been normal for you during pregnancy)
Ongoing pain or pressure in the chest
Being unable to respond to others
Blue lips or face
If you go to the hospital, try to call ahead to let them know you are coming so they can prepare. If you have other symptoms that worry you, call your ob-gyn or 911.
If you are diagnosed with COVID-19, follow the advice from the CDC and your ob-gyn or other health care professional. The current CDC advice for all people with COVID-19 includes the following:
Stay home except to get medical care. Avoid public transportation.
Speak with your health care team over the phone before going to their office. Get medical care right away if you feel worse or think it’s an emergency.
Separate yourself from other people in your home.
Wear a face mask when you are around other people and when you go to get medical care.
Talk with your ob-gyn or other health care professional about your labor and delivery plans. In most cases, the timing and method of delivery (vaginal birth or cesarean birth) do not need to be changed.
If you are sick, you probably do not need a cesarean birth. But your health care team may wear masks or take other steps to prevent spreading the infection during and after labor and delivery. Your baby may need to be separated from you after birth if you are sick. The separation helps to prevent you from infecting your baby. Talk with your care team about this possibility.
ACOG believes that the safest place for you to give birth is a hospital, hospital-based birth center, or accredited freestanding birth center. Your hospital or birth center may be adjusting their policies. For example, there may be changes to the number of visitors allowed and how long you will stay in the hospital. Check with your hospital and ob-gyn or other health care professional about your birth plan. Be sure to mention if you are planning to have a doula with you during childbirth.
ACOG believes that the safest place for you to give birth is still a hospital, hospital-based birth center, or accredited freestanding birth center.
Even the healthiest pregnancies can have problems arise with little or no warning during labor and delivery. If problems happen, a hospital setting can give you and your baby the best care in a hurry. And studies have shown that babies born at home are more than twice as likely to die around the time of birth than those born in hospitals.
Every woman has the right to choose where she will give birth. But it is important to not take any risks that might put you or your newborn’s health in danger, especially as there is a high risk for getting COVID-19. Talk with your ob-gyn or other health care professional about your birth plan and any concerns.
So far, the virus has not been found in breast milk. But there is not enough information yet on whether women who are sick can pass the virus through breast milk.
Breast milk gives babies protection against many illnesses. It also is the best source of nutrition for most babies. Talk with your ob-gyn or other health care professional about whether to start or continue breastfeeding. You can make this decision together with your family and health care team.
If you have symptoms of COVID-19 or if you have been diagnosed, you can take the following steps to avoid passing the infection to your baby:
- Wash your hands before touching your baby. See the CDC’s handwashing tips.
- Wear a face mask while breastfeeding if possible.
- Wash your hands before touching any breast pump or bottle parts and clean all pump and bottle parts after use. See the CDC’s advice for cleaning a breast pump.
You also can have someone who is not sick feed your breast milk to your baby after you pump.
What if I have questions about working, visits to my doctor, or anything else related to coronavirus?
Your ob-gyn or other health care professional should continue to be your main resource for all questions about your pregnancy. Questions about your workplace are best answered by your employer. For other questions about the coronavirus, you can check CDC web pages, which are updated often and listed below.
Centers for Disease Control and Prevention (CDC)
- Coronavirus (COVID-19): A hub for the latest information on what everyone needs to know about the coronavirus and COVID-19.
- Pregnancy & Breastfeeding: More information about COVID-19, pregnancy, and breastfeeding.
- How to Prepare: Learn how the virus spreads, how to protect yourself and your family, and how to manage anxiety and stress.
- If You Are Sick: Guidance on what to do if you have COVID-19 or think you may have it.
- Travel: Frequently asked questions for travelers and travel notices for each country.
Substance Abuse and Mental Health Services Administration (SAMHSA) Disaster Distress Helpline
1-800-985-5990 (TTY 1-800-846-8517)
Text TalkWithUs to 66746
Call or text if you or a loved one is feeling overwhelmed with emotions like sadness, depression, or anxiety.
National Association of County and City Health Officials
A tool to help you search for health departments in your area. Your local health department can advise on travel and other local restrictions.
Postpartum Support International Helpline
Text 503-894-9453 (English) or 971-420-0294 (Spanish)
Support, education, and local resources for postpartum women.
National Domestic Violence Hotline
800–799–SAFE (7233) and 800–787–3224 (TDD)
Live chat and more information: https://www.thehotline.org/
Cesarean Birth: Birth of a fetus from the uterus through an incision (cut) made in the woman’s abdomen.
Fetus: The stage of human development beyond 8 completed weeks after fertilization.
Obstetrician–Gynecologist (Ob-Gyn): A doctor with special training and education in women’s health.
Preterm: Less than 37 weeks of pregnancy.
Lisa M. Hollier, MD, MPH, FACOG, is the immediate past president of ACOG. She is an obstetrician–gynecologist, maternal–fetal medicine specialist, and a professor in the department of obstetrics and gynecology at Baylor College of Medicine in Houston, Texas. She serves as the Chief Medical Officer for Texas Children’s Health Plan.
If you have further questions, contact your obstetrician–gynecologist.
FAQ511. Copyright March 2020 by the American College of Obstetricians and Gynecologists
This information is designed as an educational aid to patients and sets forth current information and opinions related to women’s health. It is not intended as a statement of the standard of care, nor does it comprise all proper treatments or methods of care. It is not a substitute for a treating clinician’s independent professional judgment. Read ACOG’s complete disclaimer.