What to know about COVID-19, the vaccine and pregnancy

October 27, 2021

Providence Maternity Team

This article was updated on Oct. 27, 2021 to reflect recent information and research.

Pregnant individuals have a significantly higher risk of becoming severely ill with COVID-19.
The Centers for Disease Control and Prevention (CDC) recommends all pregnant and breastfeeding/chestfeeding individuals and those trying to become pregnant or who may become pregnant get a COVID-19 vaccine.
The COVID-19 vaccine is safe for pregnant individuals and their babies.
The vaccine may pass antibodies to newborns, offering a layer of protection against COVID-19.

[4 MIN READ]

When you’re expecting a baby, you’re likely eagerly counting down the days until you get to meet the newest member of you family. You prepare the nursery. You gather all the necessary (and downright adorable) baby gear. And, you dutifully research pediatricians, safety measures and advice on how to keep your baby healthy.

One important way you’re likely working to keep your baby (and yourself) healthy is learning how to best protect the entire family form COVID-19. Since early 2020, this virus has changed how expecting moms and all birthing individuals experience pregnancy. It can be hard to keep up with new research about your risk of COVID-19 and how your baby might be affected.

Maternal-fetal health specialist David Lagrew, M.D., is familiar with these concerns. In his role as executive medical director of the Women’s and Children’s Clinical Institute at Providence Health for Southern California, Dr. Lagrew oversees hundreds of doctors, certified nurse-midwives and others who provide maternity care at 11 hospitals in the region. Here he shares his perspective about pregnancy and childbirth in the time of COVID-19.

Does COVID-19 pose special health risks for me and my baby?

Research shows that you are at higher risk of developing more severe complication than if you weren’t pregnant. The Centers for Disease Control and Prevention (CDC) has been closely monitoring pregnant individuals with COVID-19. They have found that pregnant people with COVID-19 are at an increased risk of severe illness, death and pregnancy complications.

That’s what we’re seeing in the hospital. We’ve seen increased numbers of pregnant moms with COVID-19 going into the intensive care unit; going on ventilators; and experiencing serious complications like blood clots.

Even more concerning is that, while the absolute risk is relatively low, the CDC found that symptomatic pregnant people with COVID-19 have a 70% increased risk of death.

Am I at higher risk during a certain time during their pregnancy?

Research (and our own experiences) suggests that the risk for COVID-19 complications increases around the middle of a pregnancy – somewhere around 24 to 34 weeks is where they seem to get their sickest.

Should I get vaccinated for COVID-19?

Yes, you – and almost all pregnant individuals – should get vaccinated for COVID. The CDC also just updated their guidelines to strongly recommend individuals who are pregnant, are trying to become pregnant or might become pregnant in the future to get vaccinated for COVID-19. Individuals who are breastfeeding/chestfeeding should also be vaccinated.

Is it safe for me to get the COVID-19 vaccine?

The CDC has been closely tracking vaccinations during pregnancy. The data we have is very encouraging. You’re most likely to experience the same type of symptoms as everyone else – soreness at the injection site, fatigue and possibly fever. Research has found no increase in miscarriage, stillbirth, prematurity or poor pregnancy outcomes among those who received the vaccine while pregnant.

It’s also important to keep in mind that, if you have other children, the vaccine helps provide a layer of protection for those not yet eligible for a vaccine. You should also encourage family members and friends who will be around the baby to get vaccinated.

Learn more about COVID-19 vaccine safety during Dr. Lagrew’s Facebook live discussion.

I’m vaccinated. Should I get a booster shot?

If you received the Pfizer-BioNTech COVID-19 vaccine at least six months ago and are pregnant, you are eligible for a booster shot. The CDC considers pregnancy an underlying medical condition that increases your risk of severe illness and complication from COVID-19.

This third shot can help reduce your risk of “breakthrough” infection even more – an important step in staying heathy throughout your pregnancy.

Does the vaccine affect fertility?

There is no evidence that any of the COVID-19 vaccines reduce a woman’s fertility or make it more difficult to become pregnant. Multiple studies show that there’s no impact on fertility in vaccinated men and women. Studies after studies show that there is no impact on fertility in vaccinated men or women.

In fact, the complications from a severe case of COVID-19 are more likely to impact fertility. Men may be at higher risk of erectile dysfunction after infection; researchers are still studying the virus’ impact on sperm count and motility. Lung damage and disease in women – brought on by COVID-19 or a pre-existing condition – may also put them at higher risk of pregnancy complications such as pulmonary edema, pulmonary hypertension and acute respiratory failure.

Will my baby have immunity if I get vaccinated?

Yes, research indicates that if you get vaccinated, you will pass antibodies to your baby, giving them some immunity against the virus. Breastmilk may also pass antibodies. That’s true for all the vaccines we give during pregnancy, including the flu shot and Tdap, which help protect both mom and baby from whooping cough.

How does COVID-19 during pregnancy affect my baby?

Becoming severely ill with COVID-19 puts your baby at higher risk for complications, including premature birth. Fortunately, babies aren’t getting sick with COVID-19 in utero. That’s because the likelihood of the virus or vaccine crossing the placenta is very, very low.

Typically, you are much more likely to pass COVID-19 to your child through direct contact after birth during feedings and cuddling sessions.

Also, the COVID-19 vaccine has not been shown to have any impact on the development of your child. Early data from the CDC did not find any safety concerns for pregnant people or their babies.

What should I do if I’ve been exposed to COVID-19 or have symptoms?

The first thing to do if you’ve been exposed to the virus or are experiencing symptoms is to isolate yourself. Then, let your obstetrician or midwife know that you may be sick with COVID-19.

We’re following guidance from the American College of Obstetricians and Gynecologists (ACOG) on how to treat you if you are pregnant. Generally, if you’ve been exposed and have no or mild symptoms, we’ll ask you to stay home and monitor yourself. We don’t want you to rush into the doctor’s office and spread the virus.

However, it’s very important that you let your provider know if your symptoms worsen, because you are at higher risk for complications. We may be able to offer monoclonal antibody therapy, which puts COVID-19 antibodies directly into your bloodstream to help fight infection and reduce your risk of serious illness. Your provider can discuss if it’s right for you.

What will my prenatal care look like?

You will still have in-person visits, but some appointments may be shifted to telehealth. Ultrasounds, lab tests and screenings for gestational diabetes are all still done in the doctor’s office. Depending on your location and how widespread COVID-19 is in your community, you may also be asked to limit the number of support people you bring to your appointment.

How are you keeping me safe at the hospital?

We are committed to keeping you healthy and safe, and limiting the spread of COVID-19. Here are just a few ways we’re doing that.

Regularly cleaning and disinfecting our facilities to help limit the spread of COVID-19
Requiring masks for all visitors, patients, healthcare providers and staff
Limiting visitors on our labor and delivery units to support you during birth. (This may change as COVID-19 cases go up or down in your community.)
Shortening the length of time you and baby stay in the hospital whenever possible
Testing for COVID-19 before you come to the hospital to deliver or immediately after you arrive.

These changes are important for everyone’s health and safety. And we’re still doing all we can to maintain that personal touch throughout your birth experience. For instance, our labor and delivery staff are becoming pros at helping families use FaceTime, Skype and Zoom to make sure grandparents and other loved ones can participate in the big day safely.

How can I keep my newborn safe and healthy at home?

As much as you want to introduce your new baby to friends and family members, you also want to protect your baby from this virus. Social distancing and routine home cleaning are the best strategies for limiting the risk of infection.

Also, it’s essential for everyone who comes in contact with the baby, including parents and siblings, to wash their hands frequently. If family members exhibit COVID-19 symptoms, we recommend that they isolate themselves from the baby and family as much as possible until they are past the quarantine period. Of course, we also recommend that anyone who’s around the baby be vaccinated if possible.

These are challenging times for everyone. At Providence, we want you to know that our providers are with you every step of the way. Welcoming a new baby is one of the most precious and incredible experiences life has to offer, and not even COVID-19 can take that away