COVID-19 & pregnancy: What you need to know

pregnant woman reading an iPad while lounging on her bed

If you’re pregnant or have a newborn, you may be overwhelmed with questions and anxiety about how the coronavirus and COVID-19 global outbreak could affect you and your baby. You may be asking: Am I at higher risk because I’m pregnant? Is it safe to go to my appointments? Can my partner join me in the labor and delivery room?

To help keep you informed and prepared, we’ve outlined the changes we’ve made to your prenatal and postnatal care, as well as what we know about COVID-19’s effect on pregnancy and newborn care. As always, your health and safety are our top priority, and we’re here to support you and take care of you throughout these challenging times.

  

  

  

Changes to your prenatal and postnatal care

  

For your safety and to help minimize the spread of the coronavirus, we’re reducing the number of in-person appointments at our medical offices and hospitals. This means some of your prenatal appointments may be changed to virtual visits where you’ll talk with your provider over the phone or video. 

Here’s what you can expect:

  • Your provider will let you know when you should come in for an in-person visit and when it’s appropriate to do a virtual visit. It’s important to follow advice when you’re told you need to be seen in person.
  • Group care appointments have been changed to individual or virtual group visits.
  • Your provider may ask you to take additional steps to monitor yourself at home, such as checking your weight or blood pressure.
  • Your provider will give you guidance on symptoms that you should come in for immediately.

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 this crisis.

Your care team will contact you within 7 days of your appointment to discuss if you should come in person or do a virtual visit via phone or video. This decision will be based on the stage of your pregnancy and your health. If a virtual visit is recommended but you’d like to be seen in person due to a health concern, that’s not a problem. We’ll see you in person. 

To provide you with the safest care during the COVID-19 outbreak, we’ve temporarily closed or limited in-person services at some facilities. This will help us make sure staff, medical equipment, and supplies are where they’re needed most, and limit exposure of members and staff to the coronavirus. To check if your facility has limited services or is closed, please visit kp.org/coronavirus and select your region.

If your regular ob-gyn office is temporarily closed, we’ll call you within 7 days of your appointment to let you know which nearby Kaiser Permanente facility we’re moving your appointment to. 

You’ll also be called the day before an in-person appointment to see if you have any COVID-19 symptoms. If you have any symptoms, we’ll have to reschedule, and we may recommend you get tested depending on your symptoms.  

Please don’t bring anyone with you to your prenatal appointments, unless you have a physical disability or need authorized caregiver support. Right now, visitors aren’t allowed at prenatal appointments.

When you come in for appointments, please adhere to the Centers for Disease Control and Prevention’s COVID-19 safety guidelines. Wear a mask or cloth face covering over your mouth and nose and remain at least 6 feet away from others, when possible. 

In some of our facilities, our in-person prenatal education classes have been turned into online classes. If that’s the case, your provider will contact you to let you know. However, many of our in-person prenatal education classes are canceled until further notice due to the COVID-19 outbreak. We apologize for the inconvenience. We have 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. 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 “take a tour.”  

In most cases, the timing and method of your delivery (vaginal or cesarean) don’t need to be changed. You shouldn’t have to be induced early or have your baby outside the hospital. We’re here to take care of you throughout your labor and delivery, even during the COVID-19 crisis.

If you’re having labor pains, 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 delivery, 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’re limiting the number of visitors allowed during and after your baby’s birth. At this time, you can have one healthy adult stay with you during your labor, delivery, and hospital stay. Unfortunately, this means no additional visitors can come to the hospital to see you.

For your safety and the safety of others, your labor partner must remain in your room throughout your stay. Our waiting rooms won’t be available. You and your partner may want to bring food and other items to help you feel comfortable, since that person may not be able to leave the hospital until you’re released. 

If you were planning to have a doula support you during delivery, you could make them your one labor partner. Due to visitor restrictions, you won’t be able to have a doula plus a partner, family member, or friend. You’re only allowed one person in the labor and delivery room with you. However, you’re welcome to virtually bring in additional support people, like a doula, via FaceTime, Zoom, Skype, etc.

Note: These limitations may change based on the current COVID-19 pandemic conditions.

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: 

  • Patients who have COVID-19, or are suspected of having COVID-19, are isolated from other patients to prevent infection of others.
  • We’re following infection-control practices to prevent the spread of the virus. This includes your labor and delivery team.
  • Routine appointments and elective procedures have been postponed to limit the number of patients in the hospital. 
  • Visitors are limited across the hospital to prevent exposure to the virus.

Yes, in most cases, 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 COVID-19 outbreak, only one parent or caregiver may come with the child to the visit.

It’s natural to feel stressed and anxious as we face the challenges of the COVID-19 outbreak. To help you manage these feelings, here are some digital resources to support your mental health: 

  • 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 health care provider if stress gets in the way of your daily activities for several days in a row.

Having healthy relationships and a safe home environment are very important for you and your baby during your pregnancy and after the birth. Unfortunately, during stressful times, some partners don’t react well, and some people can become overwhelmed. 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. 

  

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.

 

COVID-19 is a new disease, so information on how the virus affects pregnant people is limited. Based on the most current information, pregnant women don’t appear to be more likely to get infected with COVID-19 than other people.1 Current reports also show that pregnant women who get the virus don’t have more severe symptoms than the general public.2

We do know that pregnant women experience changes in their bodies and immune systems that make them more likely to get viral respiratory infections, like the flu, with more serious complications.

While we don't yet know about possible pregnancy loss related to COVID-19, miscarriage and stillbirth have occurred in some pregnant women infected with other viral respiratory infections. High fevers during the first trimester can also increase the risk of certain birth defects.

At this time, we don't know if the virus can be transmitted during pregnancy or childbirth.

If a mother is positive or having symptoms of COVID-19, we may recommend staying in different rooms or maintaining a distance of at least 6 feet between mother and baby.

A limited set of studies has shown:3

  • Infants born to mothers with COVID-19 haven’t tested positive for the virus immediately after delivery.4
  • The virus wasn’t found in samples of amniotic fluid or breast milk.5 
  • Some preterm births have occurred among mothers who tested positive for COVID-19 during pregnancy. However, it's not clear if these cases were related to maternal infection.6

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 medically necessary, and when a provider refers you. For information on testing, and when you should get a test, visit kp.org/coronavirus.

You should take the same steps as the general public to avoid COVID-19 infection. For proactive steps you can take to protect your health and pregnancy, visit kp.org/coronavirus

You can go to work as long as you can follow the Centers for Disease Control and Prevention’s recommended safety precautions. For example, staying 6 feet away from others, avoiding crowds, and washing your hands often.

If possible, you should try to work from home or request to work in a physical space that lets you stay 6 feet away from others. 

You can email your provider for a note that says you’re pregnant. Your employer will have to decide if they can accommodate the restrictions needed for proper physical distancing. If not, your employer may offer you temporary disability. Please note, your provider can’t make your employer offer you remote work opportunities or disability.

For jobs that are considered essential services, pregnant employees may be asked to continue working. For example, law enforcement, health care, pharmacy, firefighting, and caregiving at residential nursing facilities. 

Due to the current risk of COVID-19, the Centers for Disease Control and Prevention (CDC) is continually updating its travel recommendations for all citizens. 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:

  • 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, make them 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.
  • Children 14 and younger shouldn’t visit the baby.
  • Your friends and family can still help by dropping off diapers, bags of groceries, and prepared meals. All items should be left at your front door to avoid infection. 

At this time, we don’t know whether mothers with COVID-19 can spread the virus through breast milk. Based on the limited studies available, COVID-19 hasn’t been found in the breast milk of women with COVID-19. 

We encourage you to discuss the decision about whether to breastfeed your baby with your provider.

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.

Infants and children rarely become critically ill with COVID-19. They may have mild symptoms common to most viral respiratory infections. 

Worldwide, including in areas with many thousands of cases, there have been few reported deaths of children or teens.

We’re still learning about COVID-19 in infants and children. 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 women, 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 us for advice. 

  

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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.

Coronavirus Disease 2019 (COVID-19): Pregnancy and Breastfeeding,” Centers for Disease Control and Prevention, cdc.gov, accessed April 10, 2020.

Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients,” The American College of Obstetricians and Gynecologists,” acog.org, accessed April 10, 2020.

Adapted with permission from copyrighted material of The Permanente Medical Group, Inc., Northern California.

4Practice Advisory: Novel Coronavirus 2019 (COVID-19),” The American College of Obstetricians and Gynecologists,” acog.org, accessed April 23, 2020.

5 See note 1.

6 See note 4.

7 See note 1.