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Coronavirus - advice for pregnancy or breastfeeding

18 May 2020

If you or someone you love is pregnant or has just had a baby, this can be an especially worrying time.

If you’re pregnant or breastfeeding, you may be understandably concerned about what the coronavirus can mean for your birth and the health of your baby. We’re here to help you every step of the way, and to sort through any confusion during this time.

With 350,000 babies born each day around the world, doctors and medical bodies as well as hospitals and healthcare staff have banded together to provide detailed guidelines. Making sure women’s pregnancy and birth experiences are as safe as possible.

The good news is that current advice suggests most pregnant women will not be at higher risk of complications – nor will their unborn babies.

The UK’s Royal College of Obstetricians and Gynaecologists (RCOG) says that if they do catch Covid-19, most pregnant women will experience only mild or moderate cold/flu like symptoms.

Is the risk of miscarriage higher if I get coronavirus?

If you get Covid-19 in the first 12 weeks, there’s no evidence that you are more likely to miscarry, says the RCOG.

Do take all normal precautions such as washing your hands frequently and working from home if possible, says the RCOG, and keep antenatal appointments.

Who can I take with me to appointments?

It’s best to check at your hospital, clinic or surgery about the rules relating to being accompanied to appointments, as many places are only permitting the pregnant woman to attend. If you’re able to, it is best to go alone to appointments.

If you have symptoms of the virus, call the clinic as it’s likely your appointment will need to be postponed.

What precautions do I need to take in the lead up to the birth?

After 28 weeks (the third trimester), the RCOG recommends avoiding all non-essential contact, including with family and friends. If you have a heart condition, you are classed as highest risk and your doctor will ask you to be shielded, which means staying at home for 12 weeks.

There is an increased concern for those who have gained a lot of additional weight in the third trimester.

‘Excess weight can affect breathing. So, if they get a more severe infection there would be less space for the lungs to expand whilst breathing, meaning they may face a possible higher risk.’ says Dr Annette Alaeus, a Livi doctor and specialist in infectious medicine.

Do I need to change my birth plan?

Try and stay flexible, especially if you hope to give birth at home. The NHS has suspended all its home birth services and has said women planning home births will be moved to the Midwifery-Led Unit.
The RCOG also recommends water births are avoided too because of fears over hygiene.

Who can be with me at the birth?

You can have a partner or one significant other at the birth with you, as long as they’re well, says the RCOG. But they can’t be at an induction if that takes place on a ward – social distancing rules make that impossible. Birth partners are also not being allowed on postnatal wards because of the risk of infection.

What if I have signs of Covid-19?

If you have symptoms of Covid-19 and are due to go to hospital, call in advance to warn them so the medical staff know to protect themselves. Don’t travel by public transport; use private cars instead or talk to the hospital about what help they can offer.

‘Vaginal births and C-sections are safe for women with the virus,’ says Dr Alaeus. ‘If a mother does come in with fever or a cough, staff will dress in protective clothes for their safety. But the mother is at no extra risk.’

If you’re wondering why pregnancy is considered a risk group for coronavirus by the NHS, one of the key reasons is that for a small proportion of women, pregnancy can alter how the body handles severe viral infections. This is something that midwives and obstetricians have known for many years and are used to dealing with. Make sure you keep in contact with your doctor or healthcare professional and seek help if your symptoms worsen.

Is there a higher risk of prematurity with coronavirus?

Data from China suggests some women with Covid-19 gave birth prematurely, but these numbers were very small. In the UK, every birth to a woman with Covid-19 is being monitored by the NHS so that data can be collected for future analysis.

If you have suspected or confirmed coronavirus when you go into labour, your baby’s heart rate will be monitored continuously in case they become distressed or suffer lack of oxygen. Your own oxygen levels will be monitored too.

If your baby is premature or sick, new-born intensive care units provide around-the-clock care and are still being well-staffed.

Particular care is being given to keeping wards clean and patients with Covid-19, isolated in all labour, post-natal and NICUs wards, says the RCOG.

Can I pass coronavirus on to my child?

There have been a small handful of cases reported where mother to child transmission has occurred, says Dr Alaeus. ‘But the chances of passing the virus on to your baby are extremely low’.

‘If a young baby has the virus’, Dr Alaeus adds, ‘it’s more likely it will have been passed on during an activity like breastfeeding as the closeness of mother and baby may see the virus transmitted through droplets in the air.

Is breastfeeding OK?

Coronavirus is not believed to pass through breast milk and the advantages conferred by breast milk itself in establishing a baby’s immune system far outweigh any risk of infection.

‘Try not to cough on the baby,’ says Dr Alaeus. ‘Cough into your elbow as you would in any other scenario.’

The World Health Organization agrees, suggesting new mothers practice respiratory hygiene during feeding, wearing a mask, washing hands before and after touching the baby and regularly cleaning and disinfecting surfaces they have touched.

When will I be sent home?

If a baby shows no sign of being unwell, even if its mother has tested positive for the virus, advice is to send the mother and baby home as soon as possible, says the British Association of Perinatal Medicine (BAPM).

The family will be advised to self-isolate with the baby for 14 days and given community midwife support.

Is fertility treatment still allowed?

If you’re having fertility treatment such as IVF, the European Society of Human Reproduction and Embryology (ESHRE) has recommended this be put on hold.

However, if you are planning to start urgent fertility treatment to freeze sperm or eggs because of cancer treatment, ESHRE suggests that should go ahead.

For those who have already begun the IVF process, ESHRE says freezing eggs or embryos would be a good idea, delaying implantation until after the crisis.

Hopefully, our guide has helped you understand the options and support available to help make sure both your pregnancy and birth journeys are safe.

If you have further concerns, our expert team of doctors are ready to help.

I’m pregnant and worried – what should I do next?

  • Practise social distancing throughout, but especially after 28 weeks.
  • Be flexible with your birth plan: water and home births are not recommended at this time.
  • If they’re healthy, your partner will be allowed at the birth, but not at an induction and may not be able to stay with you in the postnatal ward.
  • Breastfeed to help your child’s immune system but try to avoid coughing or sneezing on your baby. Wear a face mask while breastfeeding.
Last updated:
18 May 2020

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