Pregnant women and women who were recently pregnant are at greater risk for severe illness from COVID-19 than women who are not pregnant. Other conditions, such as being pregnant at an older age or having diabetes or obesity, can further increase the risk of severe illness from COVID-19. This increased risk can last for at least 6 weeks (42 days) after a pregnancy ends.

• Know your risk factors. Ask your health care provider about your specific risk factors.
• Work with your health care team to protect yourself against COVID-19 and other infections.

How does COVID-19 affect me?

• You may get a respiratory illness that can lead to pneumonia or severe illness. This may lead to a stay in the intensive care unit (ICU), or the use of mechanical ventilation, or death.
• You may give birth to your baby before 37 weeks of pregnancy.
• You may have other complications that can affect your pregnancy, such as having a stillbirth.

How does COVID-19 affect my care?

• You will have to tell the clinic or hospital before a visit. Steps will be taken to protect other people from the virus, including treating you in a room intended for people who have COVID-19.
• Tests and scans may be done differently before delivery.
• Your birth plan may change, including what room you will be in and who may be with you during labor and delivery.
• You may stay longer in the hospital after delivery.
• Your baby may stay in a different room. Ask about the risks and benefits of staying in the same room with your baby. Benefits include breastfeeding and mother–newborn bonding.
• You may need to feed your baby differently.
• Visitors will be limited after your baby is born.

How does COVID-19 affect my baby?

It is very rare for a mother with COVID-19 to pass the virus to the unborn baby. However, a baby can get the virus if he or she is exposed to it after birth.

Ask your health care provider about ways to protect your baby. A physical barrier can also be used, such as an incubator.

What can I do to lower my risk?

Medicines and vaccines

• You can get a COVID-19 vaccine. This may protect you from severe illness. If you have concerns, talk to your health care provider.
• Get other recommended vaccines, including the flu vaccine and whooping cough (Tdap) vaccine. You may get these vaccines at the same time you get the COVID-19 vaccine.
• Ask your health care provider if you can get a 30-day, or longer, supply of your medicines so you can make fewer trips to the pharmacy.
• If you have received a COVID-19 vaccine, consider enrolling in the v-safe program from the Centers for Disease Control and Prevention (CDC). This program uses an app on your smartphone to provide check-ins and gather information on your health after you get the vaccine. There is a separate registry for pregnant women. For more information, visit:
  • V-safe tool: www.cdc.gov/vsafe.html
  • V-safe pregnancy registry: www.cdc.gov/pregnancyregistry.html
• Over time, protection from a vaccine can weaken. Get a booster dose to improve, or boost, your body's ability to protect you from illness. The booster dose depends on which COVID-19 vaccine you received and your risk of getting very sick from the virus.
  • All people, including pregnant women, should receive an mRNA COVID-19 vaccine booster dose following the completion of their last COVID-19 primary vaccine dose or booster.
  • The usual booster vaccines are the mRNA vaccines. However, Novavax's COVID-19 vaccine can be used as a booster when a person has not yet received any booster dose, and:
    • is unable to get an mRNA COVID-19 vaccine, or
    • is unwilling to get an mRNA COVID-19 vaccine.
  • Vaccination may occur in any trimester, but a primary vaccine and boosters should be obtained as soon as possible to better protect the mother and the unborn child.

Cleaning and personal hygiene

If you are pregnant or were recently pregnant, you need to take steps to prevent infection. You should:

• Wear a mask when in public or at work. Avoid people who are not wearing a mask.
• Limit contact with other people as much as possible.
• Wash your hands with soap and water for at least 20 seconds. If soap and water are not available, use alcohol-based hand sanitizer.
• Keep your distance. Stay more than 6 feet (1.8 m) away from others as much as possible. Avoid crowds.
• Avoid touching your mouth, face, eyes, or nose before washing your hands.
• Clean and disinfect objects and surfaces that are touched often.

Other things to do

• Avoid people who might have been exposed to or infected with COVID-19, including people who live with you.
• Follow guidelines from health officials about when to wear a mask. The CDC says that all fully vaccinated people should still wear masks in some cases, including:
  • In certain places, such as in health care settings, schools, airports, and on public transit.
  • When required by law or by guidelines from businesses or workplaces.
• Avoid poorly ventilated places.
• Call your health care provider if you have any health concerns.

Follow these instructions:

Managing stress

• Using relaxation techniques such as meditation and deep breathing.
• Getting regular exercise. Most women can continue their usual exercise routine during pregnancy. Ask your health care provider what activities are safe for you.
• Seeking support from family, friends, or spiritual resources. If you cannot be together in person, you can still connect by phone calls, texts, video calls, or online messaging.
• Doing activities that you enjoy, such as listening to music or reading a book.

General instructions

• Follow your health care provider's instructions on taking medicines. Some medicines may not be safe to take during pregnancy.
• Ask for help if you have counseling or nutritional needs. Your health care provider can give advice or refer you to resources or specialists who can help you with different needs.
• Keep all follow-up visits. These include visits before and after you have your baby.

Questions to ask your health care team

• What should I do if I have COVID-19 symptoms?
• What are the side effects of COVID-19 vaccines?
• How will COVID-19 affect my care before birth, during labor and delivery, and after delivery?
• What are the risks of COVID-19 to me and to my child before and after birth?
• How do vaccines pass antibodies to my unborn baby?
• Should I plan to breastfeed my baby?
• Where can I find mental health help?
• Where can I find support if I have financial concerns?

Where to find more information

• CDC: www.cdc.gov/pregnant-people.html
• World Health Organization (WHO): www.who.int/pregnancy-and-childbirth
• American College of Obstetricians and Gynecologists (ACOG): www.acog.org

Contact a health care provider if:

• You have signs and symptoms of infection, including a fever or cough. Tell your health care team:
  • That you think you may have a COVID-19 infection.
  • That you are pregnant.
• You feel very sad or anxious.
• You feel unsafe in your home and need help finding a safe place to live.
• You are bleeding from your vagina, or you have bloody or watery discharge from your vagina.

Get help right away if:

• You have signs or symptoms of labor before 37 weeks of pregnancy. These include:
  • Contractions that are 5 minutes or less apart, or that become longer, more frequent, or more intense.
  • Sudden, sharp pain in the abdomen or in the lower back.
  • A gush or trickle of fluid from your vagina.
• You have signs of more serious illness, such as:
  • Trouble breathing.
  • Chest pain.
  • A fever of 102.2°F (39°C) or higher that does not go away.
  • Vomiting every time you drink fluids.
  • Feeling extremely weak.
  • Fainting.

• Do not wait to see if the symptoms will go away.
• Do not drive yourself to the hospital.

Summary

• Pregnant women and women who were recently pregnant are at greater risk for severe illness from COVID-19.
• Take precautions to protect yourself and your baby. Wear a mask. Wash hands often. Avoid touching your mouth, face, eyes, or nose before washing hands. Avoid large groups of people and stay away from people who are sick.
• If you have COVID-19, precautions may be taken during pregnancy, labor and delivery, and after delivery.
• If you think you have a COVID-19 infection, contact your health care provider right away. Tell them about your pregnancy as well.