COVID-19 - During Pregnancy

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  • It is unlikely that you will become seriously unwell with coronavirus if you do get it.
  • You should tell your maternity team that you have symptoms.
  • If you have any Coronavirus symptoms, then you will be asked not to attend your face-to-face appointments. Your maternity team will give you advice about what to do next. 
  • You and your household will need to self-isolate in line with Government advice.
  • If you think you may have symptoms, you can use the NHS 111 online service/ NHS 24 in Scotland for advice and guidance. 
  • Seek medical advice as early as possible if you have any questions or concerns. 

It is unlikely that you will become seriously unwell with coronavirus if you do get it.

Based on cases so far, pregnant women will probably only experience feel like they have a mild or moderate cold or flu. They may experience a cough, fever, shortness of breath, headache and loss of sense of smell as symptoms.
More severe symptoms such as pneumonia, seem to be more common in older people, those with weakened immune systems or long-term conditions. As yet, there is no evidence that pregnant women who get this infection are more at risk of serious complications than any other healthy individuals.

There is no current evidence to suggest an increased risk of miscarriage. It is also unlikely that if you have the virus it would cause problems with your baby’s development, and none have been observed currently.
There are some cases where the baby may have developed coronavirus during pregnancy or birth, but these babies have been discharged from hospital and are well.

Some babies have been born prematurely to women who were very unwell with coronavirus. We don’t know whether coronavirus caused these babies to be born early, or whether it was decided that the baby should be born early for the benefit of the women’s health and to enable her to recover.

It is really important that you attend your antenatal appointments to you and your baby safe during pregnancy and birth. Some appointments may happen over the phone, by video, or at home where appropriate. 

If you are self-isolating or have symptoms of COVID-19 and have a scheduled appointment, please let your maternity team know. 

You will have at least six in-person antenatal appointments during your pregnancy. 

What you should be asked about:

  • Your mental health at every appointment.
  • Your baby’s movements (in your third trimester).

You will need to wear a face covering to any hospital appointments. You will not be expected to wear a face covering during birth. 

From the 15th June 2020 the Government has advised that all visitors to hospitals should wear face coverings.
“The face covering should cover the mouth and nose while allowing the wearer to breathe comfortably. It can be as simple as a scarf or bandanna that ties behind the head to give a snug fit.”

If you’d like to make a face covering, here is some guidance on how.

Many maternity units are now offering your booking appointment by telephone or videoconference rather than in person with community midwives. You will still be able to ask lots of questions and be given lots of information. An appointment will be arranged for you to attend the clinic to have your blood pressure taken, a urine sample collected, to be weighed, and a blood sample for any screening tests you have requested. This is what usually happens when you’re booking in.

Your ‘booking in’ appointment may take place at the time of your 12-week dating scan to reduce journeys into hospital. 

 

Your local maternity service should have things in place to allow you to bring a support person with you to your scan appointments – based on NHS guidance. Your midwife will give you information about COVID-19 protective measures when you attend scans. You and your support person may be asked to complete a COVID-19 test on arrival.   

What you could do if you or your partner tests positive for COVID-19? 

Your midwife will speak to you about options, which may include rescheduling the appointment. Your maternity team will advise you. 

You should have a minimum of 3 appointments after your baby is born: day 1, day 5, and day 10. Your team will let you know if these will be over the phone, at your home, or in a clinic/hospital. If you have any concerns about yours or your baby’s health at this time, please let your team know so that they can support you.

Your first appointment after you’ve been discharged should be face to face at home.

Some antenatal classes have been put online to ensure that information is shared and questions answered; for example, the NCT.

There are different providers of antenatal classes – some may be better suited to your needs than others.

Ask your team for the emergency number to call if you don’t have this already. If you are worried about the health or safety of you or your baby, please do not hesitate to contact your maternity team – they will be happy to hear from you. If your baby’s pattern of movements changes or reduces in number, please call and speak to a midwife promptly.

There may be some changes to antenatal appointments to ensure your and your baby’s safety – for more information, please see our ‘Appointments’ section.

Please contact your GP, midwife or early pregnancy unit if you have concerns.

Please still contact your GP, midwife or local early pregnancy unit straight away if you have any concerns about yourself or your pregnancy. They will want to hear from you.

If you have any of the following symptoms please seek medical advice straight away:

  • pelvic pain,
  • cramping,
  • and/or bleeding

Hospitals have organised their services so that this care is still available to you, so please do not feel that you cannot contact them.

Am I more likely to have a miscarriage?

There is currently no evidence to suggest that you will be more likely to have a miscarriage if you do get coronavirus.

If you are in your third trimester (more than 28 weeks pregnant) you should really try to socially distance and minimise contact with others.
What does this mean?
Public Health England have written some guidance to follow:

Guidance on social distancing.
Guidance for individuals and households with possible coronavirus infection.

My Partner is a Key Worker

The government has suggested a number of simple ways to protect yourself if you’re classed as vulnerable (this includes pregnant women as a precaution) and living with a key worker:

  • Frequent hand-washing
  • Showering when you re-enter the house
  • Washing the clothes you travelled with

I am a Key Worker

For individuals in key professions, travelling to and participating in work remains essential in this national emergency. It is up to you, your line managers and occupational health teams, to assess risk and ensure your health and safety is maintained.
Simple things you can do to protect yourself are as above.

For detailed guidance if you’re pregnant and a healthcare worker, please see the guidance from the Royal College of Obstetricians & Gynaecologists.

First UK data about the effects of coronavirus and pregnant women have shown a relationship between being more poorly with the virus and certain demographic factors. It’s worth saying that the risks remain low, in the same way as the general population.

  • Around 1 in 10 women required intensive care
  • It emphasised that women in their third trimester (more 28 weeks into pregnancy) should take more care in socially distancing.
  • It has also suggested that pregnant women are not at greater risk of severe COVID-19 than other non-pregnant women.
  • As with the general population data, pregnant women from black and other minority ethnic groups were more likely to be admitted to hospital.
  • Older (35 and older) or obese pregnant women were also more likely to be admitted to hospital, as well as those with pre-existing conditions (e.g. high blood pressure or diabetes).
  • Around 1 in 20 babies born had a positive test for COVID-19 immediately after birth, which suggests that the virus transmission from mother to baby is low.

Pregnant women remain in the “vulnerable” category, which means they are thought to be of “moderate risk”.
They are advised to stay at home as much as possible and, if they do go out, they should take particular care to minimise contact with others outside their household.

If you feel unwell, you should not hesitate to get in touch with your maternity team.

The government’s guidance on schools and early years settings advises that: children and young people who live with someone who is pregnant (vulnerable) can attend school and early years settings.

If you choose to take your children to school/nursery/external childcare, here are some things to follow:
Practice social distancing – stay two meters away from teachers/carers and other parents and do not go inside the building. If this is difficult, then consider staggering your child’s drop off and pick up times. This is particularly important in your third trimester (beyond 28 weeks pregnant).

Remember to wash your hands when you return home and ensure that your children wash their hands when they leave the childcare setting. Alcohol gel can be used if they cannot wash their hands with soap and water.
The Royal College of Paediatrics and Child Health have set out some practical considerations for returning to school.

If you have been classed as “extremely vulnerable”, then the government has advised that you should shield. Which means:

  • The child in your household should only attend school or nursery if they can follow and understand social distancing and hand hygiene.
  • You are strongly advised to stay at home at all times and avoid any face-to-face contact to protect yourself.
  • Do not attend any gatherings, including gatherings of friends and families in private spaces, for example, family homes, weddings and religious services.
  • Strictly avoid contact with someone who is displaying symptoms of coronavirus (COVID-19).

 

In general, pregnant women are classed as “clinically vulnerable”, which means that they are thought to be of “moderate risk” during the COVID-19 pandemic. If you are a pregnant woman with significant heart disease, congenital or acquired, then you will be in considered to be “clinically extremely vulnerable”. This means you are considered to be of greatest risk of becoming very poorly with COVID-19. For a full list of who is considered to be “clinically extremely vulnerable”, please see the latest government guidance. The advice is to “shield” has now been paused, but you are still advised to socially distance.

Advice for Shielding

The guidance for the clinically extremely vulnerable is that shielding has been paused. This means:

  • You can go to work as long as the workplace is Covid-secure, but should carry on working from home wherever possible
  • You can go outside as much as you like but you should still try to keep your overall social interactions low
  • You can visit businesses, such as supermarkets, pubs and shops, while keeping 2 metres away from others wherever possible or 1 metre, plus other precautions
  • You should continue to wash your hands carefully and more frequently than usual and that you maintain thorough cleaning of frequently touched areas in your home and/or workspace
  • You will no longer receive free food parcels, medicine deliveries and basic care from the National Shielding Service

For practical tips on staying safe, see the guidance on how to stay safe outside your home.

Staying safe outside your home:

  • Keep distance from people outside your household or support bubble (at least 1 metre).
  • Avoid being face-to-face with people outside your household or support bubble.
  • Keep your hands and face as clean as possible.
  • Keep indoor places well ventilated.
  • Avoid crowded spaces.
  • Work from home if you can.
  • If you have to travel, think about how and when you travel to minimise exposure to others outside your household.
  • Wear face coverings.
  • Avoid shouting or singing close to people outside your household or support bubble.
  • Reduce the number of people you spend time with in a work setting.
  • Wash your clothes regularly.
  • When you’re in a public place, please follow their guidance on preventing the spread.
  • Pregnant women with significant heart disease. 
    If you have a significant heart disease, please continue to take the precautions set out by your local guidance. 
  • Pregnant women from Black, Asian and minority ethnic groups.
    Data have shown that pregnant women from Black, Asian, and minority ethnic backgrounds are more likely than other pregnant women to be admitted to hospital and becoming seriously unwell with coronavirus. If you have symptoms and you feel them worsening, it is important to seek medical help. 
    Your maternity team may offer you additional appointments if they feel you need additional or specialist care. 
    It is recommended that pregnant women take a vitamin D supplement – speak to your community midwife or maternity team if you have any questions about this. It has been shown that people with low levels of vitamin D are at an increased risk of serious respiratory complications and – although there is not enough evidence of this providing an effective treatment in coronavirus – it may help. 
  • Pregnant women over the age of 35
  • Pregnant women with a BMI of 30 or more
  • Pregnant women with pre-existing medical conditions (e..g high blood pressure and diabetes) 

Advice
All pregnant women should follow government and local guidance on social distancing and staying safe. It is important you seek medical help if you feel unwell or symptoms get worse – call your maternity team, GP, NHS 111 online service or NHS 24 in Scotland, or in an emergency call 999. This is especially important if you are in one of the higher risk categories (above). If you are in a higher risk category, your maternity team may wish to offer you additional appointments. 

Please remember: you are more likely to have mild or no symptoms and recover from COVID-19 than you are to become seriously unwell.

If you have any questions or concerns about your or your baby’s health then please do contact a medical professional as early as possible.

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