We Know a Lot More About COVID-19 and Pregnancy Now

The internet: excellent for last-minute shopping and learning the latest celebrity gossip. Not so great for calming your nerves if you've found yourself pregnant smack in the middle of another influx of COVID-19 infections.

Here’s the truth: We’ve come a long way since COVID-19 first arrived on the scene when pregnant people were often forced to deliver their babies, alone, masked and fearful. Today, although the risk of complications is still real, we know they are relatively rare, and we now have so much more information (and tools). That means you can better protect yourself before, during and after pregnancy, and focus on the more important things — like your new arrival.

Why pregnant people are more vulnerable when it comes to COVID-19

There are a few reasons why COVID-19 can cause more problems in people who are pregnant, and most of them have to do with the changes the body goes through when it’s, you know, growing a child.

“I don’t really consider pregnant people to have decreased immunity,” says Dr. Linda Eckert, OB-GYN and professor of obstetrics and gynecology at the UW School of Medicine. “The pregnant physiology is just different.”

During pregnancy your body is constantly working to protect both you and your baby from getting sick. That means that parts of your immune system might function differently, making you slightly more susceptible to more severe symptoms if you do get sick. Other changes (like your diaphragm shifting up and your heart and blood vessels working harder to pump more blood) can also put extra pressure on your systems, which means that your body can sometimes get hit harder by illnesses like COVID-19.

What is the risk of severe COVID-19 for mothers and babies

Experts have learned a lot over the last few years about the unique health risks that COVID-19 carries for someone who is pregnant — and their fetus.

Let’s get something straight: Yes, pregnancy does slightly increase your risk of developing severe pneumonia and other complications, including preterm birth and low birth weight, and that is scary. But it’s still very unlikely you will actually have any of those severe outcomes.

The actual overall chances that you or your newborn will experience complications are still very low: like less than 1%.

“We have fewer ICU stays and fewer hospitalizations in pregnant individuals now that most people have been vaccinated,” says Eckert. “But it still can create quite serious illness in pregnant individuals compared to non-pregnant individuals.”

And as to whether the trimester you’re in matters when it comes to COVID-19, the answer is ... yes. Eckert says that it’s more dangerous to get COVID-19 in the third trimester of pregnancy because of the physiology of pregnant bodies. As the uterus grows bigger, the lungs get more compressed, and since there is more fluid in your body at this stage of pregnancy, there’s more risk of getting fluid in your lungs. The third trimester is also the time in pregnancy when preterm labor can occur with a serious illness.

How to stay safe from COVID-19 when pregnant

No, you can’t live in a bubble for nine months, but there are a few precautions you can take that will help keep you (and your mini-me) healthy.

The COVID-19 vaccine

As of now, your best line of defense is the COVID-19 vaccine. This seems fairly obvious, but many people are still concerned about getting the vaccine during pregnancy. It might be reassuring for them to know that there’s now plenty of data about people who got the vaccine during pregnancy and their babies (who are now a few years old) and they’re just fine.

“We’re not seeing any unusual health concerns pop up, or any harmful side effects,” says Eckert. “The longer-term data is very reassuring in showing that it’s actually very safe to get the vaccine during pregnancy.”

Basically, the antibodies that the mom develops in response to the vaccine pass through the cord blood to the baby, helping to protect them. Eckert notes that the strongest impact is in the first three months of the baby’s life when they’re super vulnerable, but the protection stretches beyond that as well.

To sum it up, getting the COVID-19 vaccine as soon as it’s available is a smart decision — for both of you.

The basics

You know what I’m talking about, the basic ways to stay safe from COVID-19:

• Scrub those hands thoroughly (pretty much all the time)
• Keep your distance from folks who seem like they’re feeling under the weather
• Make sure to mask if you’re in an especially germy situation

“Maybe just be a little more careful than usual,” says Eckert. “If you're pregnant in a crowded Light Rail car and it's January, and there are a bunch of people coughing, consider wearing a mask.”

What to do if you get COVID-19 while pregnant

If you do test positive for COVID-19 during your pregnancy — don't panic. The best thing to do is call your OB-GYN and let them know. Even if you’re feeling just fine, your health team is going to want to know the news since you now have an increased risk of developing complications.

And though some doctors base their treatment purely on whether you’re symptomatic, Eckert recommends treating pregnant people who test positive for COVID-19 with Paxlovid — which can help prevent severe complications and has also been commonly (and safely) used in pregnancy.

Eckert also emphasizes that you should always monitor any shortness of breath, coughing and fevers — and if any symptoms get worse, it’s important to keep your doctor updated. The risk of hospitalization is much lower than it once was, but it’s always best to play it safe when it comes to COVID-19.

What about after the baby is born?

Once the bundle of joy has arrived ... you’re probably still going to be stressed about COVID-19, and other illnesses, etc. Take a deep breath, wash your hands and relax.

Let’s go back to that vaccine that you got while pregnant, which turns out was a very important step for both your health and your baby’s health.

Because of the antibodies that were passed to your baby through your placenta, your kid is protected during those first few months when they’re especially vulnerable. Plus, if you decide to breastfeed, your breastmilk will also provide them with more antibodies and COVID-19 protection.

Not breastfeeding? You still have more options to protect your little one — according to the Centers for Disease Control and Prevention (CDC), babies can get their own special baby-sized COVID-19 vaccines starting at just 6 months old.

Another thing: Should you happen to contract COVID-19 after the baby is born, Eckert says that it’s still safe to breastfeed. She just encourages parents to wear a mask to protect your baby. And there’s even good news with that: “You're going to start making antibodies to that virus within 14 days that you're going to pass to that baby, too.”

What a long, strange trip it’s been

So, five years after the start of the pandemic, we have learned quite a bit more about COVID-19 and how to best protect yourself and your baby during pregnancy. Hopefully this information and these tools are helpful and offer you some peace of mind ... now go get those feet up.