Philadelphia International Medicine
How does COVID-19 affect pregnancy?
If you’re having a baby — or thinking about having a baby — during the pandemic, there’s a ton of information to sift through and make sense of.
You might be wondering how COVID-19 affects pregnancy or if your unborn baby could be impacted by the coronavirus if you get sick. Another common concern is whether or not it’s safe to get vaccinated when pregnant, and if the vaccine could somehow impact fertility.
It’s certainly understandable if you’re concerned about how COVID-19 could interfere with your pregnancy, but with the right protocols in place and a strong medical support team, you and your baby will be able to have a healthy pregnancy and smooth delivery.
“Main Line Health moves with current thought and data,” says Antonette Dulay, MD, a maternal-fetal medicine specialist with Main Line Health. Because restrictions frequently change, you should always be in touch with your OB/GYN about who can be in the delivery room during labor and what the protocols are for the baby.
Here’s what to know about how coronavirus affects pregnancy and fertility.
What to know about pregnancy and COVID-19
The first thing to understand is that pregnant people are at a higher risk for experiencing severe outcomes with COVID-19.
When you are pregnant, the body undergoes changes in the lungs and cardiac system. These are normal physiological changes, but they can make the mother-to-be more sensitive to infections that cause inflammation, such as the flu and COVID-19.
When it comes to coronavirus and pregnancy, know that the vast majority of pregnant people who test positive for COVID-19 won’t develop serious symptoms or complications. However, about five percent will experience severe and critical outcomes, including being admitted to the intensive care unit, requiring oxygen support, or needing mechanical ventilation. “If you’re pregnant and you get COVID, you’re still at a significantly increased risk of developing severe and worse disease,” says Dr. Dulay.
According to Dr. Dulay, pregnant people who contract the coronavirus and develop severe or critical disease have a higher risk of pre-term birth and Cesarean section. Recent data from the Centers for Disease Control and Prevention (CDC) shows pregnant people diagnosed with COVID-19 have no greater risk of miscarriage or stillbirth, notes Dr. Dulay. It’s also widely believed that in utero transmission from mother to fetus is rare.
How do the coronavirus vaccines affect pregnancy and fertility?
Pregnant people were not included in vaccine clinical trials, so there is limited data on the safety and efficacy of the vaccines in pregnant people.
That said, Dr. Dulay thinks the benefits of getting vaccinated far outweigh the risks of contracting COVID-19. And the CDC, American College of Obstetrics and Gynecology, and Society for Maternal-Fetal Medicine have all recommended that the vaccine be made available to pregnant and lactating patients.
Despite not having pregnant or lactating patients as part of the initial trials, the available vaccines have been effective in preventing death or hospitalization for severe disease. Your chances of developing severe illness are much lower if you’ve been vaccinated.
Will I experience side effects from the vaccine?
Reactions to the vaccine are similar in pregnant and non-pregnant people and generally include pain at the injection site, body aches, fatigue, headache and fever.
The kind of short-term fever that may come on after vaccination should not be an issue for pregnant people, says Dr. Dulay. “It’s really more sustained fever that is a problem,” she said. Monitor your temperature and take Tylenol if need be, she advises. Dr. Dulay recommends alerting your doctor if you do develop a fever, even if it’s low grade.
Some have felt concern that the vaccine may inject genetic material into the body that can impact fertility, but Dr. Dulay says this is not the case. The vaccine ingredients are quickly broken down by the body and discarded. There is currently no evidence the vaccine could impact future fertility or cause genetic mutations.
Those who want to start trying to have a baby should consider getting the vaccine as soon as they qualify. “Now’s the time to get it so you don’t even have to worry about what it does to your developing baby,” Dr. Dulay said. Getting the shot will provide protection now and in the future.
Can pregnant people get the vaccine at Main Line Health?
Yes, but currently only to pregnant patients who are 20 to 32 weeks pregnant. This decision was made based on vaccine supply, as well as to avoid any scheduling conflicts with other vaccines required during pregnancy. According to Dr. Dulay, pregnant people should not get the COVID-19 vaccine within two weeks of receiving another vaccine, such as the TDAP shot. In addition, the CDC states that the second dose can be given within 48 days of the first dose, so if you experience a slight delay in getting the second shot, there is no need to panic.
After getting vaccinated, sign up for the CDC’s V-safe program where you can log any symptoms and reactions. You will get a link to register at your vaccine appointment. Not only will this help you keep track of reactions, it can also help collect data and information to help other pregnant patients. “It's the best way we have now to track pregnancy outcomes,” Dr. Dulay said.
Main Line Health has been proactively reaching out to pregnant people who are eligible for the vaccine to help them book an appointment. Check in with your doctor on a regular basis in case supply increases and more vaccination appointments become available.
If you have any questions or concerns about the vaccine, bring them up with your doctor who can review your risks, benefits, and what to expect.
Staying safe and giving birth during the pandemic
Because pregnant people have a greater chance of experiencing severe disease and pregnancy complications, Dulay says it’s critically important to continue following the safety protocols that can help prevent COVID-19: Wash your hands, wear a tight-fitting face mask, and maintain social distance from others.
Finally, stay in touch with your OB/GYN. Restrictions and guidance about who can be in the room during delivery and the protocols for the newborn change often as researchers learn more about how the coronavirus affects pregnancy.
Currently, Main Line Health is allowing two partners in the delivery room, including a doula, if the parent chooses to use one. They must produce a negative coronavirus test before labor and delivery begins. Unless there is an emergency, babies aren’t necessarily being separated from their parents.
With the right protocols in place, new mothers who test positive for the coronavirus will be able to breastfeed their newborns safely and comfortably after delivery.