Pregnancy and coronavirus: information for pregnant women

The Royal College of Obstetricians & Gynaecologists has released official guidelines to outline information for pregnant women and new mums surrounding the recent outbreak of coronavirus (COVID-19). Try not to worry and follow any advice in these guidelines. We are updating this page as new information is published.

Updated 19/10/2020

These Q&As are based on official guidance from the Royal College of Obstetricians & Gynaecologists (RCOG). Advice from the UK government is rapidly changing as more is learned about the virus. We are updating this information as new guidance becomes available. We understand that many of you will be very worried and have lots of questions. We will do our best to support you through these difficult times.      

Find out more about planning a pregnancy and the coronavirus pandemic.

What effect does coronavirus have on pregnant women?

Pregnant women were placed in a vulnerable group by the Chief Medical Officer on 16 March and this has not changed. This means you have been advised to reduce social contact through social distancing measures. This is a precautionary measure. 

Pregnancy can alter how your body handles severe viral infections in some women. This is something that midwives and doctors have known for many years and are used to dealing with. However, all available evidence suggests that pregnant women are at no greater risk of becoming seriously unwell than other healthy adults if they get coronavirus.The large majority of pregnant women experience only mild or moderate cold/flu-like symptoms.

Are some pregnant women more at risk of becoming seriously unwell from coronavirus than others?

In the UK, information about all pregnant women requiring admission to hospital with coronavirus is recorded in a registry called the UK Obstetric Surveillance System (UKOSS). Data from this study of 427 pregnant women in May 2020 found the majority of women who have become severely ill were in their third trimester of pregnancy. Therefore, it's important to pay particular attention to social distancing from 28 weeks of pregnancy.

The study also found some pregnant women are at a higher risk of developing serious illness, including:

  • pregnant women from black, Asian and minority ethnic (BAME) backgrounds
  • women over the age of 35
  • women who are overweight or obese
  • women who have pre-existing medical problems, such as high blood pressure and diabetes.

Healthcare professionals are also being advised that women known to be at higher risk should be told at each contact that they may be at risk of complications of coronavirus. If any of the above applies to you, try to seek help early if you are concerned about your health or your baby's.

If you are from a black, Asian and minority ethnic (BAME) background your maternity team may book you additional appointments, or refer you to a doctor or specialist clinic if there are any concerns about your health or your baby’s health.

What is the advice for women from a Black, Asian or minority ethnic background?

Women from Black, Asian and minority ethnic (BAME) backgrounds are at higher risk of becoming seriously unwell and being admitted to hospital so it’s important that if you feel your symptoms are worsening or if you are not getting better, you should seek medical help.

Your maternity team may offer you additional appointments, or refer you to a doctor or specialist clinic if there are any concerns about your or your baby’s health.

If you aren’t already, you should consider taking a vitamin D supplement, which is recommended to all women during pregnancy. There have been some reports that people with low levels of vitamin D are at an increased risk of serious respiratory complications if they develop coronavirus. However, there is not enough evidence to show that taking vitamin D prevents coronavirus infection or is an effective treatment.

Women from BAME backgrounds, with melanin pigmented (dark) skin, may be particularly at risk of low levels of vitamin D and are advised to take a higher dose of vitamin D. Speak to your community midwife or maternity team if you have any questions about vitamin D supplementation.

The Royal College of Midwives has developed new guidance for midwives and maternity support workers to ensure that they are aware of the increased risks for BAME women and can pass on relevant advice and support to the women in their care.

The NHS in England has written to all maternity units in the country calling on them to take four specific actions to minimise the additional risk of coronavirus on BAME women and their babies. Find out more here.

I am pregnant – what do I need to do?

As a precaution, you should follow government advice about social distancing, stay away from public places and avoid anyone who has possible coronavirus symptoms. It is still considered necessary for pregnant women to go out for essentials, such as food shopping, exercise and to attend antenatal appointments.

If you are in your third trimester (more than 28 weeks’ pregnant) you should be particularly attentive to social distancing and minimise any contact with others.

The key advice for all pregnant women is:

Shielding measures for those at high risk of severe illness

On 24 March, additional shielding measures were announced for people defined on medical grounds to be at very high risk of severe illness from coronavirus, including pregnant women with significant heart disease (congenital or acquired). The shielding guidance was updated on 31 May.

Shielding guidance is now being relaxed but this is happening differently in the four nations of the UK. Please look for advice here for England, here for Scotland, here for Wales, and here for Northern Ireland.

If you are pregnant and have significant heart disease, you should continue to take the precautions outlined in this updated guidance, and speak to your midwife or obstetrician with any questions you may have.

Should I have a flu vaccination?

All pregnant women are encouraged to get a free flu vaccination. Being pregnant can change the way your body recovers from viral infections. Although most recover quickly, flu can be serious for a small number of people and their babies. The vaccination is safe at any stage in pregnancy. 

Getting the flu vaccination is even more important during the coronavirus pandemic. Public Health England’s research shows that getting the flu and coronavirus at the same time can make you more seriously ill than if you are infected with one virus alone.

The RCOG and RCM therefore strongly recommend that pregnant women get the flu vaccination this winter.

You can ask your midwife, GP or local pharmacist for information on where you can get the flu vaccination.

I am less than 12 weeks pregnant and need medical attention. What do I do?

We have information for you if you (or someone you love) are under 12 weeks pregnant (in your first trimester) and you have a problem or concern that may require care from an early pregnancy assessment unit. Find out more.

What do I do if I think I have coronavirus?

Symptoms of coronavirus include:

  • cough
  • high temperature
  • shortness of breath
  • headache
  • loss or change to your sense of smell or tastes.

If you think you may have symptoms of coronavirus, you should use the NHS 111 online service for information, or NHS 24 if in Scotland. 

You should stay at home for 7 days. Do not go to a GP surgery, pharmacy or hospital without contacting them on the telephone first. You do not need to contact NHS 111 to tell them you are staying at home. 

You should contact your maternity unit to inform them that you have symptoms suggestive of coronavirus, particularly if you have any routine appointments in the next 7 days. 

If you develop more severe symptoms or your recovery is delayed, this may be a sign that you are developing a more significant chest infection that requires specialised care. If you feel your symptoms are worsening or if you are not getting better, you should contact your maternity care team, your GP, or use the NHS 111 online service / NHS 24 for further information and advice. In an emergency, call 999. Tell them if you believe you are at higher risk of complications.

Be aware that there are other possible causes of high temperature (fever) in pregnancy aside from COVID 19. In particular, these include urine infections (cystitis) and waters breaking. Find out more about pregnancy symptoms that you should always get checked out.

Will I be tested for coronavirus?

The process for diagnosing coronavirus infection is changing rapidly. Testing is now open to anyone in the UK, including pregnant women, with coronavirus symptoms. You should visit the NHS website to book your test, or call 119 to arrange testing. The list of symptoms has also been expanded to include loss of or change in someone’s normal sense of smell or taste.

To minimise the spread of coronavirus in hospitals, the offer of testing is being expanded to include all patients admitted to hospital, regardless of whether they have coronavirus symptoms or not. This includes offering tests to all women who attend hospitals for urgent or emergency maternity care, including attendance for spontaneous labour and birth.

New national guidance from NHS England recommends that individuals admitted for elective procedures should be offered testing prior to admission, following a period of self-isolation. For maternity units, there are particular practical concerns and the RCOG has developed more detailed information about this.

If you have an elective caesarean birth or induction planned, you may be asked to follow a period of self-isolation and offered a test for coronavirus prior to admission. Your maternity team will discuss this with you.

The ability for widespread testing in a hospital trust will depend upon the availability of testing kits, testing capacity in the local laboratory and available staff to take the tests. This is likely to vary across the UK and local adaptations will be required, adapted according to local capacity and disease prevalence.

How does the coronavirus test work?

Pregnant women are tested in the same way as anyone else. Currently, the test involves swabs being taken from your mouth and nose. You may also be asked to cough up sputum, which is a mixture of saliva and mucus.

The most effective tests currently take 24–48 hours for the result to be available. This means that if you are awaiting test results whilst in hospital you may be treated as potentially infectious until the result is returned.

If you have symptoms of coronavirus but have recently received a negative test result, your maternity team may still use caution when caring for you. Sometimes, the virus doesn’t show on the test results if you have been tested not long after you have become infected. You may be offered another test in a few days.

What is an antibody test – will I have this?

You may also have heard about antibody testing for coronavirus. This is a blood test that can show whether you have previously come into contact with the virus or not. It does this by detecting antibodies, which your body produces if you have had coronavirus. This is called an immune response.

At present, this type of test is only being offered to NHS staff and some individuals across the UK. It is hoped the results of these tests will help us to understand how immunity to coronavirus works as we do not yet know how the antibodies develop and how long immunity lasts for. Therefore, RCOG currently recommends that results from antibody tests are not used when caring for pregnant women.

Will my birth partner be tested for coronavirus?

It is possible that your birth partner may also be offered testing for coronavirus when you are admitted to hospital. Your maternity team will be able to advise you further.

What if I decline testing for coronavirus?

If you decline testing for coronavirus prior to attending hospital for urgent or planned maternity care (including labour and birth), your care will be the same as any woman who is admitted to hospital and who does not yet have a test result.

What should I do if I test positive for coronavirus?

If you test positive for coronavirus outside of a hospital setting, you should contact your midwife or antenatal team to make them aware of your diagnosis. If you have no symptoms or mild symptoms, you will be advised to recover at home. If you have more severe symptoms, you might be treated in hospital.

Why would I be asked to self-isolate (as opposed to reducing social contact)?

You may be advised to self-isolate because:

  • you have symptoms of coronavirus, such as a high temperature or new, continuous cough, or loss or change in your sense of smell or taste
  • you have tested positive for coronavirus and you’ve been advised to recover at home
  • you have an elective caesarean birth or induction planned and you have been asked to self-isolate prior to your admission to hospital.

What should I do if I’m asked to self-isolate?

Pregnant women who have been advised to self-isolate should stay indoors and avoid contact with others for 7 days. If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.

The NHS guidance on self-isolation currently recommends people should:

  • not go to school, work, NHS settings or public areas
  • not use public transport
  • stay at home and not allow visitors
  • open windows to ventilate rooms
  • separate themselves from other members of their household as far as possible, using their own towels, crockery and utensils and eating at different times
  • use friends, family or delivery services to run errands, but advise them to leave items outside.

You may wish to consider online fitness routines to keep active, such as pregnancy yoga or pilates. Keeping mobile and hydrated, even if you are self-isolating, is important to reduce the risk of blood clots in pregnancy. Find out more about staying active during the coronavirus pandemic.

What happens if I go into labour during my self-isolation period?

If you go into labour during self-isolation, you should call your maternity unit for advice, and tell them that you have suspected or confirmed coronavirus infection.

If you have mild symptoms, you will be encouraged to remain at home (self-isolating) in early labour, as usual practice.

Your maternity team have been advised on ways to ensure that you and your baby receive safe and high quality care, facilitating and respecting your birth choices as closely as possible.

When you and your maternity team decide that you need to attend the maternity unit, general recommendations about hospital attendance will apply:

  • You will be advised to attend hospital via private transport where possible, or call 111/999 for advice, as appropriate
  • You will be met at the maternity unit entrance and may be provided with a face mask, which you will need to wear until you are isolated in a suitable room

What effect will coronavirus have on my baby if I am diagnosed with the infection?

As this is a very new virus, we are just beginning to learn about it. Current evidence suggests that transmission from a woman to her baby during pregnancy or birth (vertical transmission) is probable. It is important to emphasise that in all reported cases of newborn babies developing coronavirus very soon after birth, the babies were well.

Given current evidence, it is considered unlikely that if you have the virus it would cause problems with your baby’s development, and none have been observed currently.

Premature birth

Across the world, emerging reports suggest some babies have been born prematurely to women who were very unwell with coronavirus. It is unclear whether coronavirus caused these premature births, or whether it was recommended that their babies were born early for the benefit of the women’s health and to enable them to recover.

In the recent UK study of 427 pregnant women with coronavirus, some women's conditions were serious enough that they needed to be admitted to hospital. Of the babies born during this time:

  • 1 in 5 were born prematurely and were admitted to a neonatal unit - fewer than 20 babies were born very prematurely (when the woman was less than 32 weeks pregnant)
  • 12 babies had a positive test for coronavirus, but only 6 had a positive test immediately after birth - this suggests that infection transmission from mum to baby is low.

The is also no evidence to suggest an increased risk of miscarriage.

What can I do to reduce my risk of catching coronavirus?

The most important thing to do is to follow government guidance. For pregnant women and the rest of their households, this includes:

  • wash your hands regularly
  • use a tissue when you or anyone in your family coughs or sneezes, discard it and wash your hands
  • avoid contact with someone who is displaying symptoms of coronavirus (these symptoms include high temperature and/or new and continuous cough)
  • avoid non-essential use of public transport when possible
  • work from home, when possible
  • avoid large and small gatherings in public spaces, noting that pubs, restaurants, leisure centres and similar venues are currently shut as infections spread easily in closed spaces where people gather together
  • avoid gatherings with friends and family - keep in touch using remote technology such as phone, internet and social media
  • use telephone or online services to contact your GP or other essential services.

How can I protect my mental wellbeing during the pandemic?

In times like these, it can be difficult to keep anxiety under control. But try to remember that anxiety is a normal response to a threatening situation, so it is understandable that so many people are feeling like this right now. However, there are things that can help you to feel more in control. Find out more.

What is the travel advice if I am pregnant?

If you are in the UK, you should follow the advice given by the Foreign and Commonwealth Office, which is being regularly updated in line with the evolving situation.

All individuals, including pregnant women, should ensure they have adequate insurance arrangements prior to travel. You should also check that your travel insurance will provide cover for birth and care of your newborn baby if you give birth while abroad.

What is the advice for pregnant women with older children attending school/nursery/external childcare?

As the government continues to lift restrictions and schools start opening again, some pregnant women with older children are concerned about possible exposure to the virus and what this means for them and their baby. Here, Tommy’s midwife Sophie explains the latest guidance.

How will the coronavirus pandemic affect my routine antenatal and postnatal appointments?

You will be told about any changes by your local maternity service. Antenatal and postnatal care is based on years of evidence to keep you and your baby safe in pregnancy and birth, and beyond. Antenatal and postnatal care should therefore be regarded as essential and you should be encouraged to attend, despite being advised to engage with social distancing measures.

Your local maternity team may reduce routine appointments, provide more home visits or deliver some care and support over the phone or by video to reduce the number of times you need to travel and attend hospital/clinics. You will be informed of any changes to your care in advance.

Why are changes to antenatal and postnatal care necessary during the coronavirus pandemic?

These changes are a way of ensuring we deliver the best care without overloading NHS services, which are crucial during the coronavirus pandemic. This helps them to:

  • reduce the number of people coming into hospitals where they may come into contact with other people and spread the virus
  • ensure staff are not overwhelmed and stretched too far by the additional strain on services, which could be due to staff sickness and self-isolation as well as the higher numbers of patients needing care and overnight hospital stays due to coronavirus.

This allows healthcare professionals to care for you and protect you from coronavirus, while also ensuring we protect NHS staff and services.

Who should I contact about my antenatal and postnatal care appointments?

If you have been allocated a local health continuity team or a named community midwife

You should continue to contact your continuity team or community midwife by telephone to discuss any questions or concerns you might have and to check on arrangements for all scheduled and future appointments.

If you have not been allocated a local health continuity team or a named community midwife

You should contact your GP surgery or local maternity unit in order to be connected to an appropriate continuity team or named community midwife so you can discuss any questions or concerns you might have and to check on arrangements for all scheduled and future appointments. If you are unsure when your next appointment is you should make contact as above to help us care for you.

Can I still attend my antenatal/postnatal care appointments?

Your antenatal and postnatal appointments remain an important part of your maternity care to provide checks and screening on your health and your baby’s health. A member of the maternity team looking after you may call you before your appointment, or carry out an assessment at entrance of the clinic/hospital, or both, to check whether you have any symptoms that are suggestive of coronavirus, or if you meet the current ‘stay at home’ guidance.

If you are advised to attend an appointment by your local maternity team, this is because the need for the appointment to help reduce the risk of complications for you and your baby is greater than your risk of being exposed to coronavirus.

If you are well, you should be able to attend your appointments. You may be asked to attend alone to protect your household from the risk of coronavirus. You will be told about this by your local maternity service. If you are asked to attend your antenatal appointments alone, you should be advised where possible to have a discussion with your partner, or other supportive companion, about any questions they would like you to ask your maternity team on their behalf.

If you are currently self-isolating with suspected or confirmed symptoms of coronavirus, and you have an appointment scheduled in the coming days, you should telephone your continuity team or community midwife, or local maternity unit, to inform them.

Your upcoming appointment will be reviewed by the maternity team looking after you and your baby. You will then be advised whether your appointment is urgent and a home appointment is required, or whether your appointment can be safely delayed for a period of 7 or 14 days until you are well.

How many antenatal appointments will I have?

You will have at least 6 face-to-face antenatal appointments in total. Where possible, essential scans/tests and routine antenatal care will be offered within a single appointment. This is to prevent multiple journeys and visits to clinics/hospital, and will involve contact with as few staff as possible to prevent the spread of coronavirus to you, your family and other patients.

This may mean that your initial ‘booking in’ appointment will take place at the same time as your 12-week scan. You should be asked about your mental health at every appointment, whether in person or via phone/video.

In the third trimester, you should be asked about your baby’s movements at every appointment, whether in person or via phone/video. DO NOT WAIT until your next appointment to seek advice if you are worried about your baby’s movements. Contact your midwife or maternity unit immediately if you think your baby’s movements have slowed down, stopped or changed.

All pregnant women should be provided with information about group B streptococcus (GBS) in pregnancy and newborn babies.

Sometimes, you may need additional antenatal appointments and medical care. This will depend on your individual medical needs. These appointments may be carried out over the phone or via video, provided a physical examination or test is not required. This will enable partners and other family/household members to join you for support and allow social distancing to protect you and your baby from coronavirus.

This may include:

  • appointments with a specialist doctor
  • extra blood tests
  • support for your mental health
  • discussion of plans for birth
  • local provision of antenatal/parent education classes, infant feeding support and information on safe sleeping, pelvic floor exercises and birth choices.
Maternity care is still essential during the coronavirus pandemic and services are still running. If you have any concerns about your pregnancy call your GP, midwife, nearest early pregnancy unit or maternity unit as soon as possible.

Will I be able to bring someone with me to scans?

In some hospitals and maternity units, there are restrictions on visitors which might mean that birth partners or other supportive people are not able to attend routine antenatal appointments, including scans, with you. 

On 5 June 2020, the suspension of hospital visiting in England of inpatients and those who accompany women and other patients to outpatient appointments was lifted. This means that visiting is now up to local Trusts and other NHS bodies. Please check with your maternity unit for their policy on visitors to the antenatal and postnatal wards. It is important that any visitors follow guidance in hospitals about social distancing, wearing a face covering and regular handwashing.

Restrictions around visiting inpatients and accompanying outpatients are now being eased but this happening differently in the four nations of the UK - advice in Scotland (13 July), Wales and Northern Ireland (6 July) has been updated recently. Some Trusts in England are permitting partners or other supportive people to attend these appointments but there is not a consistent approach.

If you are unable to bring someone with you to your scan, you could save a short 10–30-second video clip of the baby at the end of the dating scan and/or anomaly scan to show partners, friends or family.

In the current pandemic situation, when women attend alone, we don't recommend video calling anyone during your scans. While we understand this may be disappointing, virtual attendance can be distracting to the sonographer and prevent them from doing their job effectively.

We understand it may be upsetting if you are asked to come alone to a scan, but this measure has been put in place to protect maternity staff, other women and babies, and you and your family from the risk of infection. Scans are an essential part of pregnancy care and it is important that you continue to attend them for your and your baby’s wellbeing.

Who should care for my other children when I go into hospital for labour and birth, or a check-up during pregnancy?

Government guidelines recommend that guidelines on social distancing should be followed by everybody in the UK wherever possible. It is reasonable to leave your home when you need to do so for a medical reason (i.e. attending a routine clinic appointment, to check on the wellbeing of you or your baby or attending the maternity unit to give birth to your baby). However, your other children must not go with you into the maternity unit. If this means that there is nobody available at home to care for your other children, then you'll need to find another close family member or friend to look after them.

It's a good idea to discuss this with the chosen person in advance so they can make any necessary arrangements. When choosing another person to care for your children in this situation, please do not ask somebody who is vulnerable to the severe effects of coronavirus (e.g. people over the age of 70, other pregnant women or individuals with significant medical problems). Also, it's a good idea to make a back-up plan, in the case the person you had planned to ask is self-isolating because either they, or someone else in their home, are unwell with coronavirus when you need them.

Will I need to wear a facemask when I attend hospital for antenatal appointments, or to have my baby?

To reduce transmission of coronavirus in hospitals, the government have announced that from 15 June, face masks and coverings must be worn by all NHS hospital staff and visitors in England. All visitors and outpatients, including pregnant women attending antenatal appointments or scans, must wear face coverings at all times to protect other women and patients, and staff from coronavirus. At the moment hospital inpatients, including women giving birth, are not required to wear masks.

Can having coronavirus affect where and how I give birth?

Find out more about more about your childbirth choices during the coronavirus pandemic.

Is there increased risk to me or my baby after birth?

There is no evidence that women who are well and have recently had a baby are at higher risk. A woman who has been pregnant recently is considered as having a normal immune system if she has no other forms of infection or underlying illness.Children, including newborns, do not appear to be at high risk of becoming seriously unwell with the virus. 

It is important that your baby is feeding well and gaining weight, and if you have any concerns, please contact your midwife. Do not avoid seeking medical advice if you are worried about your baby’s health. Seek medical advice if your baby has a fever, seems very tired, highly irritable, problems feeding or any other symptoms you may have concerns about.

Find out more about bringing your baby home during the pandemic.

What are my rights when it comes to work and benefits?

Existing regulations on your rights during pregnancy and maternity leave still apply during the pandemic and you are protected against discrimination. Maternity Action have put together some frequently asked questions on rights at work and benefits during pregnancy and maternity leave during the pandemic. This includes information about health and safety adjustments at woek, furlough, redundancy and benefits. They've also produced a model letter that you can use to write to your employer to set out your health and safety rights and ask for homeworking, suspension on full pay or furlough. 

We're here to support you

Although we've had to temporarily close our support line as our midwives have moved to homeworking, our Tommy's midwives are still here to support you.

We are working hard to provide the best support and information we can during a time of extra anxiety and worry for pregnant women and their families.

Watch out for updates and contact us on the following platforms:

If you have non-urgent questions, we have developed Tommy's Midwife, a skill for Google Assistant and Amazon Alexa that answers many pregnancy queries, including some about COVID-19.

Read more about the Tommy's Midwife Alexa skill here

Further information

This information is based on the official RCOG guidelines and NHS guidance

Read more

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