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 16/06/2020

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.   

Guidance to follow

All pregnant women should follow the PHE advice:

Should I be self-isolating or social distancing? What's the difference? 

As like everyone else, all pregnant women are currently advised to avoid unnecessary contact with people and going out of the house, except in special circumstances. This is being called social distancing. If you are in your third trimester (more than 28 weeks pregnant) you should be particularly attentive to social distancing and minimising your contact with others. 

Self-isolating involves staying at home and only going outside for exercise, avoiding contact with others. If you live alone this is for 7 days, and if you live with others, it is 14 days. 

You may be advised to self-isolate because:

Women who are though to be at a very high risk, including pregnant women with significant heart disease (congenital or acquired) should follow shielding guidance. 

What effect does coronavirus have on pregnant women?

Pregnant women were placed in a vulnerable group by the Chief Medical Officer on 16 March. This means you have been advised to reduce social contact through social distancing measures.

This has been done to err on the side of caution. We already know that some viral infections are worse in pregnant women and midwives and obstetricians  are used to dealing with these. There is no evidence to show that pregnant women will be more severely unwell than other healthy adults if they develop coronavirus. It is expected that most pregnant women will experience mild or moderate cold or flu-like symptoms. Cough, fever, shortness of breath, headache and loss of sense of smell are other relevant symptoms.

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. The first report from this study looked at 427 pregnant women who were admitted to hospital with COVID-19 between March 1 and April 14. 

This study found that fewer than 0.5% of all pregnant women were admitted to hospital with the disease, and only around 1-in-10 of those needed intensive care. This is positive news, because it suggests that pregnant women are at no greater risk of severe COVID-19 than the wider population.

Risk factors

The study also found that some women are more likely to develop severe coronavirus symptoms and need hospital treatment, including:

  • women from a black, Asian and minority ethnic (BAME) backgrounds (55% of pregnant women admitted to hospital during this study were from a BAME background)
  • 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.

The study also found the majority of women who have become severely ill were in their third trimester of pregnancy, emphasising the importance of social distancing, especially from 28 weeks of pregnancy.

When to seek help

If you think you may have symptoms of COVID-19 you should use the NHS 111 online service for information, or NHS 24 if in Scotland. Tell them if you believe you are at higher risk of complications. It may help to tell your midwife, too. 

If you feel your symptoms are getting worse 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.

If you are in your first trimester

It is very important to still contact your GP, midwife or local early pregnancy unit if you have any concerns. Some symptoms, such as pelvic pain, cramping and/or bleeding during early pregnancy, are linked to ectopic pregnancy and other pregnancy complications so you should seek urgent medical advice.

You will have an appointment arranged as soon as possible with your local early pregnancy unit to check your symptoms. They will advise whether you need to visit the hospital for care.

Hospitals are trying to limit the amount of people visiting in order to reduce the spread of the coronavirus. But they have been organised to be able to offer all essential services. 

What effect can coronavirus have on my baby? 

This is a very new virus and more is being learned about it every day. Emerging 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.

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 was 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 developing coronavirus?

The most important thing you can do is to wash your hands regularly and effectively. Use soap and water and wash for at least 20 seconds.

As a precaution, you should follow government advice about social distancing, stay away from public places and avoid anyone who has symptoms suggestive of coronavirus. 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.

What if I can't work from home?

If you can’t work from home and you work in a public-facing role, talk to your employer about what steps can be taken to minimise your exposure. 

If you are in your first or second trimester (less than 28 weeks pregnant), with no underlying health conditions, you should practise social distancing but can continue to work in a public-facing role, provided the necessary precautions are taken.

If you are in your third trimester (more than 28 weeks pregnant), or have an underlying health condition – such as heart or lung disease - you should work from home where possible, avoid contact with anyone with symptoms of coronavirus, and significantly reduce unnecessary social contact. Talk to your employer if you are in or approaching your third trimester. 

Find out more about returning to work. 

What do I do if I think I have coronavirus?

If you are pregnant and have either a high temperature and/or a new, persistent cough, you should stay home for at least 7 days. Do not go to your GP surgery, pharmacist or hospital. You do not need to call NHS 111 to tell them that you are staying home. 

You should let your midwife or maternity unit know about your symptoms, especially if you have any routine appointments in the next 7 days. 

Please be alert to the other possible causes of fever in pregnancy. These include urine infections (cystitis) and waters breaking

If your symptoms are getting worse or if you are not getting better, contact the NHS on 111 (or a local alternative), your maternity unit or, in an emergency 999, straightaway for further information and advice.

This information is particularly important for women in higher-risk groups: 

  • women from a black, Asian and minority ethnic (BAME) backgrounds (55% of pregnant women admitted to hospital during this study were from a BAME background)
  • 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.

How will I be tested for coronavirus?

The process for testing for coronavirus is changing all the time. Testing is now open to anyone in the UK, including pregnant women, with coronavirus symptoms. If you have symptoms, please call 119 or visit the NHS website to book your test.

Testing is now offered to all patients admitted to hospital, regardless of whether they have symptoms. This includes all women who go to hospital for urgent maternity care, for example spontaneous labour and birth. 

New national guidance from NHS England recommends that women having elective procedures should be offered testing before arriving at hospital. You may be asked to self-isolate before having an elective caesarean birth or planned induction of labour. 

Testing in hospitals depends on availability. This is likely to vary across the UK. For maternity units, there are particular practical concerns and the RCOG has developed more detailed information about this.

If you are waiting for test results in hospital ( 24–48 hours), you may be treated as potentially having the virus until you have them.

If you have symptoms but have recently had a negative result, your maternity team may still be cautious. This is because the virus does not show on results if you have just been infected. You may be offered another test in a few days.

Anti-body test

This is a blood test that shows whether you have previously come into contact with the virus. This type of test is currently only offered to NHS staff and some individuals across the UK. RCOG do not currently recommend that results from antibody tests are used when caring for pregnant women.

Birth partner testing

Your birth partner may also be offered testing for when you go to hospital. Your maternity team will advise you further.

Refusing testing 

If you refuse testing for coronavirus before going to hospital, your care will be the same as anyone else who does not yet have a test result. 

Should I attend my antenatal appointments?

Yes, it is really important that, if you are well, you continue to attend your scheduled antenatal appointments when you are pregnant. If you normally prefer to have your partner or someone with you, check with your midwife if this is still possible. Some services may have restrictions in place to protect their staff and visitors from potential coronavirus infection. 

If you have a routine scan or visit due in the coming days, please contact your maternity unit for advice and to agree a plan. You may still be advised to attend for a visit, but this appointment may change due to staffing requirements.

If you are advised to attend for a scan or an appointment by your local maternity team, this is because the need for the appointment is greater than your risk of being exposed to coronavirus. Antenatal care is essential to support you in having a healthy pregnancy. The Royal College of Obstetricians & Gynaecologists strongly advise you to attend your appointments if you're asked to do so. If you have any concerns about this, please discuss talk to your maternity unit.

If you are attending more regularly in pregnancy, then your maternity team will be in touch with plans for further appointments, as required.

 Please remember:

  • If you have an urgent problem related to your pregnancy but not related to coronavirus, get in touch using the same emergency contact details you already have. Please do not contact this number unless you have an urgent problem
  • If you have symptoms suggestive of coronavirus contact your maternity services and they will arrange the right place and time to come for your visits. You should not attend a routine clinic.

At this time, it is particularly important that you help your maternity team take care of you. If you have had an appointment cancelled or delayed, and are not sure of your next contact with your maternity team, please let them know by using the contact numbers given to you at booking.

Who should I contact about my appointments?

If you have been allocated a local health continuity team or a named community midwife, you should continue to contact them by telephone.

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. They will connect you to an appropriate continuity team or named community midwife.

How many antenatal appointments will I have?

The NHS has provided guidance to all maternity teams that your first post-natal appointment should be a face-to-face visit at home following birth. This will be day 1 if you gave birth to your baby at home or the first day back after being in hospital or a midwifery led unit. The RCM have produced a useful infographic on preparing for a home visit from your midwife.

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 (dating) scan. In the third trimester, you should be asked about your baby’s movements at every appointment, whether in person or via phone/video. Contact your midwife or maternity unit immediately if you think your baby’s movements have slowed down, stopped or changed. Do not wait for your next appointment.

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
  • talking about your birth plan
  • local provision of antenatal/parent education classes, infant feeding support and information on safe sleeping, pelvic floor exercises and birth choices

Do I need to wear a facemask when I go to hospital?

To reduce transmission of coronavirus in hospitals, 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. This should be communicated with you through your appointment letter, local Trust websites and social media outlets. At present hospital inpatients, including women giving birth, are not required to wear masks.

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

In most hospitals and maternity units, there are now 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.

The Royal College of Obstetricians & Gynaecologists do not recommended that you video call anyone or film your ultrasound scans during the process as this can distract the sonographer and prevent them from doing their job effectively. Instead, they  encourage units to allow you to share the ultrasound scan experience with your partner, family members or friend by saving a short 10-30 second video clip of the baby at the end of the dating scan and/or anomaly scan.

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.

Visit our page on coronavirus and giving birth to find out more about birth partners and restrictions to visits at this time. 

Can I still go to antenatal appointments if I am self-isolating?

If you are currently self-isolating for coronavirus, you should speak to your midwife or antenatal clinic to get their advice on attending routine antenatal appointments. It is likely that routine antenatal appointments will be delayed until isolation ends.

However, arrangements will be made for you if, for some reason, your midwife or doctor advises that your appointment can’t be delayed.

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

What to do if you are self-isolating and become unwell or worried about your baby?

Pregnant women are advised not to attend maternity triage units or A&E unless in need of urgent pregnancy or medical care.

If you have any concerns, contact your midwife or out-of-hours maternity team. They will provide you with guidance and will advise you whether you need to go to hospital.

If you do need to the maternity unit or hospital, try to travel by private transport and let the maternity triage reception know you have arrived on the hospital grounds, before entering the hospital.

Please seek help if you have any concerns about you and your baby's health. Don't just wait and see or think it's nothing important. You can always call your midwife about anything, even if it is not coronavirus related.

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

If you are in self-isolation and think you have gone into labour, contact your maternity unit for advice. Let them know if you have suspected or confirmed coronavirus. If your symptoms are mild, they will encourage you to stay at home in early labour, which is standard practice.

When you and your maternity team decide you need to attend the maternity unit:

  • You will be advised arrive via private transport where possible (or call 111/999 for advice)
  • Someone will meet you at the entrance to give you a surgical mask, which you need to keep on until you are in a room
  • Coronavirus testing will be arranged for you
  • Your birth partner will be able to stay with you throughout, but visitors may not be permitted.

How will my care be managed after recovery from coronavirus?

To check your baby is well, you will have an ultrasound scan 14 days after your recovery.

If you have tested negative for the virus before going into labour, your birth plan should not be affected by previously having the virus.

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.

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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