Information for pregnant women and their families from the Royal College of Obstetrics and Gynaecology. Updated 18 March 2020

Q1. What effect does coronavirus have on pregnant women?

Generally, pregnant women do not appear to be more severely unwell than the general population if they develop coronavirus. As this is a new virus, how it may affect you is not yet clear. It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms.

More severe symptoms such as pneumonia appear to be more common in older people, those with weakened immune systems or long-term conditions.

If you are pregnant you are more vulnerable to getting infections than a woman who is not pregnant. If you have an underlying condition, such as asthma or diabetes, you may be more unwell if you have coronavirus.

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 enhanced care, and our advice remains that if you feel your symptoms are worsening or if you are not getting better you should contact your maternity care team or use the NHS 111 online service for further information and advice.

Q2. 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. There is no evidence to suggest an increased risk of miscarriage. There is also no evidence that the virus can pass to your developing baby while you are pregnant (this is called vertical transmission). Two cases of possible vertical transmission have been reported. In both cases, it remains unclear whether transmission was prior to or soon after birth. Another recent report from China of four women with coronavirus infection when they gave birth found no evidence of the infection in their newborn babies. Expert opinion is that the fetus is unlikely to be exposed during pregnancy. It is also therefore considered unlikely that if you have the virus it would cause abnormalities in your baby and none have been observed currently.

Some babies born to women with symptoms of coronavirus in China have been born prematurely. It is unclear whether coronavirus caused this or the doctors made the decision for the baby to be born early because the woman was unwell. As we learn about the risk of pre-term birth and coronavirus infection, we will update this information.

Q3. What can I do to reduce my risk of catching coronavirus?

The most important thing to do is to wash your hands regularly and effectively as soon as you come from public places to your home or workplace. There is useful advice on the NHS website on the best way to reduce any infection risk, not just for coronavirus, but for other things like colds and flu.

Questions 4-7 added following the announcement on 16 March 2020 that pregnant women have been placed in a ‘vulnerable group’

Q4. Why are pregnant women in a vulnerable group?

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

Based on the evidence we have so far, pregnant women are still no more likely to contract coronavirus than the general population. What we do know is that pregnancy in a small proportion of women can alter how your body handles severe viral infections. This is something that midwives and obstetricians have known for many years and are used to dealing with. 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.

What has driven the decisions made by officials is a desire to be very cautious about pregnant women. We know that some viral infections are worse in pregnant women. At the moment, there’s no evidence that this is the case for coronavirus infection, but the amount of evidence is still quite limited.

Q5.What do I need to do now?

All pregnant women should follow the PHE advice:

• Guidance on social distancing for all vulnerable people including pregnant women
• Guidance for individuals and households with possible coronavirus infection

Q6. Can I still go to work?

Pregnant women who can work from home should do so. If you can’t work from home, if you work in a public-facing role that can be modified appropriately to minimise your exposure, this should be considered and discussed with your occupational health team.

More detailed advice for pregnant women, including those who cannot work from home, such as healthcare workers, is being developed and will be made available as soon as possible.

Q7. Should I attend my antenatal appointments?

Attending antenatal and postnatal care when you are pregnant and have a new baby is essential to ensure the wellbeing of you and your baby.

If you are well, you should attend your antenatal care as normal. If you have symptoms of possible coronavirus infection, you should postpone routine visits until after the isolation period is over.

The following practical advice may be helpful:

• If you have a routine scan or visit due in the coming days, please contact your maternity unit for advice and a plan. You will still need to attend for a visit but the appointment may change due to staffing requirements.
• Some appointments may be conducted on the telephone or using videoconferencing, provided there is a reasonable expectation that maternal observations or tests are not required.
• If you are between appointments, please wait to hear from your maternity team.
• If you are attending more regularly in pregnancy, then your maternity team will be in touch with plans.
• If you miss an appointment and haven’t heard from your maternity team, please contact them to rearrange the appointment.

Whatever your personal situation please consider the following:

• If you have any concerns you will still be able to contact your maternity team but please note they may take longer to get back to you
• 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.
• You will be asked to keep the number of people with you at appointments to a minimum, including children.
• There may be a need to reduce the number of antenatal visits. This will be communicated with you. Do not reduce your number of visits without agreeing first with your maternity team.