Guidance to follow
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
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.
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:
you have symptoms of coronavirus, such as a high temperature or new, continuous cough
you have tested positive for coronavirus and you’ve been advised to recover at home.
What effect does coronavirus have on pregnant women?
At the moment, there is no evidence to show that pregnant women will be more severely unwell than the general population if they develop coronavirus. It is expected that most pregnant women will experience mild or moderate cold or flu-like symptoms.
Pregnant woman have been placed in the ‘vulnerable group’ by the chief medical officer. This is not because there is any evidence to suggest that they are more likely to contract the infection. However, we have known for years that for a small proportion of women, pregnancy can alter how severe viral infections are handled by the body. Therefore, placing pregnant women in this category and advising them to take extra measures is precautionary only.
If you also have an underlying health condition, such as asthma or diabetes, you may be more unwell if you develop the virus.
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.
As yet, there is no evidence that pregnant women who get more severe symptoms such as pneumonia are more at risk of serious complications than any other healthy individuals. But 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 or use the NHS 111 online service / NHS 24 for further information and advice.
What effect can coronavirus have on my baby?
This is a very new virus and more is being learned about it every day. At the moment, there is no evidence that the virus can pass to your baby while you are pregnant (vertical transmission). Therefore, it is considered unlikely the virus can cause harm to your baby.
There have been cases of the virus in newborn babies, but it remains unclear whether transmission was before or after birth. Expert advise that the baby is unlikely to be exposed to the virus whilst in the womb. It is also therefore considered unlikely that if you have the virus it would cause problems with your baby’s development 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 early labour, or whether it was recommended that the baby was born early in order to preserve the mother’s health.
The is also no evidence to suggest an increased risk of miscarriage.
The UK is conducting near-real-time observation of all women who develop COVID-19 during pregnancy and their newborn babies, through well-established systems already used by all maternity units. We will update our information if and as soon as there is any change in the evidence.
What about preterm birth in China?
Some women in China who had shown symptoms of coronavirus were reported to have preterm births. However, it is not known whether this is because doctors decided to deliver the baby early because the woman was unwell.
Information around preterm birth will be updated as more about the virus is known.
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.
The latest advice is that everyone must stay at home to help stop the spread of coronavirus.
You should only leave the house for 1 of 4 reasons:
shopping for basic necessities, for example food and medicine, which must be as infrequent as possible
one form of exercise a day, for example a run, walk, or cycle – alone or with members of your household
any medical need, or to provide care or to help a vulnerable person
travelling to and from work, but only where this absolutely cannot be done from home.
If there is anything you need, you can ask someone in your house to get it for you or perhaps a neighbour or friend could do this and leave the item at your front door.
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.
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.
How will I be tested for coronavirus?
The process for testing for coronavirus is changing all the time. At the moment, only people with severe symptoms who need to be admitted to hospital overnight will be tested. If you do need to be tested, you will be tested in the same way as everyone else. The test involves swabs being taken from your mouth and nose.
If you get a positive result, contact your midwife or antenatal team and let them know. If you have mild symptoms or no symptoms, you will be advised to recover at home. If you have severe symptoms, you may need to be treated in hospital.
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 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.
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.
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 Midwives, a skill for Google Assistant and Amazon Alexa that answers many pregnancy queries, including some about COVID-19.
Read more about the Tommy’s Midwives 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.
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 I give birth?
As a precaution, if a pregnant women is suspected of having, of has confirmed coronavirus, they are being advised to attend an obstetric unit (hospital) to give birth. This is because your baby can be monitored using electronic fetal monitoring and your oxygen levels can also be monitored.
Home births, or midwife led units, are not currently recommended for women who have coronavirus. It is best to speak to your midwife or maternity team about your birth plan and the pain relief options available.
If you were planning to have a birth partner, talk to your midwife or check the hospital website to see if this is still possible. Visitors to adult wards may currently be restricted, so other family members may need to keep in touch by telephone or video calls.
Can having coronavirus affect how I give birth?
There isn’t any evidence at the moment to show that you can’t give birth vaginally or that a caesarean birth is safer if you have suspected or confirmed coronavirus. Your birth plan should still be followed as closely as possible,
However, if your breathing suggests that an urgent delivery is needed, you may be recommended to have a caesarean.
Because the virus can sometimes be found in faeces, it is not recommended for people with suspected coronavirus to have a waterbirth. It may also be more difficult for healthcare staff to take any necessary protective measures.
There is no evidence that women with suspected or confirmed coronavirus cannot have an epidural or a spinal block. In our previous version of the guidance it was suggested that the use of Entonox (gas and air) may increase aerosolisation and spread of the virus, but a review of the evidence suggests there is no evidence that Entonox is an aerosol-prone procedure, so there is no reason you cannot use this in labour.
Will my baby be tested for coronavirus?
Yes. If it is suspected (or confirmed) that you have coronavirus when your baby is born, they will be tested for coronavirus.
Will I be able to stay with my baby/give skin-to-skin if I have coronavirus?
Yes, as standard practice, you will be kept together after birth if your baby doesn’t require care in the neonatal unit.
Some reports from China suggest women with confirmed coronavirus have been advised to separate from their baby for 14 days. However, this may have negative effects on feeding and bonding. A discussion between you and the doctors will weigh up the risks and benefits and care will be individualised for each baby.
This guidance may change as more is known about the virus.
If you choose to breastfeed your baby, the following precautions are recommended:
Wash your hands before touching your baby, breast pump or bottles
Try to avoid coughing or sneezing on your baby while feeding at the breast
Consider wearing a face mask while breastfeeding, if available
Follow recommendations for pump cleaning after each use
Consider asking someone who is well to feed your expressed breast milk to your baby.
Will I be able to breastfeed my baby?
There is currently no evidence that the virus can be carried in breast milk. The current advice is that the benefits of breastfeeding outweigh potential risks of transmitting the virus. However, there is concern about the close contact between you and your baby, as you may share airborne droplets infected with the virus.
You can talk to your maternity team about the risks and benefits and any precautions that you can take.
This guidance may change as knowledge evolves.
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:
by email (midwife@tommys.org)
on Facebook
on Instagram
on Twitter.
If you have non-urgent questions, we have developed Tommy’s Midwives, a skill for Google Assistant and Amazon Alexa that answers many pregnancy queries, including some about COVID-19.
Read more about the Tommy’s Midwives Alexa Skill here
Further information
This information is based on the official RCOG guidelines and NHS guidance.
Guidance to follow
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
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.
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:
you have symptoms of coronavirus, such as a high temperature or new, continuous cough
you have tested positive for coronavirus and you’ve been advised to recover at home.
What effect does coronavirus have on pregnant women?
At the moment, there is no evidence to show that pregnant women will be more severely unwell than the general population if they develop coronavirus. It is expected that most pregnant women will experience mild or moderate cold or flu-like symptoms.
Pregnant woman have been placed in the ‘vulnerable group’ by the chief medical officer. This is not because there is any evidence to suggest that they are more likely to contract the infection. However, we have known for years that for a small proportion of women, pregnancy can alter how severe viral infections are handled by the body. Therefore, placing pregnant women in this category and advising them to take extra measures is precautionary only.
If you also have an underlying health condition, such as asthma or diabetes, you may be more unwell if you develop the virus.
When to seek help
If you develop more severe symptoms or your recovery is delayed, you may need enhanced care. Our advice remains that if you feel your symptoms are getting worse, 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.
What effect can coronavirus have on my baby?
This is a very new virus and more is being learned about it every day. At the moment, there is no evidence that the virus can pass to your baby while you are pregnant (vertical transmission). Therefore, it is considered unlikely the virus can cause harm to your baby.
There have been cases of the virus in newborn babies, but it remains unclear whether transmission was before or after birth. Expert advise that the baby is unlikely to be exposed to the virus whilst in the womb. 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.
The is also no evidence to suggest an increased risk of miscarriage.
What about preterm birth in China?
Some women in China who had shown symptoms of coronavirus were reported to have preterm births. However, it is not known whether this is because doctors decided to deliver the baby early because the woman was unwell.
Information around preterm birth will be updated as more about the virus is known.
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.
The latest advice is that everyone must stay at home to help stop the spread of coronavirus.
You should only leave the house for 1 of 4 reasons:
shopping for basic necessities, for example food and medicine, which must be as infrequent as possible
one form of exercise a day, for example a run, walk, or cycle – alone or with members of your household
any medical need, or to provide care or to help a vulnerable person
travelling to and from work, but only where this absolutely cannot be done from home.
If there is anything you need, you can ask someone in your house to get it for you or perhaps a neighbour or friend could do this and leave the item at your front door.
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.
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.
How will I be tested for coronavirus?
The process for testing for coronavirus is changing all the time. At the moment, only people with severe symptoms who need to be admitted to hospital overnight will be tested. If you do need to be tested, you will be tested in the same way as everyone else. The test involves swabs being taken from your mouth and nose.
If you get a positive result, contact your midwife or antenatal team and let them know. If you have mild symptoms or no symptoms, you will be advised to recover at home. If you have severe symptoms, you may need to be treated in hospital.
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 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 symptoms of possible coronavirus infection, you should postpone routine visits until after the isolation period is over.
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.
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 Midwives, a skill for Google Assistant and Amazon Alexa that answers many pregnancy queries, including some about COVID-19.
Read more about the Tommy’s Midwives 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.
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 I give birth?
As a precaution, if a pregnant women is suspected of having, of has confirmed coronavirus, they are being advised to attend an obstetric unit (hospital) to give birth. This is because your baby can be monitored using electronic fetal monitoring and your oxygen levels can also be monitored.
Home births, or midwife led units, are not currently recommended for women who have coronavirus. It is best to speak to your midwife or maternity team about your birth plan and the pain relief options available.
If you were planning to have a birth partner, talk to your midwife or check the hospital website to see if this is still possible. Visitors to adult wards may currently be restricted, so other family members may need to keep in touch by telephone or video calls.
Can having coronavirus affect how I give birth?
There isn’t any evidence at the moment to show that you can’t give birth vaginally or that a caesarean birth is safer if you have suspected or confirmed coronavirus. Your birth plan should still be followed as closely as possible,
However, if your breathing suggests that an urgent delivery is needed, you may be recommended to have a caesarean.
Because the virus can sometimes be found in faeces, it is not recommended for people with suspected coronavirus to have a waterbirth. It may also be more difficult for healthcare staff to take any necessary protective measures.
There is no evidence that women with suspected or confirmed coronavirus cannot have an epidural or a spinal block. In our previous version of the guidance it was suggested that the use of Entonox (gas and air) may increase aerosolisation and spread of the virus, but a review of the evidence suggests there is no evidence that Entonox is an aerosol-prone procedure, so there is no reason you cannot use this in labour.
Will my baby be tested for coronavirus?
Yes. If it is suspected (or confirmed) that you have coronavirus when your baby is born, they will be tested for coronavirus.
Will I be able to stay with my baby/give skin-to-skin if I have coronavirus?
Yes, as standard practice, you will be kept together after birth if your baby doesn’t require care in the neonatal unit.
Some reports from China suggest women with confirmed coronavirus have been advised to separate from their baby for 14 days. However, this may have negative effects on feeding and bonding. A discussion between you and the doctors will weigh up the risks and benefits and care will be individualised for each baby.
This guidance may change as more is known about the virus.
If you choose to breastfeed your baby, the following precautions are recommended:
Wash your hands before touching your baby, breast pump or bottles
Try to avoid coughing or sneezing on your baby while feeding at the breast
Consider wearing a face mask while breastfeeding, if available
Follow recommendations for pump cleaning after each use
Consider asking someone who is well to feed your expressed breast milk to your baby.
Will I be able to breastfeed my baby?
There is currently no evidence that the virus can be carried in breast milk. The current advice is that the benefits of breastfeeding outweigh potential risks of transmitting the virus. However, there is concern about the close contact between you and your baby, as you may share airborne droplets infected with the virus.
You can talk to your maternity team about the risks and benefits and any precautions that you can take.
This guidance may change as knowledge evolves.