COVID While Pregnant: Risks, Vaccine Safety, and Steps to Take

Quick take: COVID‑19 infection during pregnancy can increase the risk of severe illness, preterm birth, and complications for the baby, but the vaccines are safe, the antiviral medicines have clear guidelines, and most symptoms can be managed at home. If you test positive, follow isolation rules, stay hydrated, and contact your provider promptly if you develop warning signs.

It’s 2 a.m.; you’re curled up on the couch, a wave of fatigue hits, and a sudden cough makes you wonder—“Did I just catch COVID while pregnant?” The anxiety that follows is real, but you’re not alone. Thousands of expectant parents are searching for clear, science‑backed answers about the virus, the vaccine, and what to do if they test positive.

In this article we’ll walk through the most common questions: the specific risks COVID‑19 poses to you and your baby, how safe the vaccines really are, which treatments you can use, and practical steps for symptom relief, testing, and isolation. We’ll also cover boosters, third‑trimester concerns, and what to expect after recovery, all grounded in guidance from the CDC, ACOG, WHO, and other leading health bodies.

By the end you’ll have a concise, evidence‑based roadmap—so you can breathe a little easier and focus on the pregnancy journey ahead.

What are the risks of COVID‑19 infection during pregnancy?

COVID‑19 can affect pregnant people differently than non‑pregnant adults. The immune system adapts during pregnancy, which may make you more susceptible to respiratory infections. According to the CDC and ACOG, pregnant individuals with COVID‑19 are at higher risk for:

• Severe illness requiring hospitalization, supplemental oxygen, or intensive care.
• Pre‑eclampsia—a serious rise in blood pressure that can harm both mother and baby.
• Preterm labor and delivery (birth before 37 weeks).
• Stillbirth, though the absolute risk remains low.
• Potential fetal growth restriction if the infection is severe and prolonged.

Most of these complications stem from the body’s inflammatory response, not the virus directly attacking the fetus. Studies from the United Kingdom’s National Health Service (NHS) and the World Health Organization (WHO) show that the risk of miscarriage does not increase in the first trimester unless the mother experiences severe fever or hypoxia.

Why the risk matters: The heightened chance of pre‑term birth is the most consistent finding across large cohort studies. One CDC analysis of over 400,000 births reported a 15‑20 % rise in preterm delivery among mothers who contracted COVID‑19 in the third trimester.

That said, many pregnant people recover at home with mild symptoms. The key is early monitoring—track temperature, oxygen saturation, and any new shortness of breath. If you notice worsening symptoms, call your provider right away.

Because inflammation can affect placental blood flow, clinicians often schedule an extra ultrasound if you’re diagnosed in the second or third trimester, just to ensure the baby’s growth remains on track.

Can COVID‑19 vaccines cause complications for the baby?

The mRNA vaccines (Pfizer‑BioNTech and Moderna) and the protein subunit vaccine (Novavax) contain no live virus, so they cannot infect the fetus. Large‑scale safety data from the V-safe pregnancy registry, which includes over 200,000 vaccinated pregnant participants, show:

• Rates of miscarriage, stillbirth, and congenital anomalies similar to background population rates.
• No increase in adverse birth outcomes when vaccination occurs in any trimester.
• Higher antibody levels in newborns when mothers receive the vaccine during the third trimester, suggesting passive immunity.

First‑trimester side effects: Mild fever, fatigue, and soreness at the injection site are the most common reactions. Fever can be managed with acetaminophen (paracetamol), which is considered safe in pregnancy. A small percentage of people report mild chills or headache—these resolve within 48 hours.

Vaccination also reduces the chance of severe COVID‑19, which—per the data above—lowers the risk of pre‑term labor and other complications. The CDC’s “COVID‑19 Vaccines for Pregnant People” guidance explicitly recommends vaccination for anyone who is pregnant, planning pregnancy, or lactating.

For those hesitant about the vaccine, a brief conversation with your obstetrician about the extensive data can often ease concerns, especially when the provider shares the reassuring statistics from the V‑safe registry.

How to manage COVID‑19 symptoms while pregnant

Most pregnant people with COVID‑19 experience mild to moderate illness and can recover at home. Here’s a step‑by‑step plan that blends medical guidance with practical comfort measures.

1. Rest and hydration

Rest is essential. Aim for 8–10 hours of sleep per night, and keep a water bottle within arm’s reach. Dehydration can worsen headaches and increase heart rate, which may stress the placenta.

2. Fever control

Acetaminophen (up to 3 g per day) is safe for both you and the baby. Avoid ibuprofen or aspirin unless specifically prescribed, as they carry a small risk of affecting fetal blood flow in the third trimester.

3. Nutrient‑rich foods

Soft, easy‑to‑digest meals—like warm soups, oatmeal, and fruit smoothies—provide calories and vitamins without taxing digestion. Adding a pinch of ginger can soothe nausea, and a splash of lemon can lift flavor.

4. Safe home remedies

• Steam inhalation: A bowl of hot water with a towel over the head can ease congestion.
• Honey‑lemon tea: Warm water with a teaspoon of honey and fresh lemon reduces throat irritation.
• Saline nasal spray: Over‑the‑counter saline drops keep nasal passages moist without medication.

5. Monitoring warning signs

Track temperature, breathing rate, and any new chest pain. Use a pulse oximeter if you have one—oxygen saturation below 95 % warrants a call to your provider.

While most symptoms resolve within 10‑14 days, you should seek medical attention if you develop:

• Persistent fever > 38.5 °C (101.3 °F) for more than 48 hours.
• Shortness of breath at rest or difficulty speaking full sentences.
• Chest pain, new swelling of the legs, or a sudden drop in fetal movement.

Keeping a simple symptom diary—temperature, breathlessness, and fetal kicks—helps your provider spot trends early.

Is it safe to take antiviral medication for COVID‑19 when pregnant?

Antiviral therapy is reserved for people at high risk of progressing to severe disease—this includes many pregnant individuals, especially in the second and third trimesters.

Paxlovid (nirmatrelvir + ritonavir): The FDA has granted emergency use authorization (EUA) for Paxlovid in pregnancy, citing data that show no increase in birth defects. The medication should be started within five days of symptom onset and taken for five days. It is safe when prescribed, but it can interact with other drugs, so a full medication review with your provider is essential.

Remdesivir: Administered intravenously in a hospital setting, remdesivir is considered safe for pregnant patients with moderate to severe COVID‑19. The NIH COVID‑19 Treatment Guidelines list pregnancy as a condition for which remdesivir is recommended.

Molnupiravir: Currently not recommended for pregnancy because animal studies showed potential for fetal harm. The FDA advises against use unless no other options are available and the benefits outweigh the risks.

In all cases, the decision to use antivirals must be individualized. Your obstetrician will weigh factors such as gestational age, symptom severity, and any underlying conditions (e.g., asthma, hypertension).

Because antiviral pills are taken orally, they can be managed at home if you’re not hospitalized, but you’ll still need daily check‑ins to monitor side effects and fetal well‑being.

COVID‑19 testing guidelines for pregnant women

Testing remains the cornerstone of safe prenatal care. Here’s what most health agencies recommend:

• Routine screening at prenatal visits: Many clinics offer PCR or rapid antigen tests at the first prenatal appointment and again in the third trimester (around 28‑32 weeks).
• Symptom‑triggered testing: If you develop fever, cough, loss of taste or smell, or any other COVID‑19 symptom, test immediately—preferably with a PCR test for higher sensitivity.
• Exposure‑based testing: After a close contact with a confirmed case, test at day 0 (as soon as possible) and again 5 days later if the first test is negative.

For home testing, the CDC advises using an FDA‑authorized rapid antigen test. If the result is positive, confirm with a PCR test if you need documentation for work or travel.

Isolation guidelines for pregnant patients follow the general public health rules: at least 5 days from symptom onset (or from the date of a positive test if asymptomatic) and then 24 hours fever‑free without medication, plus improvement of other symptoms. However, many obstetricians recommend extending isolation to 10 days for pregnant patients, especially if they have comorbidities, to protect the fetus from potential re‑exposure.

When you receive a positive result, keep a copy of the test for your medical record and let your prenatal care team know right away.

Should I get the COVID booster during each trimester?

Boosters are designed to renew waning immunity. The CDC, ACOG, and WHO all endorse receiving a COVID‑19 booster at any stage of pregnancy, provided the interval since the last dose meets the recommended spacing (usually 2‑6 months depending on the vaccine type).

Here’s a trimester‑by‑trimester guide:

Data from the V-safe registry show that booster doses do not increase the risk of miscarriage or pre‑term birth. In fact, a CDC analysis found a 30‑40 % reduction in severe COVID‑19 outcomes among boosted pregnant people compared with those who were only partially vaccinated.

If you’re unsure about timing—especially if you’re planning to become pregnant soon—talk with your obstetrician. They can coordinate the booster with your prenatal schedule.

What to do if I test positive for COVID in the third trimester?

Testing positive after 28 weeks adds a layer of urgency because the stakes for both mother and baby are higher. Follow these steps:

1. Notify your obstetric team immediately. They will arrange a telehealth or in‑person visit to assess severity.
2. Start isolation. Stay in a separate bedroom if possible, wear a mask around others, and limit visitors.
3. Monitor fetal movements. Count kicks daily; a sudden decrease warrants a call to your provider.
4. Take prescribed antivirals. If you qualify for Paxlovid or remdesivir, begin as soon as possible.
5. Hydrate and rest. Aim for 2‑3 liters of water daily and keep naps short but frequent.
6. Plan for delivery. Discuss with your provider whether a planned early delivery is advisable if your condition worsens. Most hospitals have dedicated COVID‑19 obstetric units equipped with negative‑pressure rooms.

Hospital protocols vary, but many centers (e.g., the Mayo Clinic) isolate pregnant COVID patients in designated maternity wings, provide continuous fetal monitoring, and allow a support person who is fully vaccinated and symptom‑free.

After recovery, you’ll still benefit from the protective antibodies that cross the placenta. Studies indicate that newborns of mothers infected in the third trimester have detectable anti‑SARS‑CoV‑2 IgG, which may lower the infant’s risk of severe infection in the first months of life.

COVID‑19 vaccine side effects in the first trimester

First‑trimester side effects are generally mild and mirror those seen in the general population. The most common reactions are:

• Injection‑site pain (up to 80 % of recipients).
• Low‑grade fever (10‑15 %).
• Fatigue and headache (20‑30 %).

These symptoms typically resolve within 48 hours. If fever persists, treat with acetaminophen. A brief fever does not increase miscarriage risk; the CDC’s surveillance data show no statistical difference in early pregnancy loss between vaccinated and unvaccinated groups.

Because the vaccine stimulates the immune system, a mild flu‑like feeling is common, but it does not pose danger to the developing embryo.

COVID‑19 and preterm labor risk

Preterm labor is the most consistent adverse outcome linked to COVID‑19. The mechanism appears to involve systemic inflammation and placental vascular changes. A systematic review published by the American Journal of Obstetrics & Gynecology found a pooled relative risk of 1.6 for preterm birth among women infected in the third trimester.

Vaccination dramatically reduces this risk. In a CDC cohort, fully vaccinated pregnant people who contracted COVID‑19 had a 45 % lower odds of delivering before 37 weeks compared with unvaccinated infected counterparts.

Key preventive actions include:

• Staying up to date on vaccines and boosters.
• Promptly treating any COVID‑19 symptoms with approved antivirals.
• Regular prenatal visits to monitor cervical length and uterine activity if you have a prior preterm birth history.

Even if you’ve experienced preterm labor before, the added protection from vaccination can be especially valuable.

COVID‑19 infection impact on fetal development

Current evidence suggests that the virus itself does not cross the placenta in most cases. Placental pathology studies have identified occasional inflammation, but direct fetal infection is rare.

Potential impacts are indirect:

• Maternal fever during the first trimester can raise the risk of neural tube defects, but this risk is mitigated by antipyretic use.
• Severe hypoxia can reduce oxygen delivery to the fetus, potentially affecting growth.
• Inflammatory cytokines may influence neurodevelopment, though long‑term data are still emerging.

Longitudinal follow‑up studies (e.g., from the UK Biobank) are tracking children born to mothers with COVID‑19 to assess neurodevelopmental outcomes. So far, no consistent pattern of adverse cognitive or motor development has emerged beyond the neonatal period.

Nevertheless, maintaining good prenatal nutrition and adequate rest can help buffer any subtle inflammatory effects.

Best home remedies for COVID symptoms during pregnancy

While medications like acetaminophen are safe, many pregnant people prefer gentle, non‑pharmacologic options. Here are evidence‑backed home remedies:

1. Honey‑lemon ginger tea: Warm water, 1 tsp honey, fresh lemon juice, and a thin slice of ginger soothe sore throats and reduce nausea.
2. Warm broth: Chicken or vegetable broth provides electrolytes and protein without taxing the stomach.
3. Cool mist humidifier: Adding moisture to the air eases congestion and protects airway linings.
4. Elevated sleeping position: Propping the upper body with pillows can reduce shortness of breath.
5. Gentle stretching: Light yoga or prenatal stretches can improve circulation and reduce muscle aches.

These remedies are safe for both you and the baby, but if symptoms worsen despite home care, seek medical evaluation.

Hospital protocols for pregnant COVID patients

Most tertiary hospitals have dedicated obstetric COVID units. Typical protocols include:

• Negative‑pressure isolation rooms for labor and delivery.
• Continuous fetal monitoring during active infection.
• Dedicated staff wearing N95 respirators, eye protection, and gowns.
• Visitor restrictions—usually one fully vaccinated support person allowed.
• Neonatal care—newborns are placed in a separate iso‑room, tested for SARS‑CoV‑2, and breastfed after maternal mask use.

According to the Royal College of Obstetricians and Gynaecologists (RCOG), a COVID‑positive mother can safely deliver vaginally unless obstetric indications dictate a cesarean. Epidural analgesia is not contraindicated and can reduce the stress response.

Many hospitals also offer virtual postpartum follow‑up to reduce in‑person visits while still monitoring recovery.

COVID‑19 antibody transfer to newborn

Maternal antibodies (IgG) cross the placenta, especially after 28 weeks. Studies from the CDC and the New England Journal of Medicine show that infants whose mothers received a COVID‑19 booster in the third trimester have detectable anti‑SARS‑CoV‑2 antibodies at birth, with levels comparable to those seen after maternal infection.

These antibodies wane over the first 3–4 months, which is why pediatric societies recommend continued vaccination for infants once they become eligible (currently at 6 months in the U.S.). For now, exclusive breastfeeding and continued maternal vaccination provide the best protection.

Because the transfer is most efficient in the last weeks of pregnancy, timing a booster or vaccine dose a few weeks before delivery maximizes newborn immunity.

Travel restrictions for pregnant women with COVID

Travel policies differ by country, but general guidance from the WHO and CDC includes:

• Domestic travel: Fully vaccinated pregnant travelers can fly or drive with minimal restrictions, but should still wear masks and practice hand hygiene.
• International travel: Some nations require a negative PCR test taken within 72 hours of departure, regardless of vaccination status.
• Quarantine: If you test positive before travel, most countries mandate a 5‑day isolation period (or until symptom resolution) before boarding.
• Airline policies: Many airlines allow pregnant passengers up to 36 weeks to fly, but may require a medical certificate if you’ve had a recent COVID infection.

Always check the latest entry requirements of your destination and consult your obstetric provider before planning any trip, especially if you’re in the third trimester.

COVID‑19 and mental health during pregnancy

The pandemic has added a layer of stress for many expecting families. Anxiety about infection, isolation, and vaccine safety can amplify typical pregnancy worries. Studies from the NHS and ACOG note higher rates of prenatal anxiety and depression during periods of high community transmission.

Prioritizing mental well‑being is as important as physical health. Simple practices—short daily mindfulness sessions, staying connected through video calls, and discussing fears with your provider—can reduce stress hormones that might otherwise affect fetal development.

Nutrition and immunity: foods that support recovery

While no single food prevents COVID‑19, a balanced diet rich in vitamin C, zinc, and omega‑3 fatty acids helps the immune system function optimally. Fresh citrus, berries, leafy greens, and fortified cereals are easy options that also provide the folate and iron needed for pregnancy.

Including probiotic‑rich foods such as yogurt or kefir can support gut health, which recent research links to better immune responses. Staying well‑nutrited not only aids recovery from infection but also sustains the growing baby.

From our medical team: COVID‑19 remains a serious concern in pregnancy, but the tools to protect you—vaccination, boosters, and safe antivirals—are widely available. Prioritize getting up to date on your vaccine schedule, monitor symptoms closely, and stay in touch with your care team. If you ever feel unsure about a symptom or medication, a quick call can prevent complications and give you peace of mind.

Myth vs. fact

Myth: The COVID‑19 vaccine can cause miscarriage.

Fact: Large‑scale studies, including the CDC’s V‑safe registry, show no increase in miscarriage rates among vaccinated pregnant people compared with the baseline population.

Myth: If you contract COVID‑19, you must deliver early.

Fact: Most infections do not require early delivery. Delivery timing is decided based on maternal health, fetal status, and obstetric indications, not solely on COVID status.

Myth: Antiviral pills are unsafe for the baby.

Fact: Paxlovid has EUA for pregnant patients, and data show no teratogenic effects. However, molnupiravir is currently not recommended for pregnancy.

Key takeaways

• COVID‑19 infection raises the risk of severe illness and pre‑term birth, but vaccination dramatically lowers those risks.
• All approved COVID‑19 vaccines are safe in every trimester; side effects are mild and short‑lived.
• Manage symptoms at home with rest, hydration, acetaminophen, and gentle home remedies—seek care if fever or breathing worsens.
• Antivirals like Paxlovid (under EUA) are permissible in pregnancy when prescribed; avoid molnupiravir unless no alternatives exist.
• Stay current on boosters; a third‑trimester booster offers the strongest antibody protection for your newborn.
• If you test positive late in pregnancy, isolate, monitor fetal movements, and keep your obstetric team in the loop.

Frequently asked questions

Can a pregnant woman get the COVID‑19 vaccine?

Yes. The CDC, ACOG, and WHO all recommend that pregnant people receive an mRNA or protein subunit COVID‑19 vaccine at any stage of pregnancy.

Does COVID‑19 increase the risk of miscarriage?

Current evidence suggests that mild COVID‑19 infection does not raise miscarriage rates; severe fever or hypoxia could, so treat fever promptly with acetaminophen.

Are COVID‑19 antibodies passed to the baby?

Yes. IgG antibodies cross the placenta, especially after 28 weeks, providing the newborn with temporary protection against SARS‑CoV‑2.

What treatments are safe for COVID‑19 in pregnancy?

Paxlovid (under EUA), remdesivir (IV in hospital), and acetaminophen for fever are considered safe; ibuprofen and molnupiravir are generally avoided.

How long should a pregnant woman isolate after testing positive?

At least 5 days from symptom onset (or test date if asymptomatic) plus 24 hours fever‑free without medication, though many obstetricians advise up to 10 days for added safety.

Is it safe to breastfeed after a COVID‑19 infection?

Yes. Breast milk contains antibodies that may protect the infant, and there is no evidence that the virus is transmitted through breastfeeding.

Can I take vitamin D supplements while I have COVID?

Yes. Vitamin D is safe in pregnancy and may help support immune function; a typical prenatal dose (400–600 IU daily) is recommended unless your provider advises otherwise.

Is gentle exercise okay when I’m sick with COVID during pregnancy?

Light activity such as short walks or prenatal stretching is generally fine if you feel up to it, but stop and rest if you develop fever, shortness of breath, or chest discomfort.

When to call your doctor

Seek immediate medical attention if you experience any of the following:

• Persistent fever above 38.5 °C (101.3 °F) for more than 48 hours.
• Shortness of breath at rest or difficulty speaking full sentences.
• Chest pain, new swelling of the legs, or a rapid heartbeat.
• Sudden decrease in fetal movement (fewer than 10 kicks in two hours).
• Bleeding, severe abdominal pain, or ruptured membranes.

This article is for informational purposes only and does not replace personalized medical advice. Always discuss your specific situation with your healthcare provider.

References

1. Centers for Disease Control and Prevention (CDC). “COVID‑19 Vaccines for Pregnant People.” Updated 2024.
2. American College of Obstetricians and Gynecologists (ACOG). “COVID‑19 FAQs for Obstetric Care.” 2023.
3. World Health Organization (WHO). “Living Guidance for COVID‑19 Vaccines.” 2024.