COVID-19 and Pregnancy: Risks, Treatment and the COVID Vaccine

In short: Most pregnant women with COVID-19 have a mild illness, but pregnancy increases the risk of severe disease and intensive care admission, and moderate or severe infection can raise the risk of preterm birth, pre-eclampsia and stillbirth. The COVID vaccine is recommended at any stage of pregnancy because it is safe and protects both mother and newborn. Its side effects are usually mild and pass within one to three days, and it has not been shown to increase the risk of miscarriage, birth defects or preterm birth.

Is COVID-19 more dangerous in pregnancy?

Most pregnant women with COVID-19 have mild to moderate, flu-like symptoms. Compared with women who are not pregnant, however, pregnant women are more likely to become seriously ill, to need intensive care or a ventilator, especially in the third trimester and if they have obesity, diabetes, high blood pressure or are over 35.

To learn what this blood is and how it is collected, see our page on umbilical cord blood collection.

These adaptations are described one by one in our article on how the body changes in pregnancy.

Moderate or severe infection is linked to a higher risk of preterm birth, pre-eclampsia, caesarean birth, blood clots, stillbirth and admission of the baby to neonatal care. Even so, the overall risk of severe illness remains low for most pregnant women.

Can the virus pass to the baby?

Transmission from mother to baby is uncommon, reported in 0 to 3.6% of cases in studies. The virus does not pass through breast milk.

What are the symptoms, and when should you seek help urgently?

Common symptoms include fever, cough, tiredness, sore throat and loss of smell or taste. Contact your doctor or go to the emergency department straight away if you have:

•     Shortness of breath or difficulty breathing, or chest pain.

•     Oxygen saturation below 95%, if you have a pulse oximeter at home.

•     A high fever that does not come down with paracetamol.

•     Reduced baby movements, bleeding, leaking fluid or regular contractions.

How is COVID-19 treated in pregnancy?

Most cases can be managed at home with rest, fluids and paracetamol to bring down a fever, as a high temperature should be treated in pregnancy. Your doctor may prescribe an antiviral medicine (nirmatrelvir with ritonavir) if you are at higher risk of severe illness. If hospital care is needed, treatment includes oxygen and usually blood-thinning injections to prevent clots, with a multidisciplinary medical team.

Is the COVID vaccine recommended in pregnancy?

Yes. The American College of Obstetricians and Gynecologists (ACOG) recommends COVID vaccination at any stage of pregnancy, for women planning a pregnancy, after birth and while breastfeeding, and reaffirmed this recommendation in 2026. The World Health Organization also considers pregnant women a priority group for vaccination.

The vaccine reduces the risk of severe illness in the mother and lowers the risk of complications such as preterm birth and stillbirth. Antibodies also pass through the placenta and breast milk, protecting the baby during the first months of life, when the baby is too young to be vaccinated.

Is the COVID vaccine safe for mother and baby?

Yes. Studies including hundreds of thousands of pregnant women show that the vaccine does not increase the risk of miscarriage, stillbirth, preterm birth or birth defects, and it does not affect fertility in women or men. mRNA vaccines (such as Pfizer and Moderna) are preferred in pregnancy.

What are the possible side effects and complications of the vaccine?

Common side effects are mild, are no more frequent in pregnant women than in others, and usually pass within one to three days:

•     Pain, redness or swelling where the injection was given.

•     Tiredness, headache, muscle or joint aches and chills.

•     A mild fever, which can be treated with paracetamol, safe in pregnancy.

•     Temporary swelling of the lymph nodes in the armpit on the side of the injection, which settles within a few weeks.

Rare complications include:

•     Severe allergic reaction (anaphylaxis): very rare, a few cases per million doses, usually within minutes. This is why you are asked to stay for 15 minutes after vaccination.

•     Inflammation of the heart muscle or its lining (myocarditis or pericarditis): rare, seen mostly in young men after mRNA vaccines and less often in women. Most cases are mild and recover fully.

•     Blood clots with low platelets: a very rare complication linked to viral-vector vaccines (such as AstraZeneca and Johnson & Johnson), which is one reason mRNA vaccines are preferred in pregnancy.

Seek medical help straight away if, after vaccination, you have shortness of breath, chest pain, a pounding heartbeat, swelling of the face or throat, a severe persistent headache, or pain or swelling in a leg. The vaccine should not be given to anyone who has had a severe allergic reaction to a previous dose or to one of its ingredients.

Breastfeeding and caring for your baby

Breastfeeding is safe and beneficial even if you have COVID-19: the virus does not pass into breast milk, while the milk carries antibodies that protect your baby. If you are infected, wash your hands before holding your baby, wear a mask while feeding and clean your breast pump carefully.

How can you protect yourself?

•     Get the updated COVID vaccine as advised by your doctor.

•     Wash your hands regularly and avoid contact with people who are ill.

•     Wear a mask in crowded places during waves of infection.

•     Keep your antenatal appointments and tell your doctor if you become infected.