Coronavirus Pregnancy: Birthing During COVID-19

Delivering a baby, at any time, can create a lot of stress and anxiety. Throw COVID-19 into the mix and you probably have even more questions. OB-GYN Paul Gisi, MD, UnityPoint Health answers your top COVID-19 delivery questions in hopes of easing concerns before you welcome your new little one(s) into the world during a pandemic. Please understand, COVID-19 is a fluid situation and the following information could change as further COVID-19 clinical evidence and updates become available.

Who Receives COVID-19 Testing?

All labor and delivery patients who are admitted, or will be admitted for delivery, will be screened for COVID-19 with a nasal swab.

When Will My Care Team Do a COVID-19 Test?

If you have a scheduled procedure, like a c-section or induction, you’ll be tested 48-72 hours prior to your appointment. A nurse will reach out to you and set-up a time for you to be tested. If you are admitted to the hospital and haven’t been tested, or it’s been more than 72 hours since a test, you will be tested at our facility.

Will My Delivery Experience Change if I’m COVID-19 Positive?

If you test positive for COVID-19 and are pregnant, your delivery experience will look very similar to anyone who is COVID-19 negative. When team members and providers are in the room with you, they’ll be wearing personal protective equipment (PPE), including face masks, face shields and gloves. You’ll receive the very best care while minimizing the risk of transmission.

If you test positive for COVID-19, you'll also need to wear a surgical mask (provided by the hospital) in order to reduce the risk of spreading the virus. If you do not test positive for COVID-19, you may choose to put on a face mask but are not required to wear one.

What Happens to My Baby if I Test Positive For COVID-19?

The latest recommendations from the CDC and AAP say if you test positive for COVID-19 it's OK to stay in the same room as your baby.

These are the recommended precautions:

  • Keep distance between you and the baby when not providing hands-on care.
  • When providing hands-on care, it's best to wear a face mask, wash your hands or use hand sanitizer before touching the baby. It's also best to wear a cover gown or change your clothes.
  • A curtain or isolette between you and the baby may help keep the baby safe from virus droplets. 
  • If a virus-free partner or other family member is present, they should wear a face mask and wash their hands before touching the baby.

If you test positive for COVID-19, your baby will also be tested. Those tests are recommended at around 24 hours of age and again at 48 hours of age.

How Long Should I Keep These Extra Precautions if I'm positive for COVID-19?

It's best to continue these precautions (wearing a mask, washing hands, wearing a cover gown/changing clothes prior to caring for your baby) until the following:

  • You are fever free, without the use of fever reducing medicines, for 24 hours
  • You have improvement of symptoms
  • 10 days have passed since the onset of first symptoms 

If you had no symptoms but tested positive, you may continue enhanced precautions at home for 10 days following your positive test. Keep an eye out for any new symptoms, wear a mask, wash your hands frequently and wearing clean clothes when around your baby.

What If I'm too Ill to Care For My Baby in the Room?

If you are too ill to care for your baby in the room, a private room can be used for the newborn. A designated (healthy) caregiver may stay with the baby. It's best for the caregiver to avoid moving between the mother and infant’s room to prevent the spread of the virus. 

What is a Designated (Healthy) Caregiver?

This is the term used to define the person who is with you during your delivery. Designated caregivers must not have any signs of illness. Individuals at high risk for severe disease (e.g., underlying cardiopulmonary disease, poorly controlled diabetes) are advised not to visit or be caregivers.

Designated caregivers include, but are not limited to:

  • Parent/stepparent
  • Spouse/significant other

Designated caregivers must:

  • Be 16 years of age or older
  • Remain in your hospital room as appropriate
  • Limit movement within the facility and avoid common areas
  • Not show any signs of illness, such as fever, sore throat, cough, diarrhea, vomiting or runny nose

Exceptions may be made in certain situations and can be discussed with your care team.

Can a Baby Get Coronavirus?

Newborns can contract COVID-19 through respiratory droplets transmitted both through the air and on surfaces, just as adults can. Please talk to your child’s doctor for guidance on how to best care for your newborn.

Can I Take My Baby Home if I Test Positive for COVID-19?

If you test positive for COVID-19, and are ready to be discharged from the hospital, you will be allowed to go home if you have a healthy designated caregiver, like a spouse or partner, accompanying you and your baby.

Can I Breastfeed if I Am COVID-19 Positive?

You can breastfeed while taking precautions (wearing a mask, washing hands, changing clothes/wearing a cover gown prior to feeding). You may also express breast milk using a dedicated breast pump while you're sick.

Expressed breast milk can be fed to the newborn by a healthy designated caregiver.

If I Test Positive for Coronavirus, Will I Be Required to Labor Alone?

You will not labor alone. You may have one designated caregiver with you during your labor and delivery. Your designated caregiver will be evaluated when entering the hospital, which includes screening questions and a temperature check.

What About a Doula or Birth Coach?

If your COVID-19 test is negative or you are waiting for the results during labor, you may choose to have a birth coach or doula present. The birth coach/doula may stay until shortly after your delivery and will be asked to leave at that time. The birth coach/doula must wear a mask when in the facility.

If your COVID-19 test comes back positive during labor, the birth coach/doula will be asked to leave at that time. If you are COVID-19 positive a doubla/birth coach will not be allowed during your hospital stay.

Will My Designated Caregiver Be Tested?

At this time, we are not providing COVID-19 tests to designated caregivers. If your designated caregiver has been tested due to symptoms, or possible exposure, and has tested positive, he/she cannot come to the hospital with you. It’s best to select a different caregiver for your delivery.

For more information on COVID-19, please visit our coronavirus resources page.