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Pregnant Women with Autoimmune Disease: What to do About COVID-19

Pregnant Woman

I’m pregnant and I have an autoimmune disease. What should I do about COVID-19?

We recognize that a global pandemic such as COVID-19 is a worrisome time in which to bring forth new life. No doubt the plans and expectations you had about your pregnancy and the birth of your child have changed quite a bit. It may feel as though you don’t have much control right now. However, all indicators so far show that, with proper prenatal care, you are likely to have a safe pregnancy and a healthy delivery in the current environment. The new procedures being put in place in many delivery suites are designed to put a sense of control back into the labor and delivery process and safeguard you and your baby. Focusing on the positives of these new procedures might ease your concerns and let you celebrate the moment when your baby enters the world.

The information below may also help relieve some of your fears.

  • Am I at higher risk for COVID-19 because I am pregnant? We don’t have much information on this, but preliminary data suggest that you are NOT at higher risk.
  • What will happen to my baby if I have COVID-19? Reports from around the world, though still very few, show that babies born to mothers with COVID-19 sometimes have the virus but do not seem to become seriously ill and do not have malformations.
  • What will happen when I give birth? Many hospitals are not currently allowing family members to attend the birth or to visit afterward. This is meant to reduce exposure to others and to keep everyone safe. Also, women in labor or undergoing a Caesarean section are separated from areas of the hospital in which people with COVID-19 are being treated so they have little risk of new exposure to the virus. If you are wondering whether you should try to deliver at home rather than come to the hospital, the hospital is much safer for both you and your child.
  • Will I be able to breastfeed after I give birth? Recommendations at this moment are that you should not breastfeed until it is clear that neither you nor your baby have COVID-19. But it’s up to each mother to make that decision.
  • Should I keep taking my medications for my autoimmune disease? Please continue to take your medications, including if you are taking hydroxychloroquine. You and your baby are at less risk if your illness is under good control.
  • Is it safe to take medications for COVID-19 while pregnant? Drugs now widely used—whether or not they are known to be effective—such as azithromycin (Z-pak) and hydroxychloroquine are safe in pregnancy. Another type of treatment called convalescent plasma, which may be used, will likely be safe. Drugs known as angiotensin converting enzyme inhibitors (ACEI) should not be used in pregnancy. The effects on pregnancy of other experimental drugs, such as remdesivir, are not known.
  • Where can I get more information? Your first resource is your doctor. There are also a number of websites that provide reliable information.

Dr. Michael Lockshin, rheumatologist

Dr. Michael D. Lockshin is the director of the Barbara Volcker Center for Women and Rheumatic Disease at HSS. He is the author of nearly 300 research papers, book chapters, and books, most on the topic of lupus, pregnancy, antiphospholipid syndrome and sex differences in disease.

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.