Episode 40: Revisiting Covid-19 and Pregnancy
Season 1, Episode 40, Mar 25, 2022, 03:00 PM
Additional resources
- OHA COVID-19 vaccine website: covidvaccine.oregon.gov
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OHA Facebook
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Safe+Strong website
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Ask a Black Doctor on The Numberz
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REACH webpage and REACH Facebook
COVID-19 and Pregnancy
Q1: What are the risks for a pregnant person if they get COVID-19?
Glad you asked! If a pregnant person gets COVID-19, they are more likely to get severely ill compared to non-pregnant people. Risks to pregnant people can include hospitalization, intensive care, the use of special equipment for breathing, or in the worst cases, death.
Pregnant people who have COVID-19 also have a higher risk of stillbirth, pre-eclampsia and preterm birth. COVID-19 has also been associated with newborns being admitted into intensive care units.
Some reasons for this may be:
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In unvaccinated people, COVID-19 can invade and destroy the placenta. This can lead to a lack of oxygen to the fetus.
- COVID-19 has led to increased stress, mental health problems and substance use, which can affect maternal health.
Q2: How likely is stillbirth in people with COVID-19?
Stillbirths due to COVID-19 are uncommon, but they do happen. Overall, there are about 24,000 stillbirths in the United States each year. But a recent study by the Centers for Disease Control and Prevention (CDC) found that:
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Pregnant people who had COVID-19 when they delivered their babies were almost twice as likely to have a stillbirth as someone who did not have COVID-19.
- The severity of COVID-19 symptoms was the key factor in their heightened risk of stillbirth. Unvaccinated pregnant people were the most severely ill.
The Oregon Center for Health Statistics (CHS) does not have stillbirth rates due to COVID-19 because this information is not collected on the stillbirth certificate in any way that could indicate that COVID-19 was the cause of a stillbirth.
Q3: In the United States, the number of people who died during pregnancy or shortly after giving birth increased during the pandemic. Why?
At the beginning of the pandemic, the number of people who died with pregnancy related issues increased sharply. This was partly due to pandemic-related disruptions. For example:
Q3: In the United States, the number of people who died during pregnancy or shortly after giving birth increased during the pandemic. Why?
At the beginning of the pandemic, the number of people who died with pregnancy related issues increased sharply. This was partly due to pandemic-related disruptions. For example:
- Hospitals hadn’t figured out how to deliver obstetric care safely.
- Health systems were not set up yet to manage telehealth, and many doctors stopped seeing patients in person.
- Hospitals were crowded and emergency rooms were filled with COVID-19 patients.
There were also barriers like having kids home from school that didn’t allow for parents to get away for medical appointments.
Q4: The CDC recently reported that Black people are dying from childbirth at greater rates than white people. Why is this happening?
Vaccination rates among pregnant people are lower in general. Fewer than one-third of pregnant people were vaccinated before or during their pregnancy. But the lowest rates have been among pregnant Black people, at 15 percent.
In Oregon, Black people have suffered disproportionately from the pandemic. While the percentage of people who tested positive with COVID-19 who died is higher among the White community, the percentage of people with COVID-19 who were hospitalized is higher in the Black community. And the overall case rate per 100,000 among the Black community is nearly double that of the white community.
But, Black people experienced higher rates of maternal mortality long before COVID-19. Reasons for this include:
Q4: The CDC recently reported that Black people are dying from childbirth at greater rates than white people. Why is this happening?
Vaccination rates among pregnant people are lower in general. Fewer than one-third of pregnant people were vaccinated before or during their pregnancy. But the lowest rates have been among pregnant Black people, at 15 percent.
In Oregon, Black people have suffered disproportionately from the pandemic. While the percentage of people who tested positive with COVID-19 who died is higher among the White community, the percentage of people with COVID-19 who were hospitalized is higher in the Black community. And the overall case rate per 100,000 among the Black community is nearly double that of the white community.
But, Black people experienced higher rates of maternal mortality long before COVID-19. Reasons for this include:
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Structural health inequities that have complex root causes: Multiple factors contribute to these disparities, such as variation in quality healthcare, underlying chronic conditions, structural racism, and implicit bias. Social determinants of health have historically prevented many people from racial and ethnic minority groups from having fair opportunities for economic, physical, and emotional health.
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The leading causes of pregnancy-related deaths are cardiovascular conditions, and infections. Research has found that cardiomyopathy, a disease of the heart muscle; blood clots to the lung; and hypertensive disorders of pregnancy contribute to a higher proportion of pregnancy-related deaths among Black people than among white people.
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Some experts find that pregnant people’s complaints are often dismissed, and that is probably much more significant for Black and brown people.
In the United States, one-third of the pregnant people and new mothers who died in 2020 were Black, though Black people only make up 13% of the total population. In Oregon, Black people make up only 2.2% of the total population of the state. According to the Oregon Center for Health Statistics (CHS), there were 19 maternal deaths in 2020, two (10.5%) of those were of Black birthing parents.
Q5: Is it true that if you get vaccinated during pregnancy, this can protect your child during pregnancy and after the baby is born?
In general, mothers pass antibodies to their babies during pregnancy. This protects them against diseases in the early months of life when they have no antibodies of their own. Recent reports from the CDC have shown that people who received the COVID-19 mRNA vaccines during pregnancy similarly can transmit antibodies to their fetuses, which may help protect them from COVID-19 after they are born.
Q5: Is it true that if you get vaccinated during pregnancy, this can protect your child during pregnancy and after the baby is born?
In general, mothers pass antibodies to their babies during pregnancy. This protects them against diseases in the early months of life when they have no antibodies of their own. Recent reports from the CDC have shown that people who received the COVID-19 mRNA vaccines during pregnancy similarly can transmit antibodies to their fetuses, which may help protect them from COVID-19 after they are born.
- The antibodies have been found in umbilical cord blood.
- At 6 months old, 57% of infants born to vaccinated people had detectable antibodies against COVID-19.
- mRNA COVID-19 vaccination during pregnancy can help protect babies younger than 6 months old from hospitalization due to COVID-19. The CDC’s report noted 84% of babies hospitalized with COVID-19 were born to people who were not vaccinated during pregnancy.
The CDC also reports that women who breastfeed and have been vaccinated with an mRNA vaccine have antibodies in their breast milk, which can help to protect their babies. The COVID-19 vaccines are not considered a risk for people who are breastfeeding, nor for their nursing babies because the vaccines do not contain a live virus or alter people’s DNA.
Q6: What are the long-term effects on the baby when a person gets a COVID-19 vaccine during pregnancy?
Scientific studies to date have shown no safety concerns for babies born to people who were vaccinated against COVID-19 during pregnancy. Based on how these vaccines work in the body, experts believe they are unlikely to pose a risk for long-term health effects.
Q7: Is there a risk for miscarriage or infertility from the COVID-19 vaccine?
NO! The COVID-19 vaccines have undergone rigorous safety testing. Researchers have found both the Pfizer and Moderna vaccines produced robust immune responses in pregnant people and did not damage the placenta.
There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in people.
None of the three FDA-approved vaccines change people’s DNA or interact with the organs necessary for reproduction.
People who are thinking about having children can get the vaccine as an effective way to prevent infection and complications caused by COVID-19 during pregnancy.
It is not necessary to avoid getting pregnant after getting vaccinated against COVID-19.
Q8: How can pregnant people protect themselves and their fetus from COVID-19?
While being fully vaccinated and boosted is the safest and best way to protect yourself from COVID-19, we recommend that people who are pregnant or nursing talk with their doctor about any doubts or worries they might have about the vaccines. Every person is different, with different needs to consider about their health care decisions.
Whatever people decide, we recommend that people continue to take precautions to prevent infection during pregnancy, such as wearing a mask in crowded indoor settings and distancing from others, especially when transmission levels are high.
Q9: Which COVID-19 vaccine should pregnant people receive?
In most situations, including for people who are pregnant or breastfeeding, the mRNA (Pfizer and Moderna) vaccines are preferred over the Johnson & Johnson vaccine for primary and booster vaccination.
The J&J COVID-19 vaccine can cause low platelets and blood clots in large blood vessels. The J&J/Janssen COVID-19 vaccine may be considered in some situations, including for persons who
Q6: What are the long-term effects on the baby when a person gets a COVID-19 vaccine during pregnancy?
Scientific studies to date have shown no safety concerns for babies born to people who were vaccinated against COVID-19 during pregnancy. Based on how these vaccines work in the body, experts believe they are unlikely to pose a risk for long-term health effects.
Q7: Is there a risk for miscarriage or infertility from the COVID-19 vaccine?
NO! The COVID-19 vaccines have undergone rigorous safety testing. Researchers have found both the Pfizer and Moderna vaccines produced robust immune responses in pregnant people and did not damage the placenta.
There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in people.
None of the three FDA-approved vaccines change people’s DNA or interact with the organs necessary for reproduction.
People who are thinking about having children can get the vaccine as an effective way to prevent infection and complications caused by COVID-19 during pregnancy.
It is not necessary to avoid getting pregnant after getting vaccinated against COVID-19.
Q8: How can pregnant people protect themselves and their fetus from COVID-19?
While being fully vaccinated and boosted is the safest and best way to protect yourself from COVID-19, we recommend that people who are pregnant or nursing talk with their doctor about any doubts or worries they might have about the vaccines. Every person is different, with different needs to consider about their health care decisions.
Whatever people decide, we recommend that people continue to take precautions to prevent infection during pregnancy, such as wearing a mask in crowded indoor settings and distancing from others, especially when transmission levels are high.
Q9: Which COVID-19 vaccine should pregnant people receive?
In most situations, including for people who are pregnant or breastfeeding, the mRNA (Pfizer and Moderna) vaccines are preferred over the Johnson & Johnson vaccine for primary and booster vaccination.
The J&J COVID-19 vaccine can cause low platelets and blood clots in large blood vessels. The J&J/Janssen COVID-19 vaccine may be considered in some situations, including for persons who
- Had a severe reaction after an mRNA vaccine dose or who have a severe allergy to an ingredient of mRNA COVID-19 vaccines
- Would otherwise remain unvaccinated for COVID-19 due to limited access to mRNA COVID-19 vaccines
Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.