If you’re pregnant and have tested positive for COVID-19, the most important first step is calling your prenatal care provider. They can evaluate your symptoms, confirm the diagnosis if needed, and decide whether you need in-person care or can recover safely at home. Most pregnant people with COVID have mild illness and recover without complications, but pregnancy does put you at higher risk for more severe disease, so staying in close contact with your provider matters more than it would otherwise.
First Steps After Testing Positive
Contact your OB or midwife as soon as you get a positive result, even from an at-home test. Let them know your current symptoms, how far along you are, and whether you have any underlying conditions like diabetes or high blood pressure. Your provider may diagnose you based on the home test and your symptoms alone, or they may order a lab test to confirm.
Your provider will also help you figure out which over-the-counter medications are safe during your specific stage of pregnancy. Acetaminophen (Tylenol) is generally considered safe for managing fever and body aches, but always confirm with your provider before taking anything, including cough suppressants, decongestants, or anti-inflammatory drugs like ibuprofen. If your provider thinks you’re a candidate for antiviral treatment, they’ll walk you through the options and timing, since these work best when started within the first few days of symptoms.
Why Pregnancy Raises the Stakes
Pregnancy naturally changes your immune system, heart, and lungs in ways that make respiratory infections harder on your body. Pregnant people with COVID are more likely to need hospitalization, ICU admission, and ventilator support compared to non-pregnant people of the same age. As of mid-2022, over 225,000 pregnant women in the U.S. had been diagnosed with COVID, resulting in roughly 34,700 hospitalizations and 306 deaths.
Beyond the lungs, COVID during pregnancy has been linked to blood clots, heart damage, and kidney problems. One of the most striking findings is that rates of preeclampsia (dangerously high blood pressure) have increased up to fourfold among people who tested positive for COVID during pregnancy. Some providers have also identified a “preeclampsia-like syndrome” in pregnant patients with active COVID that mimics the signs of true preeclampsia, which can complicate diagnosis.
Risks to the Baby
COVID during pregnancy is associated with a higher chance of preterm birth, and some data suggest a possible increased risk of stillbirth. Babies born to mothers who had COVID are also more likely to need time in a neonatal intensive care unit (NICU). The virus can pass to the fetus during pregnancy, but this appears to be rare. The bigger concern is how the mother’s illness, particularly fever, low oxygen, or preeclampsia, can indirectly affect the baby’s health and development.
Monitoring Yourself at Home
If your provider clears you to recover at home, keep a close eye on a few key things. A pulse oximeter, the small clip-on device that measures blood oxygen through your fingertip, is worth having on hand. Most maternal health guidelines recommend keeping your oxygen saturation at 95% or above during pregnancy. If your readings consistently dip below that number, call your provider right away.
Track your temperature at least twice a day. Fever above 100.4°F (38°C) that doesn’t come down with acetaminophen is worth reporting. Stay well hydrated, rest as much as possible, and keep a written log of your symptoms so you can describe any changes clearly when you check in with your care team.
Pay attention to your baby’s movement patterns, especially in the second and third trimesters. If you notice a significant decrease in fetal movement, that’s a reason to call your provider or go to the hospital regardless of your COVID status.
Warning Signs That Need Emergency Care
Some symptoms go beyond what you should manage at home. Get emergency help if you experience:
- Difficulty breathing or shortness of breath that doesn’t improve with rest
- Chest pain or pressure that is persistent
- Oxygen saturation below 95% on a home pulse oximeter
- Confusion or inability to stay awake
- Decreased fetal movement or no movement at all
- Signs of preeclampsia such as severe headache, vision changes, sudden swelling in the face or hands, or upper abdominal pain
- Vaginal bleeding or fluid leaking
Because COVID raises the risk of blood clots during pregnancy, also watch for sudden swelling, redness, or pain in one leg, or unexplained chest pain with shortness of breath.
Breastfeeding With COVID
Current CDC guidance says you can and should continue breastfeeding even with a confirmed COVID infection, regardless of vaccination status. The virus has not been found in breast milk in amounts that would infect a baby, and breast milk provides antibodies that may actually help protect your newborn.
The main risk is close contact during feeding, not the milk itself. To reduce transmission:
- Wash your hands with soap and water before touching your baby or any feeding equipment
- Wear a mask while breastfeeding or bottle-feeding
- Clean and sanitize breast pump parts and bottles after every use
- Improve ventilation in the room by opening windows or running a fan
If you’re too sick to nurse directly, expressing milk with a pump and having a healthy caregiver feed the baby is a good alternative. Never place a mask on a baby under 2 years old.
What to Expect if You Deliver While Positive
If you’re close to your due date and test positive, call your hospital’s labor and delivery unit before you arrive so they can prepare an appropriate room and have protective equipment in place. Hospitals typically limit visitors for COVID-positive patients to one essential support person, and that person is usually asked to stay in your room rather than moving around the facility.
Having COVID does not automatically mean you’ll need a cesarean section. The method of delivery depends on your overall health, the baby’s condition, and your usual obstetric factors. After birth, you won’t necessarily be separated from your baby. Current guidelines say that decision should be based on your wishes after a conversation with your care team about the risks and precautions.
Vaccination During Pregnancy
COVID vaccination is available at any point during pregnancy. The 2025-2026 vaccine recommendations are now based on individual decision-making, meaning you and your provider weigh the benefits and risks together rather than following a blanket recommendation. Vaccination during pregnancy can reduce your chance of severe illness and may pass protective antibodies to your baby before birth. If you haven’t been vaccinated or are due for an updated dose, it’s worth discussing timing with your provider, even if you’ve already had COVID, since reinfection is possible.