Advice and information for women who are pregnant or breastfeeding
Pregnant women may be at increased risk of more serious cases of certain viral infections if they are infected, for example in the case of influenza. We do not yet know if this is the case for COVID-19 disease but there is little to indicate that pregnant women are at risk of a serious course of COVID-19.
Coronavirus is a group of viruses that can cause anything from a common cold to serious diseases such as SARS and MERS. Of known coronaviruses, SARS-CoV-2 is most similar to the SARS virus that caused an outbreak in 2003. However, SARS caused more serious illness than COVID-19.
During the SARS outbreak, there was concern that some pregnant women had more serious course and that infection early in pregnancy could cause miscarriage, but it was never confirmed that SARS infection caused foetal injury.
The virus is mainly spread by droplet or contact transmission. Whether the coronavirus is transmitted from mother to child before, during or after birth is unknown, but the few studies that have been carried out so far indicate that it does not transmit via the placenta. Mothers who are sick could infect their newborn baby after birth so they should follow the infection control advice given by healthcare workers after the birth.
Preventive measures for this coronavirus are similar for other infectious diseases. Follow good hand hygiene and cough etiquette, and limit contact with people outside the family. Discuss the possibility of working from home with your employer.
If someone in the household has symptoms of respiratory infection, try to limit contact and follow good hand hygiene and other basic infection control advice.
Are some pregnant woman at increased risk of severe COVID-19 disease?
The most important risk factor for a severe course of COVID-19 disease is high age (over 65 years). Adult patients with chronic diseases are also at higher risk. Whether this also applies to pregnant women with chronic diseases or pregnancy complications such as gestational diabetes and high blood pressure is uncertain.
Pregnant women with chronic diseases or pregnancy complications should discuss with their doctor whether or not there is reason to exercise extra care and if workplace adjustment is necessary. Sick leave is not recommended unless work adjustments are impossible.
The health service is now in a challenging situation that may lead to temporary changes in the normal pregnancy check-up routines. Ask your midwife or doctor who carries out your check-ups if this may affect pre-arranged appointments.
Women who have symptoms of respiratory infection or who have confirmed COVID-19 must contact the health service before check-ups to discuss how these should be carried out.
If pregnant women are concerned for their own health or the health of the foetus, extra check-ups can be carried out according to the usual criteria. The Norwegian Gynaecological Association has issued advice about pregnancy check-ups for women during the COVID-19 outbreak.
Pregnant women in their second and third trimester, and pregnant women in their first trimester who have risk factors, are recommended to take the seasonal influenza vaccine. This advice applies regardless of coronavirus infection.
Healthcare professionals who are pregnant
Healthcare professionals with patient contact are at risk of exposure to infection from sick people who need medical attention. The recommended infection control equipment should be used by all healthcare professionals during contact with a patient with suspected or confirmed COVID-19 disease.
As a precaution for health professionals who are pregnant, it is recommended that other health professionals should take samples and treat people with suspected COVID-19 disease where possible. Workplace adjustment should be done in consultation with the employer.
For health professionals who are pregnant and who have pregnancy complications or chronic diseases with an increased risk of severe COVID-19 progression (see section on pregnant women and risk factors above), work adjustment or remote working should be assessed based on individual risk.
Sick leave is not recommended unless workplace adjustment or remote working is not possible.
Birth and maternity
Women who give birth and who had confirmed COVID-19 just before birth can be together with their newborn after the birth, unless the mother is seriously ill or the child is very premature or ill.
However, there will be restrictions on visits to the mother and child.
Maternity and neonatal departments in Norway are prepared to handle a woman with confirmed COVID-19 giving birth and her baby and procedures have been issued in collaboration with the Norwegian Institute of Public Health.