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Advice and information for women who are pregnant or breastfeeding
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Pregnant women may have an increased risk of a more severe course of certain viral infections, such as influenza. It appears that pregnant women with COVID-19 who develop symptoms have a slightly higher risk of needing treatment in a hospital, intensive care unit and with a respirator compared with non-pregnant women of the same age. However, young women have a very low risk of severe COVID-19 disease course.
Studies have so far shown:
- It is possible that a larger proportion of pregnant women infected with COVID-19 do not develop symptoms, but it may be because healthy pregnant women are being tested to a greater extent. The most common symptoms among pregnant women are coughing and difficulty breathing. It appears that fever and moderate general symptoms are not as common as in non-pregnant women.
- It appears that pregnant women with COVID-19 who develop symptoms have a slightly greater risk of needing treatment in hospital, intensive care units and with a respirator.
- The risk groups for severe course of COVID-19 are the same as for others: underlying conditions such as diabetes, cardiovascular disease and / or obesity. See Risk groups and their relatives
- Some studies suggest that the risk of premature birth is somewhat higher if the mother has COVID-19. However, this does not apply to spontaneous births, and may be related to how pregnant COVID-19 patients have been treated in different places.
- COVID-19 has not been shown to increase the risk of miscarriage during pregnancy.
- There have been some cases of transmission from mother to child before or during birth but this is extremely rare. In the cases where it has happened, all has gone well with the child.
In the studies, the incidence and risk of a severe disease course among pregnant women with COVID-19 is partly compared with the risk among pregnant women without COVID-19, partly with the risk among non-pregnant women in the same age group, and partly only observed and described. It is stressed that the figures are uncertain, because many countries test pregnant women for coronavirus regardless of symptoms to a large degree. Some countries have had routines for delivering babies from pregnant women with confirmed COVID-19 infection by Caesarean section and also in treating them differently than other pregnant women. The uncertainty is great, which is reflected in the researchers' conclusions. Read more in the research review of the study.
To prevent infection with the new coronavirus among pregnant women, the same advice applies as for the general population: good hand hygiene and limit contact with others than your closest contacts (you can decide who is "closest" yourself, but they should not be too many, and should be the same over time). You can discuss the possibility of working from home with your employer.
If any of your closest contacts have symptoms of a respiratory tract infection, you should limit contact with them if possible, and otherwise have good hand hygiene and follow other basic infection control tips.
All pregnancy check-ups should follow normal guidelines.
Women who have symptoms of respiratory infection or who have confirmed COVID-19 must contact the healthcare 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 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. In the event of an increased risk of transmission in society and in work where it is not possible to follow advice on the recommended distance to others, transfer to other tasks should be considered.
There is still little experience with vaccination of pregnant and breastfeeding women.
Studies to date indicate that vaccination is safe for the pregnant woman and / or foetus. Vaccination of pregnant women can therefore be considered where the advantages outweigh the disadvantages. It is especially important that pregnant women who are at risk of a severe disease course due to another underlying illness / health condition, consider vaccination in consultation with a doctor when the pregnant woman is offered a vaccine. In addition, it may be relevant to consider vaccination of pregnant women in geographical areas with widespread transmission and cannot limit their contact with others, even if the pregnant woman herself does not have a risk condition. The risk of a severe disease course in the pregnant woman should be weighed against a possible unknown risk when vaccinating the mother and child. Any vaccination of pregnant women should, as a general rule, not be done in the first trimester of pregnancy. The pregnant woman's partner and other household members can reduce the risk of infection to the pregnant woman by being vaccinated when / if they are offered it.
There is no known risk of transition to breast milk for non-live vaccines such as mRNA vaccines and viral vector vaccines. Breastfeeding women can be vaccinated.
When you are fully vaccinated, it is likely that you will have a lower risk of becoming ill with COVID-19. Since the vaccines prevent disease, they will also prevent transmission, but we do not yet know to what extent. Vaccinated people should therefore continue to follow the current infection control advice. Vaccination is currently not exempt from the requirement for quarantine after travel or close contact, with some exemptions.
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
The recommended personal protective equipment should be used by all healthcare professionals during contact with a patient with suspected or confirmed COVID-19 disease.
As a precaution for healthcare professionals who are pregnant, it is recommended that other healthcare professionals should take samples and treat people with probable, suspected or confirmed COVID-19 disease where possible.This also applies if the pregnant health professional has been vaccinated during pregnancy. Pregnant women who have been vaccinated before pregnancy, or who have undergone COVID-19, are assumed to be protected for at least 6 months. Workplace adjustment should be done in consultation with the employer.
For healthcare 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.
Birth and maternity
There is uncertainty about whether coronavirus can be transmitted from mother to child before or during birth. Babies born to mothers with COVID-19 that have been infected after birth have had mild or no symptoms. There have been some studies that can indicate that it is possible that the child can be infected before birth, even though this is extremely rare. The virus is mainly spread by droplet and contact transmission. Mothers who are sick may infect their child after birth and shall follow the infection control advice given by the healthcare personnel.
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 sick.
Hospitals must arrange for a partner / next of kin (defined by the mother herself) to be able to be present before and during the birth, and while in the maternity unit.
Maternity and neonatal departments in Norway are prepared to handle women with confirmed COVID-19 giving birth and her baby and procedures have been issued in collaboration with the Norwegian Institute of Public Health.
After returning home from the hospital, it is important to remember that new mothers may be vulnerable and need support from those around them, even during the corona pandemic. Anyone who visits newborns should be healthy and without symptoms.
Coronavirus has not been detected in breast milk from women with COVID-19 infection, where this has been studied. Women with COVID-19 infection can therefore breastfeed normally. This is also the advice of the World Health Organization (WHO).
Information for the general public
Information helpline for questions about coronavirus: 815 55 015 (weekdays 08-15.30)
The Norwegian Directorate of Immigration has answers to many frequently asked questions about travelling to Norway, and a helpline 23351600 that is open on weekdays from 10:00-14:00.
The Ministry of Foreign Affairs also has answers to many frequently asked questions.
If you need acute medical attention, contact your doctor. If you cannot reach your doctor, contact the emergency out-of-hours clinic on 116117. If life is in danger, call 113.