Last updated on March 31, 2020
FAQs answered by Dr. Hope Riciotti, based on the latest clinical guidance, data, and information.
Hela Health works to provide women of all ages and lifestages with trusted, evidence-based information to make informed decisions for their health and wellness. During this uncertain time, our medical advisory board is closely monitoring the novel coronavirus (COVID-19) pandemic and continuing to review the guidance and recommendation of the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), American College for Obstetrics and Gynecology (ACOG) and the American Society for Reproductive Medicine (ASRM).
This guide covers the following:
Things EVERYONE Should Know About Coronavirus
Pregnancy & Breastfeeding
We will update this guide as possible and as new information becomes available.
Things EVERYONE Should Know About Coronavirus
What is the novel coronavirus (COVID-19)?
A novel coronavirus is a new coronavirus that has not been previously identified. While there are some more common coronaviruses like colds, COVID-19 is different and has unique symptoms, signs, transmission, and treatment. There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses. COVID-19 is a new disease, caused by a novel (or new) coronavirus that has not previously been seen in humans.
The virus likely was transmitted from an animal to a human, and the virus can feel like a bad cold or flu and can progress into a more severe pneumonia-like virus that impacts the respiratory system, or your ability to breathe.
What are some important facts to know about Coronavirus?
Time it takes for symptoms show: Latest data is showing 2-14 days from when a person is exposed to when a person develops signs and symptoms. On average, a person feels sick about 5 days after exposure.
The signs and symptoms of coronavirus: fever, cough, and trouble breathing. It also may cause stomach problems, such as nausea and diarrhea, and a loss of your sense of smell or taste. Other sources have reported flu-like symptoms including dizziness, feeling achy, and vomiting.
According to the CDC, if you develop emergency warning signs of coronavirus, seek medical attention immediately. Emergency warning signs include difficulty breathing or shortness of breath, persistent pain or pressure in the chest, new confusion or inability to arouse, and bluish lips or face.
If you are sick and feel you need a test for coronavirus, or in close contact with someone who has a confirmed case, there are tests available but you should call your healthcare provider for guidance on if you are recommended and eligible for a test. Keep in mind that there are limited testing supplies that vary by your state and community, so not everyone who wants a test may be able to access it at this time.
How is the virus transmitted?
COVID-19 is a new disease and everyone is still learning how it spreads, the severity of illness it causes, and to what extent it may spread in the United States. However, it is thought that the virus spreads mostly from person to person contact, people who are within 6 feet of one another, as well as when a carrier coughs or sneezes. The virus is thought to have the highest risk of transmission when someone is the most sick, but there may be cases when the virus spreads from a person without any symptoms but is a carrier.
According to the CDC, it may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.
How contagious is coronavirus?
The virus is thought to easily spread to people around those sick and carrying the virus, more so than the common cold or flu. In addition, while at-risk groups largely have taken the flu shot, there is little protection against contraction of the coronavirus for vulnerable populations.
Is there a treatment for coronavirus?
There are no known, proven medications for the novel coronavirus at this time. According to ASRM, there are no antiviral drugs licensed by the U.S. Food and Drug Administration (FDA) to treat patients. Some patients have received an investigational new drug, Remdesivir, through compassionate use outside of a clinical trial setting. At this time, it is unclear whether the drug can be used safely in pregnant or breastfeeding women.
What should I do if I have been around a person who later is diagnosed with coronavirus?
Call your local healthcare provider for guidance and advice, or use a telemedicine service to get the latest guidance on if it’s necessary to be tested and how to go about doing so. Each state and community has different access and procedures for testing. DO NOT proceed to your healthcare provider for an in person visit unless you are specifically advised to do so.
In addition to the test, if you are exposed, most employers, doctors, public health officials recommend a 14-day isolation or social separation.
What should I do if I have a procedure or appointment with my gynecologist or healthcare provider?
The surgeon general has issued guidance that hospitals and offices suspend elective surgeries during the COVID-19 pandemic. Individual offices may be continuing with in-person or teleconsultation visits not related to surgery or procedures, so it is best to call your provider for specific guidance.
Obstetric and gynecologic procedures for which a delay can negatively affect health and safety are not recommended to be delayed. This includes gynecologic procedures and procedures related to pregnancy for which delay would harm health.
Should I stay away from certain groups of people?
You might be worried that particular groups of people are carriers of the coronavirus based on ethnicity or people who were previously in quarantine. That fear and anxiety leads to unneeded discrimination and can fuel gossip that spreads rumors and myths. But no one group is more likely to carry or transmit coronavirus. We urge, alongside the CDC, to take overall precautions to stay safe and healthy by taking the proper precautions towards all people, no matter their ethnicity or previous quarantine status.
How can I prevent further infection?
Wash your hands frequently for at least 20 seconds and use hand sanitizer frequently while out of the house.
Take everyday precautions to keep space between yourself and others. Many sources have suggested at least six feet of space.
Minimize socialization and practice social distancing to the extent possible to prevent contributing to the spread or getting sick. Try to stay home as much as possible. When you go out in public, keep away from others who are sick, limit close contact and wash your hands often.
Avoid crowds as much as possible.
Avoid cruise travel and non-essential air travel.
Keep household surfaces clean as possible to prevent infection.
If you may have been exposed to the virus, do not use any ride-shares, public transportation, or taxis.
f you must go to an urgent care center or the Emergency Room, be sure to wear a mask so as to prevent exposing others (or yourself).
In addition to CDC updates, closely follow the latest guidance and advice from your state and local governments.
How do I know if I am high risk?
Early data shows that older people as well as people with autoimmune disorders, heart disease, diabetes, and lung disease are at higher risk of contracting and getting very sick from coronavirus. PCOS and hormonal conditions are not known to make you high risk. Pregnant women are also considered high risk by the American College of Obstetrics Gynecologists (ACOG). There is no known difference between men and women at this time. Everyone is still learning more but if you fall into those categories, please visit the CDC page to see resources on how to prepare your home, community, and caregiver in the event you become ill.
What additional precautions can be taken if a woman is high risk?
In addition to best practices above, those who are immunocompromised should be vigilant to practice social distancing, take great care to practice good hygiene and hand washing, and place boundaries to family. and friends where necessary. What you can do to help others at this time is enough, no matter any limitation or personal guilt felt.
Can I have sex with my partner?
Yes, there is no guidance released to refrain from any type of physical or sexual interaction if you or your partner are not displaying symptoms. Coronovirus is not thought to be sexually transmitted, but through air droplets so if you are displaying signs
How can I manage stress and anxiety during this time?
This is an uncertain time for many, and your mental health is just as critical to protect as your physical health and wellbeing. First, know that your response is completely normal, whether you are feeling anxious, depressed, scared, confused, and more.
The CDC has a recommended page for managing stress. On Hela Health you can sign up for live, video peer support groups by topic totally free. There are also many online platforms for therapy with a professional psychologist, such as Talkspace, that has a special COVID-19 management program and a coupon code for $100 off services.
If you or a loved one are feeling overwhelmed, you can call the Disaster Distress Helpline run by the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-985-5990 (TTY 1-800-846-8517). You also can text TalkWithUs to 66746. If you feel like you want to harm yourself or others, call 911 right away.
Additional tips include:
Try to stay connected with your support network, including family and friends over the phone, text, or video platforms
Take time each day to relax and unplug from news and media
Reach out to a healthcare or mental health provider to seek help if you are feeling depressed or anxious
What can I do if I experience abuse at home?
First, know that you are not alone. If you are experiencing intimate partner violence or domestic violence, call the 24-hour, toll-free National Domestic Violence Hotline: 800-799-SAFE (7233) and 800-787-3224 (TTY). Or you can use the live chat option at https://www.thehotline.org/.
Should I try to get pregnant now?
There is no guidance yet to avoid becoming pregnant at this time, though not enough is known about the risks to advise. If you or your partner experience symptoms or develop a fever, there may be an impact on sperm from elevated body temperature generally. You should speak with your healthcare provider for individual guidance.
What happens if I become pregnant while ill with Coronavirus?
Currently, very little is known about the impact of coronavirus on early pregnancy. It is really important to know that COVID-19 is very different and unrelated to the ZIKA virus which has known and clear implications for pregnancy and fetal development. Different providers recommend different courses of action as to whether to proceed with natural conception at this time or to avoid pregnancy. However, for those already pregnant, COVID-19 is not listed as a reason to terminate on it’s own by the American Society for Reproductive Medicine as of today (March 19, 2020).
What happens if I am currently undergoing fertility treatments?
Each clinic has its own policy on whether a cycle will continue or be postponed. However, the latest guidance from the American Society for Reproductive Medicine (ASRM) has released the following guidance:
If you have not yet started a fertility cycle, it is recommended not to begin a cycle at this time. This includes ovulation induction, intrauterine inseminations (IUIs), in vitro fertilization (IVF) for both egg retrieval and return and frozen embryo transfers (FETs), as well as non-urgent gamete cryopreservation.
If you have already started a fertility cycle, physicians are recommended to continue treatment but not to move forward with an embryo transfer, whether fresh or frozen.
If you require urgent stimulation and cryopreservation fertility, physicians are recommended to continue care.
If you have an elective surgery and non-urgent diagnostic procedure, such as in the case of a non-urgent fertility workup or egg freezing procedure, it is recommended not to start or continue at this time.
Note: While age and diminished ovarian reserve are time-sensitive, at present these are not included in the definition of urgent care.
Is there a risk that my cycle could be cancelled even if I have already started?
According to ASRM, some states and local governments are implementing mandatory “shelter in place” requirements, and it is likely that more restrictions are to come. A clinic that begins a treatment cycle could be forced to cancel it by their city or state regulations. Furthermore, healthcare workers who are exposed to the Coronavirus may not be able to come to work. It is possible that even if you begin to invest time and money into fertility treatment now, it could be cancelled due to governmental restrictions or lack of available staff.
How should I communicate with my fertility team at this time?
ASRM recommends you minimize in-person interactions and increase utilization of telehealth. In the case you are unsure if you are starting or continuing your cycle, call your clinic or use their electronic communication system before going to your in-person appointment.
Does Coronavirus affect eggs?
Not enough is known about the virus yet to determine if there is an impact on eggs. In general, fertility treatments are often delayed if a patient has fever or flu-like symptoms, and this may be the guidance if you have symptoms or confirmed coronavirus, or have been in contact with someone who has a confirmed case. Some fertility clinics may delay treatment in any case for all patients until more is known.
Will postponing my planned treatments make it less likely for me to have a baby?
Reproductive endocrinologists and fertility clinics recognize how difficult it is to physically and emotionally delay treatment. According to ASRM, there is no evidence that delaying treatment for a month or two will ultimately affect your ability to have a child, even if you have concerns about advanced age and/or diminished ovarian reserve (low egg supply).
Are my fertility treatments considered elective and do I have to stop?
We stand by ASRM’s belief that treatment of infertility is medically necessary. There is a distinction between a treatment that cannot be postponed even for a few days that is life threatening (such as surgery for a ruptured appendix), and treatment that is time sensitive and extremely important (such as IVF) but not a medical emergency. Because *most* fertility treatments do not fall in the life threatening bucket, they are being postponed.
Are my current eggs, embryos, and/or sperm safe?
According to ASRM, there is no immediate threat to the safety of cryopreserved eggs, sperm or embryos. Clinics have policies and procedures to maintain the liquid nitrogen tanks containing frozen embryos, eggs, and sperm. Please ask your doctor if you have any questions about the systems in place at your provider’s clinic.
Pregnancy & Breastfeeding
Are pregnant women at higher risk for coronavirus?
According to the latest guidance from ACOG, current reports show that pregnant women do not have more severe symptoms than the general public. However, many physicians are urging pregnant women to take the same steps as the general public to avoid coronavirus.
Unfortunately, there is still little data and evidence to understand how high-risk pregnant and breastfeeding women are to coronavirus. In general, it is known that some pregnant women are more susceptible to illness broadly, and the best course of action for pregnancy women is to practice social isolation to their best extent possible.
It is always important for pregnant women to protect themselves from illnesses and remain vigilant.
Towards the end of pregnancy in particular, many women have decreased lung capacity as the uterus expands and pushes against organs that may make the illness more severe.
Is my baby at risk if I get coronavirus?
There is still little evidence around the new coronavirus, and no one knows enough to say for sure there is not significant risk of transmission of coronavirus from mom to baby in any trimester, as well as during and after birth. There have been a very small number of reports of preterm birth for moms who tested positive for COVID-19 but it’s unclear if it is related to other maternal infection.
No infants born to mothers with coronavirus have tested positive for the virus at this time. In these cases, which are a small number, the virus was not found in samples of amniotic fluid or breastmilk.
It is still best to remain vigilant and protect yourself as much as possible as the medical community learns more.
What can pregnant women do in this uncertain time?
This is an emotional and stress-filled time for many pregnant women. The most important thing is to try to remain calm and relaxed. Since the full risk is not known, key medical societies recommend the following:
Cover your cough (using your elbow is a good technique)
Avoid people who are sick
Clean your hands often using soap and water or with an alcohol-based hand sanitizer that contains at least 60% alcohol if you can't wash them
Avoid touching your eyes, nose, and mouth
Stay at home as much as possible and practice social distancing
If you need to go out, stay at least 6 feet away from other people and avoid people who are sick
Should pregnant women wear a face mask?
Pregnant women who are feeling well do not need to wear a mask. If you have COVID-19 or have symptoms, you should wear a mask while you are around other people. You also should wear a mask if you are taking care of someone who has COVID-19 or has symptoms.
What should I do if I suspect I have coronavirus and am pregnant?
If you experience any signs or symptoms of the virus, you should immediately call your healthcare provider overseeing your pregnancy. Do not go to the office in person without calling first unless already instructed to do so. If you have a fever or cough it is especially important to call right away. If you have difficulty breathing at any point, you should call your provider immediately and ask whether it’s appropriate to proceed to the closest emergency room, while wearing a mask, covering your mouth and taking other precautions to prevent the spread. The emergency room should be notified before your arrival to protect other patients.
If you have emergency warning signs, call 911 or go to the hospital right away.
Emergency warning signs include the following:
Having a hard time breathing or shortness of breath (more than what has been normal for you during pregnancy)
Ongoing pain or pressure in the chest
Being unable to respond to others
Blue lips or face
If you go to the hospital, try to call ahead to let them know you are coming so they can prepare. If you have other symptoms that worry you, call your ob-gyn or 911.
What should I do if I know I have coronavirus and am pregnant?
ACOG guidance if you are diagnosed with COVID-1 is to follow the advice from the CDC and your ob-gyn or other health care professional. The current CDC advice for all people with COVID-19 includes the following:
Stay home except to get medical care. Avoid public transportation.
Speak with your health care team over the phone before going to their office. Get medical care right away if you feel worse or think it’s an emergency.
Separate yourself from other people in your home.
Wear a face mask when you are around other people and when you go to get medical care.
What should I do if I think I suspect or know I have coronavirus and am breastfeeding?
To date, there has not been a case of coronavirus spreading through breastmilk to a baby. It is known that there is likely a higher risk of infection to the baby simply from breathing closely and sharing droplets through the air to the baby while breastfeeding. The most important step you should take is to speak with your healthcare provider to decide an appropriate plan forward given your unique situation.
It is known that breast milk is extremely beneficial to the baby and contains important antibodies and protection to help build a baby’s immune system to fight many types of infections.
Whether and how to start or continue breastfeeding should be determined by the mother in coordination with her family and health care practitioners. Currently, the primary concern is not whether the virus can be transmitted through breast milk, but rather whether an infected mother can transmit the virus through respiratory droplets during the period of breastfeeding. Therefore, in past situations, like when a mom has the flu or contracted SARS or MERs, there has been a recommendation to continue breastfeeding or feeding pumped/expressed milk to the baby while washing hands and taking other precautions.
If you decide with your healthcare team it is appropriate to continue breastfeeding, you should take additional precautions including washing your hands before touching the baby, wearing a face mask, and if using a breast pump should follow recommendations to clean the pump after each use. Some providers may also recommend having someone who is healthy feed the pumped or expressed breast milk to the baby.
Should I continue my prenatal and postpartum appointments?
As the number of cases are growing, it is a good idea to call your healthcare provider overseeing your pregnancy and ask them if you should change any of your visits or monitoring plans. The answer will be unique to you and the nature of your pregnancy. Given your specific profile and risk, your provider may suggest to continue as normal, proceed with care and oversight over a teleconsultation, or to suspend visits temporarily.
Can I travel during pregnancy right now?
The CDC is frequently updating recommendations, including those for pregnant women. You should see the CDC’s Coronavirus Disease 2019 Information for Travel page for the latest updates.
Additional restrictions may be in force locally that are rapidly evolving. It is important to check with and stay current on your local or state health department for information about travel and restrictions in your area.
Should I make any changes to my labor and delivery plans?
You should speak with the healthcare provider overseeing your pregnancy to discuss your specific needs and whether a cesarean birth (or c-section) is appropriate. Each state and provider has unique practices around practices if you are suspected or diagnosed with the virus.
Most healthcare providers, and ACOG, believe that safest place for you to give birth is a hospital, hospital-based birth center, or accredited freestanding birth center. Your hospital or birth center may be adjusting their policies and each are unique at this time, so it is recommended to stay in contact with your choice to understand changes that may impact your plan.
Should I give birth at home?
At this time, guidance from ACOG remains that you should proceed with the safest place for you to give birth that is still advocated as a hospital, hospital-based birth center, or accredited freestanding birth center. It is critical if you are thinking about a home birth to immediately discuss all of the risks involved with a home delivery, as even the healthiest pregnancies can have problems arise with little or no warning during labor and delivery.
Women Who Are Caretakers
What should I do if my child or relative has a suspected case of coronavirus and I am their caretaker?
It is recommended to follow the CDC guidance on how to prepare your family.
What should I do if I care for young children and also elderly adults?
It is recommended to keep young children away from elderly and high risk populations at this time. While children are not likely to experience a severe illness, that may not be the case with older or high risk populations. Since you may carry the virus without symptoms for many days, it is recommended to find alternate care either for your children or older/high-risk relatives from someone at less risk of being a carrier of the virus. Even though children may be home from school at this time, it is also recommended not to leave children in the care of anyone high risk.
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Disclaimer: The information provided on this FAQ and the entire Hela Health platform is for educational and informational purposes only. This information is not intended as legal advice or medical advice, and is provided on an “as is” and “as available” basis without any warranties of any kind. Moreover, due to rapidly changing developments, we make no warranty or guarantee concerning the accuracy or reliability of the content on this page. For the latest information regarding COVID-19, we refer you to the Centers for Disease Control and Prevention website (www.cdc.gov).