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What women who are pregnant or breastfeeding need to know.

Pregnancy comes with many decisions—what tests to get, whether to learn the gender, where to give birth—and soon, women who are pregnant or planning to conceive, will have to decide whether to get a coronavirus disease 2019 (COVID-19) vaccine.

So what does this mean for pregnant women and those planning to conceive soon?

To learn more, we talked to UNC Health infectious disease expert Cynthia Gay, MD, MPH, who leads the Moderna clinical trial at UNC, and Brian Brimmage, MD, an obstetrician who delivers babies at UNC REX Healthcare.

More Research Is Needed on Pregnancy and the Vaccines

The vaccine clinical trials did not enroll pregnant women—at least purposefully. But, some women in the trials were pregnant and did not know it, and researchers are following those pregnancies and newborns.

“It is a standard precaution not to enroll pregnant women for phase III studies,” Dr. Gay says. “Based on everything we know about other vaccines and what we know about these vaccines, there’s not a particular safety concern in pregnant women. But we don’t have that safety data of pregnant women having received a vaccine.”

The World Health Organization (WHO), American College of Obstetricians and GynecologistsSociety for Maternal Fetal Medicine and the American Society for Reproductive Medicine have all issued statements supporting offering the COVID-19 vaccines to women who are pregnant or breastfeeding.

“There is speculation based on the mechanism of how the vaccines work, that in theory, it should be safe for both of those groups, which is what led them to come up with these statements of support,” Dr. Brimmage says. “But, we don’t know for certain, and it’s probably going to be a good long while before we have data to know for sure.”

Don’t Delay Vaccination if You’re Trying to Conceive or Breastfeeding

If you’re not yet pregnant, but planning to conceive or undergo fertility treatment, the American Society for Reproductive Medicine says you do not need to delay conception or fertility treatment if you get a vaccine.

“These folks treat infertility all day long and have even said that if you find out you’re pregnant between your two doses of a vaccine (each vaccine requires two), you should still be offered the second dose,” Dr. Brimmage says. “And, they recommend against requiring a negative pregnancy test before someone gets a dose of a vaccine because that would be an unnecessary obstacle for sites administering the vaccines.”

The American College of Obstetrics and Gynecology says COVID-19 vaccines should be offered to breastfeeding individuals who would like to receive them when they become available.

“I think there’s less concern with breastfeeding because one of the most important benefits of breastfeeding is that maternal antibodies (like the kind you develop from vaccinations) get passed to the infant and protect them, and that is exactly what we want,” Dr. Gay says. “So, there’s less of a safety concern with getting the vaccines for women who are breastfeeding.”

Talk to Your Doctor

Whether you’re pregnant, planning to conceive or breastfeeding, talk to your doctor about what’s best for you.

“Talk to your doctor and try to evaluate with how high risk you are for COVID-19 exposure,” Dr. Brimmage says, “and talk through which thing scares you more—the possibility of getting really sick from COVID-19 or the very theoretical and unlikely risk that there could be some adverse effect from the vaccine.”

Brian C. Brimmage, MD, is a board-certified obstetrician/gynecologist who practices at Raleigh OB/GYN Centre and delivers at UNC REX Hospital.

Cynthia Gay, MD, MPH, is an associate professor of medicine in the division of infectious diseases in the UNC School of Medicine. She is a practicing physician and the medical director of the UNC HIV Cure Center.

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