Everything pregnant women need to know about Covid and the vaccine

When it comes to the vaccine rollout, there is a group of people who seem to be lagging behind: pregnant women. Data collected by The Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM) in July showed that 58 per cent of pregnant women are refusing to get the vaccine.

In the latest press briefing, Professor Chris Whitty made a plea to pregnant women to get the jab, noting the high proportion of women in ICU with Covid. "These are preventable admissions to ICU and there have been deaths," he said. According to data from February 1 to September 30, 1,714 pregnant women were admitted to hospital with Covid. Of these, Whitty explained that 1,681 - equivalent to 98% - had not been vaccinated.

“And if you go to those who are very severely ill in intensive care, of 235 women admitted to ICU, 232 of them – over 98% – had not been vaccinated," he added. The stark figures come amid a warning of a "blizzard" of coronavirus cases coming from Europe, which could cause substantial pressure on the NHS during the Christmas period.

Earlier this year, research from the University of Oxford showed a rise in the number of pregnant women being hospitalised with Covid-19. According to the findings, the overwhelming majority (98pc) of 171 pregnant women hospitalised with coronavirus symptoms since mid-May had not received a coronavirus vaccine, compared to just three women who had received a first dose, and no fully vaccinated pregnant women.

Experts are in agreement that the vaccine is safe for pregnant women, and is the most effective way of preventing severe illness, so why the ‘jab gap?’. Here is everything else you need to know...

Should pregnant women get the Covid vaccine?

The short answer is yes. In April, ministers advised that pregnant women should get the vaccine at the same time as the general population. And, in July, the RCOG altered their guidance from asking women to “strongly consider” vaccination in pregnancy to saying it “recommends” full vaccination. According to the RCOG’s president Dr Edward Morris, having the jab in pregnancy is the most effective way to protect women and their babies from severe illness and premature birth.

To encourage uptake of the jab, the Antrim Area Hospital in Belfast has set up a walk-in vaccine centre especially for pregnant women. Louisa Lapworth, the Northern Trusts outpatients manager, said they were recommending that all pregnant women get the vaccine as soon as possible. "The evidence is there. Vaccines are safe. They are safe in pregnancy. They are safe in breastfeeding women and we are encouraging all women to come forward and please get the vaccine and protect themselves and protect their baby,” she said.

Are there any side-effects of the Covid vaccine for pregnant women?

Data from Public Health England released in October showed that over 81,000 pregnant women have now received the first dose of Covid jab. In Scotland, almost 4,000 pregnant women have had the jab with no adverse side-effects reported, according to figures released in July by Edinburgh University and Public Health Scotland. Studies undertaken in animals who received a Moderna or Pfizer vaccine before, or during, pregnancy, have found no safety concerns in pregnant animals or their babies.

When side-effects do occur, they tend to be mild, and the RCOG says there is no reason to think that symptoms will be worse in pregnant women. Common side-effects include pain at the injection site, tiredness, headache, muscle pain, chills, joint pain and fever.

A study published in the American Journal of Obstetrics and Gynecology found that side effects such as fever and chills were rare among participants, and occurred with similar frequency in all women both pregnant and non-pregnant. It also suggested that women who have had the vaccine can pass on antibodies to their newborns through the placenta and breast milk.

Earlier this year, experts established a link between the AstraZeneca vaccine and a rare type of blood clot. The Joint Committee for Vaccination and Immunisation (JCVI) has since recommended that the Pfizer or Moderna vaccines are offered in pregnancy, where available.

What are the risks of Covid-19 in pregnancy?

Overall, the risks of Covid-19 for pregnant women remain low, and women shouldn’t panic if they catch the virus during the early stages. However, in recent months, there has been a rise in the number of unvaccinated pregnant women being admitted to hospital with the Delta variant, which is believed to present a bigger danger than previous strains of Covid-19. According to data from the University of Oxford, one in 10 pregnant women admitted to hospital with Covid symptoms requires intensive care, and around one in five gives birth prematurely, with the likelihood of needing a C-section doubling. More than 99 per cent of the pregnant women admitted to hospital with coronavirus are unvaccinated.

This builds on previous research from the INTERCOVID study, which tracked 2,130 pregnant women across the world to examine the risks of catching Covid during pregnancy. The researchers found that pregnant women who contracted the virus were over 50 per cent more likely to experience complications such as premature birth, pre-eclampsia, admission to intensive care and death compared with pregnant women unaffected by the disease.

Women are particularly at risk of becoming severely ill in their third trimester. Partly, this is because the growing foetus exerts pressure on the lungs, which are already working harder than they usually would. In late pregnancy, the cardiovascular system provides up to 50 per cent more oxygen to the foetus, which can multiply the stress that Covid-19 already places on the heart. Since pregnancy weakens the immune system, pregnant women may also be more susceptible to developing complications from a Covid-19 infection.

Can I pass Covid-19 to my unborn baby?

It's unlikely. The evidence so far suggests that the placenta acts as a barrier to stop the virus crossing over from mother to baby. Last year, there were two reported cases of coronavirus infections being passed from mothers to unborn babies in the womb. However, the chances of this happening remain very low, and both mothers and babies made a good recovery.

Daniele De Luca, medical director of paediatrics and neonatal critical care at the Antoine Béclère hospital in Paris where a baby was born with Covid-19, explained: “Pregnant women should be reassured - pregnancy is very controlled and if you have something like this, it can be controlled. In most cases, there will be no damage to the baby. There are many things we can do, but clinicians must be aware that this may happen.”

However, there is a chance that infection with Covid-19 during pregnancy may affect an unborn baby in other ways. The INTERCOVID study found that the babies of infected women were almost three times more likely to face “severe medical complications, such as admission to a neonatal intensive care unit – mostly due to premature birth.”