For expectant parents living in active-transmission zones, Zika has triggered a fear bordering on hysteria. Some pregnant women have become shut-ins. Others have fled homes in Miami, abandoning their obstetricians in the hopes of protecting their unborn babies from Zika. And at least some would-be parents have talked of deliberately exposing themselves to the virus, in the hopes of developing immunity quickly, before conceiving.

While many mysteries remain about how the Zika virus works and how far-reaching its effects may be, here’s the latest advice for expectant parents from the Centers for Disease Control and Prevention, as well as several doctors we consulted.

Before Pregnancy

Wait to conceive. If there’s a chance that you have been exposed to the Zika virus, you should delay conception by at least six months, according to the WHO. Zika can persist in sperm and vaginal secretions for weeks to months after infection, and can be transmitted sexually during that time. Most people who contract the virus exhibit no symptoms, never get tested, and have no idea they’re infected, which means they could pass the virus along unwittingly. 

Don't try to "self-vaccinate" by exposing yourself to the virus on purpose. It's true that once you are infected, and recover, you should be immune to the virus. But that doesn’t mean you should try contracting the virus on purpose to “get it out of the way” so you can proceed with plans to start a family. While the greatest risks from Zika are to the developing fetus, the virus has also been linked to neurological issues in adults, including Guillain-Barré syndrome, a potentially deadly condition marked by muscle weakness, paralysis, and dangerous changes in heart rate and blood pressure.

During Pregnancy

Avoid areas of active Zika transmission. Don’t travel to Zika-affected regions. And if you live near an active-transmission zone, try to avoid that area as much as possible. The Aedes aegypti mosquito that transmits Zika doesn’t travel very far (not more than 150 feet, according to the CDC), so you can minimize your risk by avoiding affected areas.

Stay indoors as much as possible during the daytime. Aedes mosquitoes are day-biters. So deferring as many outings and errands as you can until the evening will help reduce your risk of exposure. Make sure your window and door screens are in good shape and absent any holes or tears. And use air-conditioning liberally, since it tends to keep mosquitoes away. 

Wear insect repellents and use insecticides as needed. If you do go outside during the day, you should cover your exposed skin with one of our top-rated insect repellents, and spray your clothing with an effective repellent, too. (Pre-treated clothing is also available, but Zika-carrying mosquitoes have shown resistance to permethrin, the chemical used in that clothing). If you have mosquitoes nesting inside your home, you might also consider using an indoor insect fogger, or insecticide spray. While we usually don't recommend foggers, the CDC says that given the seriousness of Zika they can make sense for pregnant families in Zika-affected regions. (We recommend calling a professional insect control team to deploy this particular tool).

Long sleeves and light colors are best when you go outdoors. The thicker and more tightly-woven the material, the harder it will be for mosquitoes to bite through. And the lighter the color, the less attracted to it they will be in the first place. 

Practice safe sex throughout your pregnancy, for two reasons: Sexual transmission of Zika has proven more common than scientists initially thought; and the virus can cross the placenta at any point during fetal development. Research suggests that the first trimester of pregnancy is the most risky, but babies infected during the second and third trimesters have also been known to suffer serious birth defects, including microcephaly. 

Get tested and talk with your doctor. You should be tested for Zika even if you feel fine. The vast majority of people who are infected with the virus show no symptoms. If you test positive for Zika, your doctor should order ultrasounds every 4 to 6 weeks, beginning at 15 weeks of pregnancy (that's the earliest point at which abnormalities may be spotted). The ultrasounds will help doctors monitor the growth of your baby’s skull and check for brain calcifications and other signs of infection. Your doctor may order these tests even if you don't test positive for Zika, if you live in an area of active transmission and there's a chance you've been exposed to the virus.  

After Pregnancy

Don't panic. The CDC estimates that just 30 percent of the babies exposed to Zika during gestation will be born with defects ranging from mild to severe, and that only between 1 and 13 percent of exposed babies will develop full-blown microcephaly. As alarming as those numbers may sound, they mean that even if you've been infected with the virus during your pregnancy, there's still a good chance that your baby will be born without any birth defects. 

But do stay vigilant, and expect testing. Babies' brains continue to develop once they are born, and some case studies suggest that Zika infections acquired in the womb may continue to attack the nervous system after birth. That means babies exposed to Zika but born without any obvious defects may still develop problems as they grow.

If your baby was exposed to Zika in utero but born without any obvious defects, your doctor may want to keep him or her in the hospital for a week or so after birth for monitoring and to conduct additional tests. MRIs and ultrasounds can detect calcifications and other signs of infection; EEGs will measure brain activity; and routine skull measurements will track brain growth. Spinal taps will also test for signs that the virus has invaded the central nervous system.

Find the right specialists. Hospitals in Washington D.C., Baltimore, and Houston are creating Zika specialty centers where infants and children can be seen by a range of specialists. As they work on more and more Zika cases, those specialists expect to develop greater expertise in treating the virus and its  complications. If you don’t live near such a facility, your doctor may still be able to consult with the doctors concentrated there, and benefit from their collective knowledge.