What the Coronavirus Pandemic Means for Pregnant Women
Pregnancy, birth and parenting can be stressful in the best of times. Navigating pregnancy and birth during a global pandemic is a bit trickier. Now, moms-to-be are wondering if it’s safe to attend prenatal visits when ‘stay-at-home’ orders are in place and if their support person will be allowed to accompany them during labor and delivery.
Here’s what we know so far about the risks of coronavirus for mother and baby, prenatal visits in the era of social distancing, and recommended precautions for labor, delivery and breastfeeding.
Pregnancy and Coronavirus Risk
Doctors don’t currently know if pregnancy increases a woman’s risk of contracting coronavirus or developing COVID-19, the disease caused by the novel coronavirus (SARS-CoV-2). Pregnant women who get influenza are at increased risk of developing severe illness (compared to nonpregnant women), so there’s a theoretical risk that pregnancy may increase a woman’s chance of getting sick after coronavirus infection.
You can decrease your risk of infection by washing your hands frequently with soap and water and staying away from others. A pregnant woman should not care for someone who is coughing or has a fever, unless absolutely necessary. (If contact between a sick person and pregnant woman is unavoidable, the sick person should wear a mask; the pregnant woman may choose to as well.)
Effect of Coronavirus on Baby
“We still do not know if pregnant women with COVID-19 can pass the virus that causes COVID-19 to her fetus or baby during pregnancy or delivery,” according to the CDC (U.S. Centers for Disease Control and Prevention). From available data, no babies have been born with coronavirus infection, and researchers have not found the novel coronavirus in amniotic fluid or breastmilk.
However, research from China suggests that babies may be exposed to coronavirus in the womb, if the mother is infected. Two separate, small studies reported the presence of a specific type of antibody in newborns’ blood, a type of antibody that can’t pass through the placenta to the baby. Researchers think the babies’ bodies may have developed the antibody in response to the virus. The infants were healthy at birth.
Another Chinese study notes that 3 of 33 babies born to coronavirus-infected mothers in Wuhan, China developed pneumonia and tested positive for coronavirus days after birth; the other 30 babies were healthy and did not develop any symptoms of COVID-19. Two of the 3 sick babies recovered fully within a few days. The 3rd baby was born two months early, so researchers aren’t sure if the baby’s breathing problems were caused by coronavirus, prematurity or both. The premature baby also made a full recovery.
Much more research is needed to understand the possible effects of coronavirus on fetuses and babies.
Prenatal Visits During a Pandemic
The WHO (World Health Organization) website states, “pregnant women… should attend their routine care appointments.” Prenatal care has been proven to reduce the risk of pregnancy complications and remains especially important for women who have pre-existing health conditions.
Prenatal visits during a pandemic might look a bit different, though. Some providers are switching to virtual visits, and equipping women to perform some simple at-home monitoring of vital signs. Unfortunately, insurance doesn’t always cover telemedicine or virtual visits. Check with your insurance provider; some are increasing access to telehealth in response to the COVID-19 crisis.
Many providers continue to offer in-person visits for obstetric care. They carefully disinfect all surfaces between patients. Practices are reducing gynecologic visits as well, to minimize the number of people in and out of the office.
The coronavirus pandemic may affect the number of ultrasounds you undergo during your pregnancy. The Society for Maternal-Fetal Medicine has said the number of ultrasounds may be minimized, depending upon the patient’s personal risk factors.
Labor and Delivery Precautions With Coronavirus
To decrease the risk of infection and protect healthcare workers, most hospitals and birth centers now only allow one support person in the room during labor and birth. Some hospitals are requiring the support person to stay in the hospital for the duration of the woman’s stay. Be sure your overnight bag includes a few days’ worth of supplies for you and your partner.
Coronavirus shouldn’t affect how you give birth. According to WHO, C-section “should only be performed when medically justified.”
Postpartum Care and Breastfeeding
If the mother has COVID-19 or has tested positive for coronavirus infection, it may be a good idea to separate the baby from the mom, temporarily, to keep the baby from becoming sick. However, because it may be days or weeks until the mother is no longer infectious, and because physical touch is important for both moms and babies, the CDC recommends the postpartum team should discuss the risks and benefits of temporary separation with the family. WHO does not currently recommend separating mothers and babies.
All parents should wash their hands well before (and after) caring for their infants. If the mother is COVID-19-positive, she should wear a mask when feeding or caring for her baby.
SARS-CoV-2, the virus that causes COVID-19, has not been found in breastmilk. Women with COVID-19 should wear a mask when nursing their infants.
New moms may be discharged from the hospital 12 to 24 hours after birth, according to the American College of Obstetricians and Gynecologists (ACOG), if they are medically stable. Early discharge home minimizes the risk of picking up an infection in the hospital.
Due to social distancing recommendations and potential health risks, it’s not a good idea for friends or family to visit. But, it’s essential to remain connected. Call and reach out for support as needed. Some lactation consultants offer virtual visits. Your healthcare provider will likely call you to see how you’re doing. Report any concerns and be sure you know who to call for help if you need assistance.
You may not have the pregnancy and birth you initially envisioned, but your healthcare providers will do their best to help you have a positive experience.