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The coronavirus (COVID-19) pandemic continues to disrupt daily life, and threaten the health and wellness of people all around the globe. Moms-to-be like you are concerned about everything from keeping prenatal appointments to managing disruptions at work. But beyond any worry about lifestyle changes is a focus on your health and the impact of COVID-19 on your pregnancy.
We asked obstetrics doctors who handle the most complicated pregnancy issues to answer your questions about the coronavirus. Here are their responses, provided by Dr. Sarah Dotters-Katz and her colleagues at the Society for Maternal-Fetal Medicine.
Am I at more risk for COVID-19 if I'm pregnant?
Pregnant women may be at increased risk of severe illness from COVID-19 compared to non-pregnant women, but the overall risk is still considered quite low.
In the face of recent reports from the CDC saying pregnant women are more likely to need intensive care and require a ventilator, it's important to note the percentage of pregnant women needing these clinical interventions is small.
It's not clear why pregnant women might face higher risk from COVID-19, but it's likely because the immune system is mildly suppressed during pregnancy, leaving women more vulnerable to severe respiratory infections in general. It's important to know the steps you can take to minimize your risk of getting COVID-19 during your pregnancy. Here's what the CDC researchers suggest:
- Don't skip your prenatal appointments: These help you ensure your pregnancy is progressing well and allow your provider to identify and treat any problems promptly.
- Practice social distancing: Limit your interactions as much as possible, preferably to close family members inside your social bubble. If you do have to go out, be sure to wear a mask.
- Ask your healthcare provider for advice: She can give you individualized tips on how to stay healthy during the pandemic.
Of course, it's still important to take everyday preventive actions to avoid infection, such as washing your hands often and avoiding people who are sick.
How might coronavirus affect my pregnancy?
Most women who get COVID-19 during pregnancy do quite well with minimal complications. And we know that women with other coronavirus infections (such as SARS-CoV) did NOT have miscarriage or stillbirth at higher rates than the general population.
In terms of risks, we know that having other respiratory viral infections during pregnancy, such as flu, has been associated with problems like low birth weight and preterm birth. Also, having a high fever early in pregnancy may increase the risk of certain birth defects.
How can I tell if I should get tested for COVID-19?
The CDC has a Self-Checker tool that you can use to help you determine if you need to seek testing for COVID-19.
Could I transmit coronavirus to my baby during pregnancy or delivery?
It’s possible, but it’s likely very rare. There are now hundreds of documented cases where the virus was not transmitted to the baby during pregnancy or delivery. And babies who do contract the virus tend to do well.
However, studies are ongoing and there have been a couple of reports suggesting possible transmission to the baby during an active infection in the mother.
Will I need to have a c-section if I have COVID-19?
No. Your mode of delivery is not affected by your infection status.
Will I have to wear a face mask during labor and delivery?
The hospital may require you to wear a mask during labor and delivery. The CDC recommends that “individuals wear a mask in public settings when around people who do not live in your household, especially when social distancing can’t be maintained”, and this is often the case during labor and delivery.
Boston-based Brigham and Women's Hospital's current policy states that "patients in any clinical setting will be supplied with a procedural or surgical mask, which must be worn as part of our continued efforts to protect our health care workers and our patients and to combat community spread. Dr. Laura Reilly, Obstetrician and Gynecologist-in Chief at Weill Cornell Medical, reported in an online Q & A that "all women who arrive at the hospital in labor will be tested for COVID-19 regardless of symptoms, and the staff will provide masks to women in labor to wear when they arrive."
On the other hand, Wasatch Midwifery and Wellness Founder, Adrienne Brown said, "So far we are wearing masks as a staff at all patient interactions. We ask those in the clinic to wear a mask, and the birth partner, but not the laboring person. If a patient were presumed positive or known positive, they would be sent to a hospital to give birth."
That said, ACOG (American College of Obstetrics and Gynecology) cautions "Although a person with suspected or confirmed COVID-19 would normally be instructed to wear a mask, active pushing while wearing a surgical mask may be difficult and forceful exhalation may significantly reduce the effectiveness of a mask in preventing the spread of the virus by respiratory droplets."
Is it safe for me to deliver at a hospital where there have been COVID-19 cases?
Yes. We know that COVID-19 is a very scary virus. The good news is that hospitals are taking great precautions to keep patients and healthcare providers safe.
According to the CDC guidelines, when a patient is even suspected to have COVID-19, they should be placed in a negative pressure room. (Think of these rooms as vacuums that suck and filter the air so it's safe for the other people in the hospital.) If there are no rooms available, these patients should be asked to wait at home until they can be accomodated safely. This should make it possible for you to deliver at the hospital without putting you or your baby at risk.
Hospitals are also implementing stricter visiting policies to keep patients safe. It's worth calling your hospital to check if there are any new regulations to be aware of.
What plans should I make now in case the hospital system is overwhelmed when it's time for me to deliver?
Every hospital is making different plans for dealing with this scenario. Talk with your doctor or midwife once you're at least 34 weeks pregnant.
If I work in healthcare, a school, the travel industry, or some other high-risk setting, should I ask my doctor to excuse me from work until the baby is born?
Healthcare facilities should take care to limit the exposure of pregnant employees to patients with confirmed or suspected COVID-19, just as they would with other infectious cases. If you continue working, be sure to follow the CDC's risk assessment and infection control guidelines.
If you work in a school, travel industry, or other high-risk setting, talk with your employer about what it's doing to protect employees and minimize infection risks. Wash your hands often.
What if my OB gets COVID-19?
If your doctor or midwife tests positive for COVID-19, they will need to be quarantined until they recover and are no longer at risk of transmitting the virus. In this case, you'll be assigned to another OB in your doctor's practice (or you may choose another practitioner yourself).
Ask your new OB or your doctor's office if you should self-quarantine or be tested for the virus. (It will depend on when you last saw your provider and when that person tested positive.)
Should we hold off on trying to conceive because of COVID-19?
At this time, there's no reason to hold off on trying to get pregnant, but the data we have is really limited. For example, we don't think the virus causes birth defects or increases your risk of miscarriage. But we don't know for sure whether you could transmit COVID-19 to your baby before or during delivery.
We also don't know if the virus lives in semen or can be sexually transmitted.
We have a babymoon scheduled in the next few months – should we cancel?
Yes. At this time, the virus has reached more than 140 countries, and there are travel bans to China, most of Europe, and Iran. Places where large numbers of people gather are at highest risk, especially airports and cruise ships.
If you were planning travel in the U.S., note that any travel setting increases your risk of exposure, and there are already many places where everyone is being asked to stay home. To see how the virus is spreading, check The New York Times map based on CDC data.
For the most current advice to help you avoid exposure, check the CDC's COVID-19 travel page.
Will the hospital separate me from my newborn and keep the baby in quarantine?
If you don't have COVID-19 and have not been exposed to the virus, the hospital will not separate you from your newborn.
If you do test positive for COVID-19 or have been exposed, the CDC, ACOG, and the Society for Maternal-Fetal Medicine all strongly recommend that you consider temporary separation from your baby to decrease the risk of transmission.
But according to the American Academy of Pediatrics, evidence to date suggests that the risk of mother to baby transmission is low and COVID-19 positive mothers can safely room in with their newborns as long as the proper infection prevention practices are followed to protect the baby.
Many hospitals will consider how and whether to separate you based on your particular situation. It could mean staying in a separate room, especially if your baby is premature or has a medical condition or if you are severely ill.
If you're both doing well, after discussion with your healthcare team, you may decide against separation. In this case, you would need to wash your hands and wear a mask when you're holding your baby and keep her in a temperature-controlled isolette (a clear plastic enclosed crib) or 6 feet away from you whenever possible.
Once you leave the hospital, you would be encouraged to continue taking precautions until you're no longer at risk of transmission, such as if you test negative or your baby tests positive. However, if you have symptoms of the virus, you may be contagious for several weeks.
This scenario would, of course, be beyond heartbreaking. Talk to the hospital, your baby's pediatrician, and your family about how to plan for care of your baby in the event that you have to be separated after delivery. And try to make sure you have the emotional support you would need to endure the sadness and stress of having to potentially wait weeks to meet your newborn.
Would I be able to breastfeed my baby if I test positive for COVID-19?
Yes. We don't know for sure whether the virus is transmitted through breastmilk, but most of the data shows that it isn't. ACOG believes the benefits of breastfeeding outweigh the small risk of transmission.
But since you can transmit the virus through respiratory droplets, you'll need to take care to minimize the risk of transmission when you're near your baby. This means washing your hands before touching your child and wearing a mask while nursing, if possible.
Another option is to pump your milk and have someone else bottle feed it to your baby until you are free of the virus. You'll still need to wash your hands carefully before touching the pump parts or bottles and clean them properly after using them. The hospital should be able to provide you with a pump, at least while you're staying there.
My hospital is restricting visitors and only allowing one support person. If my support person leaves after the delivery, will they be allowed to come back?
Every hospital has different policies. Contact your hospital or labor and delivery unit a week or so before delivery to get the most up-to-date restrictions.
In general, if your support person needs to leave, they would be allowed back unless they knew they were exposed to COVID-19 after leaving your company.
My mom was planning to fly here to help me care for my new baby after delivery. Should I tell her not to come?
Yes. If your mom is over 60 or has any serious chronic medical conditions (such as heart disease, lung disease, or diabetes), she is at higher risk of serious illness from COVID-19 and should avoid air travel.
And remember that any travel setting increases a person's risk of exposure. So, it may be risky to have her around the baby after she has been traveling.
For the most current advice on traveling, check the CDC's COVID-19 travel page.
our site understands that the coronavirus pandemic is an evolving story and that your questions will change over time. We'll continue asking moms and dads in our Community what they want to know, and we'll get the answers from experts to keep them – and you – informed and supported.
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