Coronavirus and Pregnancy
Pregnancy is an exciting time of life but can be very scary when we are faced with a pandemic like the novel coronavirus (COVID-19).
There are lots of questions to be answered and lots of concerns to be addressed. First, since this virus is so new, there is a lot we are still learning.
However, there is some information from small research studies and observations that can guide us and try to address concerns at this point.
Protection During Pregnancy
According to the Centers for Disease Control and Prevention (CDC), we are not sure whether being pregnant makes a woman more at risk than the general public for contracting the novel coronavirus. However, due to the changes in the body, pregnant women may experience an increased risk of some infections in general.
The best way to fight off infection is to protect oneself from illness in the first place. The best ways to protect against coronavirus are avoiding people who are sick and proper hand-washing with soap and water or an alcohol-based hand sanitizer.
If a pregnant woman thinks she may have COVID-19, she should notify her provider and/or call the Health Department and follow their advice.
Practicing social distancing may be more difficult due to prenatal visits that are monthly or weekly. If the pregnant woman is sick, she should either reschedule her prenatal appointment or wear a mask.
A good alternative is virtual appointments, if available through the provider. Telemedicine is becoming more common, especially since the Coronavirus Preparedness and Response Supplemental Appropriation Act, 2020 was put into place. This Act broadens the coverage and reimbursement for telemedicine services for Medicare, and possibly Medicaid, in the near future.
Telemedicine is ideal for virtual prenatal visits, at-home monitoring (weight, blood pressure, fetal heart rate, blood sugar, etc.), consultation with specialists (maternal-fetal providers, genetic counselors), online communication with providers, mental health care, virtual postpartum visits and lactation support.
At this time, the University of Maryland Medical System encourages all patients to utilize the MyPortfolio service to communicate with their providers online, giving patients better access to providers rather than needing to schedule appointments to have questions answered.
Risk of Pregnancy Loss
To date, there has not been any evidence that links the novel coronavirus to increased risk of pregnancy loss. The statistics currently show pregnancy loss to be equal in women with COVID-19 and the general population. Additionally, there is no current evidence that COVID-19 causes complications in pregnancy.
Passing the Virus to the Baby
There is no evidence that contracting the novel coronavirus affects the health of the fetus or newborn. Thus far, the virus has not been found in any baby born to a mother with COVID-19, nor in the amniotic fluid, umbilical cord or placental tissue. However, there have been a few cases of the baby contracting the novel coronavirus after birth.
The Virus and Breastmilk
The virus has not been found in breastmilk and the CDC encourages mothers to breastfeed their babies to introduce antibodies and other protection against illness.
If a mother with COVID-19 chooses to breastfeed her baby, she should practice proper precautions to not spread the virus to her baby. These include washing her hands before touching the infant and wearing a mask if possible while the baby is at the breast.
Another precaution would be to have a well person feed the baby with expressed milk. In this case, the mother should take proper precautions while pumping, such as washing her hands before touching any part of the pump or bottle parts and following the recommendations for cleaning the pump after each use.
Most births take place in hospitals. Most hospitals, such as all of the University of Maryland Medical System (UMMS) facilities, are taking special precautions to keep patients safe.
To protect the patients, temporary visitor restrictions have been put in place. We highly recommend that women check the visitation policy of the hospital at which they plan to give birth. The woman's birth plan may have to be altered to accommodate a tighter policy.
Additionally, most hospitals use negative pressure rooms for contagious patients, which will keep other patients safer. Hospital staff have been trained to take proper precautions while treating patients as well.
While vaccines are being developed, there may be a further delay in getting them to pregnant women. Historically, medicines and vaccines are generally not tested on pregnant women and are held back until there is more information. Once the FDA approves the vaccine or drug for the general population, it will be made available to pregnant women, if safe.
While more information is needed, our knowledge base is growing every day. The key takeaways are to follow protective protocol: practice hand hygiene with soap and water or alcohol-based hand sanitizer and stay away from sick people.