Pregnancy and Coronavirus

Am I at risk? How will it affect my pregnancy?

By Dr. Washington Hill

Originally published in the Sarasota Herald-Tribune

A tearful nine-months pregnant woman stopped me the other day in the paper products aisle and said, “I heard somewhere that if I had my baby now and have this coronavirus infection thing, that my baby would get it and my support person would be banned from labor and delivery. Is that true?”

I answered no to both questions. Then I sat down and wrote this Q&A. As of today, it is up to date.

Q: Am I at more risk for COVID-19 if I’m pregnant?

A: No. There is NO evidence that is the case. You should, as should everyone, take preventive actions to avoid infection, such as washing your hands frequently with soap and water or use alcohol-based hand sanitizer, avoiding people who are sick and practicing social (physical) distancing. Stay at home and remind your peeps to stay home as well.

Q: How might coronavirus infection affect my pregnancy?

A: Data for COVID-19 is limited at this time. There have been only a few number of cases during pregnancy. We are learning more every day, but we know that women with other coronavirus infections did not have miscarriage or stillbirth at higher rates than the general population. Flu has been associated with low birth weight and preterm birth. A high fever early in pregnancy may increase the risk of certain birth defects.

Q: Should we hold off on trying to conceive because of COVID-19?

A: At this time, there’s no reason to hold off on trying to get pregnant, but again the data we have is really limited. As mentioned, 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 just don’t know. We also don’t know if the virus lives in semen or can be sexually transmitted.

Q: Could I transmit coronavirus to my baby during pregnancy or delivery?

A: Really unknown. There are only a few case studies of infants born to mothers with COVID-19 to help answer this question. Those published show few of the infants tested positive for the virus. And there have been no reports of mother-to-baby transmission for other coronaviruses. There was no virus detected in samples of amniotic fluid or breast milk. But there have been a few reports of newborns as young as a few days old with infection, suggesting that a mother can transmit the infection to her infant through close contact after delivery.

Q: Is it safe for me to deliver at a hospital where there have been COVID-19 cases?

A: Yes. We have two problems: the virus and fear. The good news is that Sarasota Memorial Hospital and others are taking great precautions. Having your baby in the hospital is safe, whether vaginally or by Cesarean delivery. Hospitals are also implementing stricter visiting policies to keep patients safe. No visitors are allowed at Sarasota Memorial at this time.

Q: What if the hospital system is overwhelmed when it’s time for me to deliver? Should I just have my baby at home?

A: No. Every hospital is making different plans for dealing with this scenario. The plan should be to talk with your doctor or midwife now, or once you’re at least 34 weeks pregnant.

Q: Will the hospital separate me even temporarily from my newborn and keep the baby in quarantine?

A: 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 but have no symptoms, your OB provider and pediatrician will follow the most recent recommendations of the CDC, American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine to decrease the risk of transmission. Wearing a mask while breastfeeding is recommended and OK.

Q: Isn’t that scenario heartbreaking?

A: Yes, it is more than 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. Use the technology we all have available to us to provide virtual support and even a virtual shower.

Q: My mom was planning to fly here to help me care for my new baby after delivery. Should I tell her not to come?

A: Yes, especially 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. As hard as it is, she should stay home.

Q: I am really afraid and have a lot of stress and anxiety. What should I do?

A: This is normal. Don’t worry alone. Talk to your OB or midwife. This is going to be a marathon not a sprint. Advice many of us share, and have been given ourselves, is to turn off the news and the news alerts. You don’t need them. Read a book, take a walk — remembering to stay 6 feet away from others. Call someone you haven’t talked to in awhile. Remember, a beautiful Florida sunrise or sunset will occur tomorrow, and you are going to experience the joy of having a baby!

Q: We have a “babymoon” scheduled in the next few months. Should we cancel?

A: That’s an easy one. Yes. Stay home and be safe.

Washington Hill, M.D., a maternal-fetal medicine specialist with CenterPlace Health and Sarasota Memorial Hospital, has been an obstetrician-gynecologist for 55 years, almost 30 in Sarasota. [email protected]

Felice Baron, MD, the Director of SMH Maternal-Fetal Medicine, discusses the impact COVID-19 has had on local moms,
and the importance of vaccination before or during pregnancy.