As the COVID-19 pandemic continues to impact all facets of life, many have raised questions about the virus’ effect on pregnancy and delivery. Brian Wagner, MD, Medical Director of Labor and Delivery at Mount Sinai West, gives advice to expectant parents and those trying to conceive, and explains how Mount Sinai is creating a safe birthing place for mother, baby, and the extended care team.
Is it safe to get pregnant during the COVID-19 pandemic?
It is unclear whether couples should delay attempts to get pregnant. If you become pregnant now and become sick with the coronavirus, infection would most likely happen during the early part of your pregnancy. Unfortunately, we have limited research on what this could mean, and important questions about an increase in miscarriages or birth defects remain unanswered. Current data suggests that pregnant women are not at any increased risk when compared to non-pregnant individuals. We would recommend you have a conversation with your OB/GYN about your personal medical and obstetric history to help decide if this is the best time to conceive.
How does having COVID-19 complicate pregnancy?
As this viral infection is new, data is limited and just emerging. However, the limited data that exists is reassuring as it indicates that there is no increase in miscarriage or birth defects. With severe disease, there appears to be an increased risk of preterm birth; however, many of these babies were delivered to improve maternal outcomes and were not the result of preterm labor. Additionally, there is no strong evidence that the virus can pass from mom to baby. More information on how COVID-19 may affect pregnancy will emerge as more women deliver.
Are COVID-19 symptoms more severe in pregnant women? Are the symptoms different? Are pregnant women more at risk of contracting COVID-19?
In general, respiratory infections, like the flu, have been thought to be more severe in pregnant women. However, current data suggests the symptoms of COVID-19 appear to be the same as in the non-pregnant population. Symptoms tend to appear between 2 to 14 days from exposure and the most common symptoms appear to be cough, shortness of breath, and fever. In addition, pregnant women also appear to have the same risk for disease severity as non-pregnant individuals. The majority of pregnant women have mild symptoms and recover completely.
Pregnancy itself does not seem to increase the risk of infection or severe reaction to the virus. Pregnant women who have conditions such as diabetes and hypertension may be at increased risk for severe illness, but at the same level as the general population with those conditions.
Are obstetrics appointments being spaced further apart and/or being done via telemedicine appointments?
COVID-19 has necessitated a number of changes in the practice of medicine, in obstetrics and prenatal care. This has included spacing out appointments and grouping components of prenatal care together, including vaccinations and diabetes screening, and utilizing telehealth. As a result, a number of visits are being performed through videoconferencing and telephone. Patients are being asked to self-monitor with blood pressure cuffs and fetal heart rate monitors. This ensures that prenatal care continues to offer all the benefits while reducing the risk of exposure that comes with being out in the community. Of course, some elements of care will continue to require a face-to-face visit, including ultrasound examinations of the fetus.
How do pregnant women stay healthy during this time?
It is recommended that pregnant women take the same precautions as the general public to reduce their risk of COVID-19 infection. We know that the virus spreads from person to person through a number of methods, including droplets created when someone sneezes or coughs, close personal contact, and touching one’s eyes, nose, or mouth before washing one’s hands.
Steps that can help reduce your risk of infection include:
- Wash your hands with soap and water for at least 20 seconds or clean your hands with hand sanitizer that contains at least 60 percent alcohol
- Avoid touching your face, eyes, nose, and mouth
- Avoid people who are sick, and maintain a safe distance of six feet from other people
- Wear a face cover when leaving your house or apartment
In addition, general tips to stay healthy in pregnancy include eating a healthy diet, and getting regular exercise and plenty of rest.
Is it safe to give birth in a hospital during the pandemic? What is Mount Sinai doing to keep it safe for women to give birth during this time?
A hospital or certified birth center is the safest place to have your baby. Even the most uncomplicated pregnancies can develop problems or complications with little warning during labor and delivery. Being in a hospital allows you and your baby to have access to all the necessary medical care if these problems arise.
Due to COVID-19, at Mount Sinai we are taking extra precautions to ensure that you, your newborn, and your care team are safe and well. This includes extra cleaning and disinfection protocols, and wearing masks at all times and personal protective equipment as necessary. To enhance safety, you and your support person will be required to wear personal protective equipment—including a mask, gloves, and gown. The Mount Sinai Health System is screening all pregnant patients and their support partners for fever and symptoms of COVID-19 prior to admission since we know some people can have the virus yet be asymptomatic. All admitted patients and their support partners also will be tested for COVID-19. This ensures all the correct protective measures can be in place as needed to protect yourself and your newborn.