COVID-19 and pregnancy: Tips from experts

Spectrum Health will soon roll out virtual visits for prenatal care, reducing the need for in-person appointments. (For Spectrum Health Beat)

No mom-to-be expects to add details about a global pandemic to her baby book.

But expectant moms and dads everywhere suddenly find themselves with a new what-if for their list: COVID-19.

What risks do they and their baby face?

How can they protect their child and ensure a safe delivery?

To help pregnant women as they prepare to welcome a new life into the world, we sought guidance from Spectrum Health pregnancy and childbirth experts.

Q: Do pregnant women and their unborn children face additional risks from the coronavirus that causes COVID-19?

“So far, there is no evidence that pregnant women are more susceptible to getting COVID-19 than the average healthy adult,” nurse midwife Courtney Hilbert, CNM, said.

However, experts have very limited data about coronavirus and pregnancy. And there is plenty of reason for women to be cautious, noted Michael Tsimis, MD, a maternal fetal medicine specialist.

Because women experience changes in their immune system during pregnancy, it’s always important for pregnant women to protect themselves from illness.

“We know that, in general, women who are pregnant and get coronavirus might be at risk for severe illness based on what we know about pregnant women and other viral respiratory infections like influenza, SARS, and MERS,” Hilbert said.

Q: How can I protect myself and my baby?

“Stay home and practice social distancing as much as possible. Wash hands frequently, cover coughs with your elbow, and avoid people who are sick,” Hilbert said.

Q: Can I still deliver my baby at the hospital?

“We continue to provide the high-quality care we are known for to those women presenting to our hospitals to give birth,” Hilbert said.

That is true even if a woman is severely ill with COVID-19.

Spectrum Health screens pregnant women for symptoms of the disease. It has plans in place to treat those who have COVID-19—while isolating them from other patients, Dr. Tsimis said.

The maternal fetal medicine team continues to update its policies, following guidelines from the American College of Obstetricians and Gynecologists, as well as the Centers for Disease Control and Prevention.

Hilbert encouraged parents to turn to those trusted sources for information.

“Hospitals are still the safest place to have your baby,” added Suzanne West, MD, an obstetrician and division chief for women’s health at Spectrum Health. “Research from the American Journal of Obstetrics and Gynecology shows that the overall risk of neonatal death was significantly higher in planned home births compared with hospital births by certified nurse midwives or physicians.”

Q: Can a pregnant woman pass COVID-19 onto an unborn child?

Although there is not much research on that question, what is available so far is reassuring, Dr. Tsimis said.

A study published in the medical journal Lancet focused on nine women in China who had the disease when they gave birth. Researchers found no sign of transmission to the infant—and no evidence of the virus in amniotic fluid or breast milk.

The babies were born healthy and the mothers recovered from the illness.

Although there has been at least one report of a newborn who has COVID-19, doctors don’t know if the child acquired the infection in the womb, said Daliya Khuon, MD, a pediatric infectious disease specialist with Spectrum Health Helen DeVos Children’s Hospital.

Q: Should pregnant women continue prenatal appointments?

“Prenatal care is very important to the health of mom and baby, so we ask women to come to their appointments as scheduled,” Hilbert said.

Spectrum Health will soon offer virtual options—connecting through telehealth—that will allow patients to get some of their prenatal care from home, instead of coming to the office. Patients could receive four to six virtual visits during the pregnancy.

The virtual prenatal visits will begin mid-April.

Q: But what should a woman do if she has symptoms of a respiratory illness?

“If you have mild to moderate symptoms, stay home,” Hilbert said. “Call your obstetrical provider if you have shortness of breath, with fever and cough.”

Q: What reactions are you hearing from moms-to-be?

Many lament the restrictions on hospital visitors—only one visitor allowed for a woman in labor and delivery.

“They have to make hard choices between, for example, their partners and their mothers being by their sides during this momentous life event,” Hilbert said.

Q: We should cancel baby showers, right?

That’s right. Pregnant women should avoid all social gatherings, and that means no in-person childbirth classes and baby showers, Hilbert said.

Skipping those treasured rites is disappointing to many expectant mothers, she acknowledged. Some worry whether they will have everything they need when baby arrives.

She gently reminds them to think about what is truly necessary—such as diapers, a car seat and a safe place to sleep.

The other “nice-to-have” items can wait.

Q: What advice do you give moms-to-be who feel isolated during this pandemic?

“You are not alone. There are pregnant women all over the world with similar concerns,” Hilbert said. “Lean into your support network, whether that be with pregnant moms in your real or virtual community, women in your childbirth classes or CenteringPregnancy groups and your supportive friends and family.”

She encourages parents to use FaceTime, Skype or other video connections to share celebrations and childbirth and to introduce their new little one to family and friends.

Also, parents can connect with family and friends with CareCircle. The free online resource allows patients to provide updates on their health and share private information with a select audience rather than on traditional social media.

from Spectrum Health Beat https://ift.tt/2xnnae3