Ask an OB: Pregnancy During COVID

Ask an OB: Pregnancy During COVID

image via @enginakyurt

We spoke with Dr. Karianne Silverman at St. Francis Hospital in Hartford, CT, to answer some of the most frequently asked questions about being pregnant during the COVID-19 pandemic.

MAMAS Please note: information on COVID-19 is changing daily.  The below is a Q & A that took place on 5/20.  Our team is working to provide the most up to date information as it becomes available.

1) What can I do to protect myself while I am pregnant?

The American College of Obstetrics and Gynecology (ACOG) alongside The Society for Maternal and Fetal Medicine (SMFM) continue to advise all pregnant women to follow the CDC guidance in preventing infection with COVID-19 by taking precautions to minimize exposure to the virus.  These things are well known to most and include regular hand washing and social distancing in accordance with your local government advisories.

Continuity of prenatal care and communication with their OB/GYN, midwife or other maternity care professional is essential at this time. Many pregnant women have other health conditions or comorbidities that make them at risk for severe illness resulting from COVID-19.  So, consulting about any one person’s personal risk with their healthcare provider is important.

2) Am I more at risk and/or is my baby more at risk?

It’s important to remember that current guidance from the CDC regarding COVID-19 and pregnancy is based on limited data.  However, at this point, it does NOT appear that pregnancy alone puts women at higher risk from severe illness resulting from COVID-19 infection. This is in direct contrast to what we know about other respiratory illnesses such as Influenza or other Coronaviral infections such as SARS-CoV in which pregnancy by itself DOES appear to confer a more severe illness on women. This  explains the hesitancy of most healthcare providers to dismiss pregnancy as a risk factor for COVID-19 infection.

Currently, it is unclear if COVID-19 can cross through the placenta and infect the fetus in utero. This mode of transmission- from mother to fetus while in utero is called vertical transmission.  In limited studies of infants born to mothers infected with COVID-19, none of the infants tested positive for the virus which suggests that vertical transmission does not occur with COVID-19 unlike other viral illnesses in our recent past such as ZIKA. 

“rest and hydration are very important!”

HEALTH UPDATE: Current guidance from the CDC regarding COVID-19 and pregnancy is based on limited data, and the CDC is collaborating partners to better understand COVID-19 during pregnancy. Up until last week, the CDC guidance was that pregnant women are not at an increased risk for severe illness resulting from COVID-19 infection. The CDC has updated their guidance that pregnant women with COVID-19 are at increased risk than non-pregnant women, but much remains unknown. Each pregnancy is different, so consulting about any one person’s personal risk with their healthcare provider is important.  Stay safe, Mamas. We are with you. 

3) What will happen to me or my baby if I do contract COVID-19?

If you contract COVID-19 and are still pregnant and remote from your due date, you should contact your OB/GYN or obstetric health care provider. If testing is available in your area, you should be tested if your symptoms are compatible with those of COVID-19.  Remember, not all upper respiratory illnesses (“URIs”) are COVID-19.  Influenza is still prevalent this time of year in certain parts of the country, so your healthcare provider may wish you to be tested for Influenza as well. There is an antiviral that is active against Influenza called Tamiflu that is safe and recommended for pregnant women who are Influenza positive. Make sure to talk to your OB/GYN about this.  

If you are well enough to stay home during the infection as many pregnant women are, you should distance yourself from other members of your family to decrease their chances of getting infected.  You should use Tylenol as a fever reducer and to decrease body aches if it is safe for you to take that mediation.  You can use some cough suppressants and nasal decongestants as well but it’s best to talk to your OB/GYN before starting any of these medications.  Also, rest and hydration are very important. If your symptoms worsen, contact your healthcare provider right away for further guidance.

 “ If offered, an audio or video visit is a great way to reach your provider, get reassurance and have questions answered.”

4) Should I leave home to go to my doctor’s appointments?  Should I opt for online appointments if offered?

There has been some guidance on spacing out in office visits for low-risk pregnant populations in an effort to decrease transmission of the virus. If you qualify to have your visits spaced out, I encourage you to do so. Some pregnancies are at risk for various illnesses and/or complications and shouldn’t be spaced out as the risk of not being seen by a provider outweighs the benefits of spaced out visits.  If offered, an audio or video visit is a great way to reach your provider, get reassurance and have questions answered.

5) My OB/GYN is spacing my appointments- how do I know if my baby is safe?  Any alternatives?

In between visits, there are a few things you can do.  Making sure you feel the baby move at various times during the day is an important way to know that the baby is getting the oxygen and nutrients he or she needs to be healthy.  There are various definitions of what constitutes normal fetal movement, but one is between 5-10 movements over 1-2 hours  Check with your OB/GYN for what they think the correct number and time are.  Doing this daily is a great way to be reassured that your baby is doing well.  Another consideration would be to obtain a blood pressure device over the counter.  Some insurances do cover these devices, so make sure to ask your provider. Measuring a blood pressure 1-2 times per week is another good way to make sure you are staying free of common pregnancy complications.  Log these readings to share at your next visit.  Check with your OB/GYN about this to see if you are a good candidate for doing this at home and what readings should be communicated to them.

6) Can I exercise outdoors if I maintain social distancing?

The short answer is yes.  This is not the time to start a new exercise plan, train for an event or lose weight, of course.  It is merely a time to maintain some fitness, enjoy fresh air and stay healthy.  Being outdoors is a great way to maintain social distancing and is important for us all to engage in.  Make sure to stay hydrated and eat healthy while engaging in exercise during pregnancy.


Learn more:

Approaching your due date, and want to learn more? Get your questions about delivery answered over on part one of Ask an OB: Labor During Covid