I get it.
Pregnancy is already a time of uncertainty.
I saw the looks on my patient’s faces today.
And I will see them tomorrow.
And the next day.
I thought back to when I was pregnant during residency.
What does this virus mean for pregnant women?
What does it mean for their unborn babies?
What does it mean during my labor process?
What does it mean for breastfeeding?
Will I get sicker from coronavirus because I am pregnant?
These are uncertain times.
There is a lot we don’t know.
But I do know is that we take this day by day. And we follow the guidelines that have been set.
What measures are your hospitals and offices taking?
Everyone is instituting different measures. Our hospitals, similar to others, have cancelled all elective and non emergent cases effective immediately. As OB this does not necessarily have a huge effect as most of our cases have to happen i.e., deliveries and C sections, emergent D and C’s if someone is bleeding. But if the procedure can be postponed for a few weeks the recommendation is to postpone it.
What will happen when I come in for delivery.
At our hospitals, again likely similar to others, there is only one support person allowed in the rooms. No having both parents, friends, children etc. Only one.
In our office we have also limited visits to the patient only. No spouses and no children. We have staggered visits so the waiting room isn’t crowded. And if it does get crowded ask patients to wait in their vehicles until we have cleared out the waiting room. And of course diligently wiping down everything multiple times a day including dopplers, tape measures, ultrasounds, door handles, and seating in the waiting room.
Are pregnant women more likely to get sick or die from coronavirus?
From what we know right now, as of today, March 16, 2020 the answer is no. We do know that pregnant women are immunocompromised and are at a greater risk of morbidity and mortality from diseases such as the flu and from SARS. Pregnant women, however, are generally young and healthy which we know helps with COVID-19. The current studies have very small sample sizes and in those studies, pregnant women did not get worse symptoms than those who weren’t pregnant which is great news. This information may change in the future as we get more updates.
What should pregnant women do differently?
There are no specific recommendations for pregnant women according to the CDC. Pregnant women should do what we have advised to everyone. Social distancing, no unnecessary travel, wash your hands like crazy, don’t touch your face. Stay away from people who are sick.
What if I am pregnant and confirmed to have the coronavirus?
The CDC suggests discussion with your healthcare team regarding temporarily separating a mother who has confirmed or is under suspicion for COVID-19 until her transmission based precautions have been discontinued. If there is separation, breast pumping is encouraged and mothers should wash their hands thoroughly before each pumping session and all breast pump parts should be thoroughly washed. It has been suggested that mothers can also breastfeed but they should put on a face mask and wash hands prior to each feeding and clean all surfaces. Others have said separation will interfere with the bonding time between mother and infant and risks vs benefits need to be weighed. It is unknown whether the virus is transmissible through breast milk. I am sure this will be an ongoing discussion.
Should I stay home from work?
Again, this is likely individually based. There are no specific recommendations for pregnant women. I will say that if you have a high risk job where you will have contact with individuals with COVID-19 or are in a high risk area, and have the ability to work from home; I would highly advise you do that.