Worried about pregnancy and coronavirus? Me too. My wife is 14 weeks pregnant with our third child. The Agenda reached out to an Atrium Health OB/GYN with 16 questions. Below are her responses.
Dr. Lorene Atkins Temming is an OB/GYN and maternal fetal medicine physician with Atrium Health and a medical director of labor and delivery.
(1) Is a pregnant mother at higher risk of contracting COVID-19?
There is limited data to guide our understanding of COVID-19 in pregnancy.
So far, it seems the rate of contracting COVID-19 and the overall risk of severe complications from COVID-19 is low. That said, the unique immunologic and physiologic changes of pregnancy likely make pregnant women at higher risk of complications from COVID-19.
We have seen that pregnant women are at higher risk from other similar infections like influenza.
(2) At what point will the maternity ward need to be used for other critical needs? Will there always be a bed for a mother in labor?
At Atrium Health, we will always take care of women in labor.
There are no plans to use the maternity ward for anything else!
(3) What can pregnant women do to protect themselves?
Pregnant woman should do the same things that all of us should for prevention of spread: handwashing, social distancing, limiting exposure to large groups of people, and avoiding exposure to people who are sick.
The best advice for everyone right now is to mostly stay home to “flatten the curve” and decrease community spread of this virus.
Pregnant women should also focus on taking care of themselves at this time – doing things like getting plenty of rest and drinking plenty of fluids is helpful.
(4) If I’m pregnant and have symptoms, should I contact my OB/GYN first? Will expecting mothers be given priority testing?
Pregnant women can contact their primary care provider or OB/GYN.
In many cases, patients may be seen with a virtual visit to determine next steps.
Certainly, if any obstetric complaints like contractions, vaginal bleeding, or leakage of fluid, pregnant women should reach out to their OB/GYN provider.
Testing guidelines are changing nearly daily as more widespread testing becomes available. At this time, pregnant women are not given priority testing.
(5) What should I do if I’m pregnant and test positive?
First, be reassured that for most pregnant women they will experience coronavirus much like a common cold with mild symptoms. Most pregnant women will recover on their own. Follow the advice of your doctor.
In most cases, you will likely be advised to stay home, stay hydrated, and take over the counter medications to help with fever/aches/congestion (your doctor can advise you which are safe in pregnancy). You’ll be advised to contact your doctor if symptoms get worse.
(6) What plans should I make now in case the hospital system is overwhelmed when it’s time for me to deliver?
Hospital systems are taking every measure to plan to be available for your delivery and to expand capacity if needed, so in general, you don’t need to be overly concerned about that.
You should however, plan for the potential of visitor restrictions. These regulations are specific to each hospital and are designed to protect you and your baby as well as your visitors – check with the hospital you plan to deliver at regarding these restrictions.
(7) Can I pass along COVID-19 to my baby during pregnancy and delivery?
Currently, it is unclear if COVID-19 can cross the placenta and affect the baby during pregnancy.
In early reports, we have found no evidence of in-utero infection with COVID-19.
Special precautions will be taken to decrease risk of transmission to the baby during delivery if you have COVID-19 at the time of delivery.
(8) Should pregnant mothers be doing anything different when going to the hospital in labor?
No. Moms should call their doctors to discuss if they should come in.
Moms will be screened for symptoms on the phone or upon arrival to the hospital.
(9) Is it safe for me to deliver at a hospital that treated Covid-19 cases? What precautions are being taken on delivery and maternity floors?
It is absolutely safe to deliver at a hospital that is treating COVID-19 cases.
As we always do at Atrium Health, we will be taking appropriate precautions to prevent spread of COVID-19 in the hospital.
(10) Are babies that have been delivered to infected mothers being tested?
This question is probably better answered by a pediatrician, but my understanding is that yes, the baby will be tested.
(11) What happens if I have COVID-19 during my delivery?
At Atrium Health, we will take excellent care of you! You’ll likely be able to have an epidural if you wish and go through the normal delivery process.
You may be asked to wear a mask on arrival to the hospital.
The care team taking care of you will be taking appropriate precautions.
(12) Are OB/GYN doctors and nurses being tested regularly?
At this time, asymptomatic people, including doctors and nurses, are not being tested.
(13) Are you still seeing patients for routine prenatal appointments?
We are still recommending that pregnant patients be seen for their appointments. It’s possible that some appointments may be spaced out, but your doctor will let you know any plans in this regard.
(14) If a mother is infected while giving birth, do they need to be quarantined from their newborn? What’s the protocol?
This is likely a better question for a pediatrician. These protocols are evolving every day.
The baby may need to be separated from the mother for a time, depending on the case. Decisions about how long you stay in the hospital will depend on the situation.
(15) Can I pass it on by breastfeeding?
We don’t have any evidence that COVID-19 is passed into the breast milk.
Moms may need to take special precautions like wearing a mask or pumping and letting the baby be fed by family if they have an active infection. Your physician and pediatrician will advise you on the best steps to keep you and your baby safe and healthy.
(16) Should we hold off on trying to conceive because of coronavirus?
It is very early in this pandemic and very little is known about the impact of the virus on early pregnancies, so it is very difficult to make recommendations in this regard.
Definitely, if you are acutely ill or have recent exposure, I would recommend waiting as we know that fever at the beginning of pregnancy can be dangerous to the pregnancy.
Otherwise, the potential risks are something for you to be aware of and discuss with your partner and your doctor. As it always is, this will ultimately be a very personal decision.