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OB-GYN Q&A: How COVID-19 Affects Expectant Mothers and Their Babies

As the world scrambles to understand the novel coronavirus, normal aspects of life must go on. More importantly, new life continues to develop. While this is an unprecedented time for all, being an expectant mother through the pandemic can make things feel even more unnerving. It’s only to be expected that the questions and concerns you have will be multiplied and amplified.

So to better understand how COVID-19 affects expectant mothers and babies, People teamed up with Johnson’s Baby— who has more than 125 years of experience caring for babies and is committed to providing support for new and expectant parents — and OB-GYN Dr. Kim Marakovits. Dr. Marakovits gives tips on how to keep safe and healthy, and offers advice on how to talk to your healthcare provider about your COVID-19 concerns.

Are expectant mothers at higher risk of contracting COVID-19?

Dr. Marakovits has been getting this question often, and the CDC states that they “do not currently know if pregnant people have a greater chance of getting sick from COVID-19 than the general public, nor whether they are more likely to have serious illness as a result.” Because “the physiology of pregnancy is immune-suppressing,” Dr. Marakovits says pregnant women, in general, are slightly more susceptible to all infections — like the flu. The CDC suggests that pregnant women should avoid people who are sick or who have been exposed to the virus, and they should wash their hands frequently to help protect themselves from COVID-19.

How can an expectant mother keep herself safe during the pandemic?

“Take the same precautions that the CDC are recommending to the general population,” Dr. Marakovits says. “Make sure you're washing your hands very frequently, avoid touching your face to prevent transmission of the infection to yourself, practice social distancing and try to avoid contact with other people. If you have to be in contact with others, try to maintain six feet of separation.” If you do have symptoms that you believecould be COVID-19, Dr. Marakovits says it’s vital to talk to your healthcare provider.

How is prenatal care changing amid the pandemic?

Because of social distancing guidelines, Dr. Marakovits says many OB-GYN practices are spacing out prenatal visits or performing some visits via phone or video chat for women with low-risk, uncomplicated pregnancies.

“In our practice, we are sending home blood-pressure monitors to patients and ensuring that they have access to a scale,” she says.“And if they have a fetal doppler, they are using that to monitor fetal heart rate or performing fetal kick counts to monitor fetal movement. Then, during the telemedicine visit, we talk about routine prenatal care concerns, and the patient checks her blood pressure and weight at home. Often telemedicine visits will be alternated with in-office visits for routine prenatal care.” Speak with your practice to determine the best care for you and your baby.

Is it safe for an expectant mother to go outdoors?

“It is considered safe to be outside,” Dr. Marakovits says, so long as you’re complying with the CDC guidelines. “Just maintain a safe distance (the CDC recommends at least six feet) from other people if you encounter them while you're walking. For things like the grocery store or other essential shopping that needs to be done, again, try to maintain distance from other people in the stores, wear a mask (as is now the CDC recommendation) and make sure you wash your hands after you're done shopping to prevent infection with any germs that you may have touched.”

Is it okay to feel afraid to go to the hospital right now?

With so many novel coronavirus-infected patients seeking care, Dr. Marakovits says that a lot of women are expressing fear of going to the hospital if they are pregnant during COVID-19. And though she understands this on a human level, as a physician, it worries her.

“I worry, particularly for my pregnant patients, that people will be afraid to come to the hospital in a situation where they really should,” she says. “For example, high blood pressure and headache in pregnancy can be a sign of preeclampsia that really needs to be evaluated in the doctor's office or a hospital. Or shortness of breath could be a sign of a life-threatening blood clot that a patient should really be seen in the hospital for. We are trying to keep patients away from the hospital as much as is medically appropriate, but if you feel like something isn't right or like you need to be emergently seen, then please don't be afraid to call your doctor or to come to the hospital. I keep trying to emphasize that to everyone.”

Additionally, take advantage of your healthcare provider’s on-call system so a professional can answer your concerns over the phone.

Make sure you're washing your hands very frequently, avoid touching your face to prevent transmission of the infection to yourself...”

Are there any common pregnancy symptoms that could be confused for COVID-19 symptoms?

Dr. Marakovits explains that the common symptoms of the novel coronavirus —that we know of at this point — include cough, shortness of breath and fever. “Many of those [symptoms] are typical things that a woman experiences in pregnancy,” she says. “Because of the changes in a woman's body during pregnancy, pregnant women can feel more shortness of breath. Often pregnant women do feel more congested as well. So, yes, sometimes that can be something confused for a symptom of COVID-19.” Stay calm if you’re pregnant and experiencing these symptoms. If you have concerns, you should always speak to your healthcare provider first and foremost.

Should an expectant mother revise her birthing plan given the circumstances?

If this has caused you a lot of anxiety, Dr. Marakovits says it’s not uncommon. Because different hospitals have different policies (that have been changing rapidly), the best thing to do is keep in touch with your healthcare provider. “A pregnant woman should talk to her doctor about her plan, her expectations and what is realistic in such an uncertain time,” Dr. Marakovits says. “Providers and hospitals are doing their best to be present for women, support women, and make it the best birthing experience possible.”

Talk to your healthcare provider about your current plan and ask if they think it’s necessary to have a backup in place. This can help put your mind at ease and give you realistic expectations of how your plan could change on delivery day.

Can partners be in the delivery room?

Keep in mind that each hospital’s policy is different, so keep in touch with your healthcare provider to ensure that you’re up to date with the frequently changing rules.

“Initially, one of the big points of anxiety for women was that [institutions] weren't allowing any support partner into the hospital, except for during labor,” Dr. Marakovits says. “Now, because we have more masks and personal protective equipment available, we are allowing partners throughout the laboring process. They are allowed to stay in the room with the patient postpartum, and they are allowed to be present for a C-section. That has helped women feel a lot more comfortable throughout their labor and postpartum.”

Again, each medical institution is different, so it’s important to be aware if the rules are changing in your situation so you can prepare yourself as well as possible.

With the changing situation of who is allowed in the birthing room, have doulas and midwives taken on new roles? Are expectant mothers now connecting with them virtually instead of in person?

“Midwives attend deliveries either in a hospital, a birthing center or at home and continue to be present for deliveries even during the pandemic,” Dr. Marakovits says. “Recently there have been more women interested in home birth, likely because of apprehension about being exposed to COVID-19 in the hospital and changes in visitor policies—so in that way the midwifery role has shifted a little bit. Midwives are an integral part of providing safe home birth for women.”

“The role of a doula is as a labor support person, and therefore they cannot always be present for labor and delivery depending on the hospital’s visitor policy,” she adds.“Many women are connecting with their doulas by phone for support leading up to delivery and in the delivery room. Many of my patients have had their doulas, partners, or family and friends present via video chat for support throughout their hospital stay including labor, delivery and postpartum.”

Is a newborn more susceptible to contracting COVID-19?

Based on the research so far, it doesn’t seem that newborns are more susceptible to contracting COVID-19.“In terms of the information [from the CDC] that we have right now, the virus does not appear to be transmitted vertically — meaning that while Mom is pregnant, it does not seem like she can transfer the virus through the placenta to the baby while in utero,” Dr. Marakovits says.

So can a newborn get the novel coronavirus?

Once born, babies are susceptible to person-to-person spread, so different hospitals have different policies. Practice CDC guidelines along with the hospital’s recommendations to keep your babyhealthy and reduce newborn COVID-19 risks.

Is it safe to breastfeed?

Dr. Marakovits knows that many new moms look forward to breastfeeding and bonding skin-to-skin with their bundle of joy — and both activities are said to have lots of benefits. “For women who have COVID-19 or are undergoing testing for COVID-19 and want to breastfeed, we [and the CDC] recommend wearing a face mask and washing your hands before and after breastfeeding to try and prevent transmission of the virus to the baby,” she says. “Some women are choosing to pump breast milk and then have someone else who is not infected with the virus bottle-feed the breast milk to the baby. I really think the key is handwashing and trying to wear a mask to prevent transmission to the baby as much as possible.”

According to the CDC, the virus has not been detected in breast milk in limited studies, so doctors do not think the virus can be transmitted to the baby that way. Plus, breast milk contains antibodies that help protect little ones from infection, which can help during the pandemic.

Johnson’s Baby is committed to the care and safety of expectant mothers and their babies during the COVID-19 outbreak. Visit the website to learn more about their initiatives and how they are #InItTogether with expectant mothers and families. This story was published on 5/7/2020. The COVID-19 situation is always changing, so check the CDC website for the most up-to-date information.