What to Expect When Expecting: Pregnancy During COVID-19

by Brian Thompson, MD, FACOG

*As COVID-19 is an evolving disease, guidance around pregnancy may change as of publication of this blog on April 10, 2020.

As an obstetrician and gynecologist (OB/GYN) physician working in the time of COVID-19, I hear the fear in my patients’ voice and see the worry in their faces. “I’m scared. I’m scared for my baby.” Due to social distancing restrictions, many of my patients are worried that they will face this life-changing event alone. “I was planning to have my family attend my delivery. Can my partner be with me during delivery? Can my baby stay with me in the room after the birth? Am I going to be alone?” These are some questions that I get asked but there are countless others. Their concerns are valid. Pregnant women are part of the vulnerable population for contracting Coronavirus.

Pregnant moms can expect to have limited companions present for prenatal appointments. Depending on the number of COVID-19 cases in the mom’s location and the provider’s policies, moms can expect to attend appointments alone or have only one support person. If mom wants to include others in the pregnancy, ask the provider if it is allowable to video or audio call to have others join virtually. This would also include ultrasound exams. Ask first, as each provider and office have their own policies. Finally, for some, expect telehealth to be introduced into your prenatal care over a digital device, like a smartphone or laptop.

If mom is experiencing COVID-19 symptoms including fever, cough or shortness of breath, call a provider immediately. Physicians are learning that the symptoms of COVID-19 are on a spectrum and include mild symptoms to not showing symptoms at all – a condition we call “asymptomatic.”

It’s good practice to diligently perform all required preventive health measures. This includes maintaining a safe social distance of six feet between mom and baby and others. Moms should wear a non-medical mask to appointments and wash hands for 20 seconds before and after appointments. If mom is unable to wash hands, then use hand sanitizer with at least 60% alcohol. Avoid touching the face and stay at home.

For any hospital visit for labor and delivery, contact the provider or hospital to stay updated on current recommendations. If available, check the hospital’s website for any updates. In general, expect to have only one support person with mom during labor and delivery. Each hospital has their own COVID-19 policies, but in general, expect to wear a mask during labor and delivery. Providers and nurses will also be wearing personal protective equipment (PPE) during pushing and delivery. This includes an N95 mask, if available, and a face shield. Mom’s support person will have to wear a mask too. Mom may be able to video call family to share the delivery experience but be sure to ask the provider or hospital.

Only if the pregnant mother is being evaluated or is positive for COVID-19, then after delivery the baby will be separated from mom to protect the newborn. As a physician, I cannot emphasize enough the importance of personal hygiene and social distancing during this unprecedented time.

If the mother is negative for COIVD-19 and not feeling any related symptoms, then baby will be able to join mom in the room after delivery. Depending on the policy of mom’s delivering hospital, expect that only one person will be allowed to visit. Mom may be given the option of to go home early.. Early discharge from hospital care for a vaginal delivery may be the day after delivery and for a cesarean section, the second day postpartum. Discharge may also depend on how both mom and baby are progressing postpartum.

After discharge from the hospital, expect that mom’s postpartum experience will include limited visits with the provider, as many offices are delaying postpartum appointments until six weeks or more. The provider or hospital may also provide telehealth visits. Many patients ask if it is safe to breastfeed. Currently, COVID-19 has not been identified in breast milk. Therefore, if mom is COVID-19 negative you may breastfeed your newborn.

This is an incredibly difficult time. Having a baby and experiencing the wonder and excitement of seeing the baby for the first time is unforgettable. As a dad, I remember and cherish the first moments of our three boys. It’s difficult for me to imagine not being at my wife’s delivery, not being with our children, not being the protector of our family. As a people, we struggle, but we always find a way. We are survivors. We are Native. We are strong, resilient and spiritual. Creator made us that way. How you experience your delivery is made only by you and nothing can take that away. Stay strong and be safe.

Brian Thompson, MD, FACOG

Brian Thompson, MD, FACOG is Assistant Dean for Diversity in the College of Medicine and a Clinical Assistant Professor in the Department of Obstetrics and Gynecology at Upstate Medical University in Syracuse, New York.

Dr. Thompson also has an active practice as a board-certified OB/GYN.

Dr. Thompson is a strong advocate for the health of Native Americans and underserved populations as well as the recruitment and mentoring of Native American medical students.

Dr. Thompson is of Oneida and Mohawk ancestry and was raised on the Onondaga and Oneida Nations.