FAQ for Pregnant Women during COVID-19
MEREDITH ROCHON, MD, CHIEF, MATERNAL FETAL MEDICINE
Lehigh Valley Health Network (LVHN) remains vigilant as the impact of coronavirus (COVID-19) evolves, and we are committed to being your partner in health – and in motherhood – during these unprecedented times.
Meredith Rochon, MD, Chief, Maternal Fetal Medicine, for LVHN, assures expectant mothers that LVHN is here to provide personalized, compassionate and comprehensive care even as the impacts of COVID-19 result in temporary changes for your protection and for the safety of our caregivers. Rochon provides answers to some of your most frequently asked questions.
FOR PREGNANT WOMEN
Are pregnant women at higher risk for acquiring a COVID-19 infection than women who are not pregnant?
Information regarding COVID-19 and pregnancy is limited. However, due to changes in the immune system during pregnancy, pregnant women have the potential to experience more severe coronavirus infections, just like other types of viral respiratory infections, like influenza (flu). Fortunately, the limited data that is available suggests that pregnant women may not more severely affected by COVID-19.
I just found out I am pregnant. What should I do?
If you just found out you are pregnant, call your obstetrician-gynecologist or primary care provider. Your health care provider will decide when you need to be seen in the office. In many cases, initial information may be provided by phone or video visit to keep you safe at home. Let your doctor know immediately if you have any complications, like pain or bleeding.
How can I protect myself against COVID-19?
Pregnant women should do the same thing as non-pregnant women to protect themselves against COVID-19. Stay home, wear a mask in public and practice social distancing and good hand washing.
What is LVHN doing to protect me and my unborn baby?
LVHN has done many things to protect you and your baby, including:
Decreased the frequency that you need to come to the office by being able to provide virtual prenatal visits to you from the safety of your home.
Developed virtual pre-screening options for those who think they have COVID-19 or may have been exposed to someone who does, including:
Established safe, standalone COVID-19 Assess and Test locations in each of our regions for those with suspected COVID-19 to be tested in areas separated from other areas providing non-COVID-19 related care.
Implemented processes to keep our health care providers safe so that your doctor is available when you need them, including:
Working in shifts to minimize the risk of being exposed or getting sick.
Decreasing the number of face-to-face patient encounters, while still providing patients with virtual care to reduce the spread of COVID-19.
Wearing appropriate personal protective equipment (PPE) like masks and eye protection for every face-to-face patient encounter.
Postponed routine surgeries and procedures to preserve existing PPE needed to treat patients with COVID-19.
Additionally, we will continue to provide you with the latest information and updates regarding COVID-19 from LVHN, the Pennsylvania Department of Health and the Centers for Disease Control and Prevention (CDC).
Which pregnant women should be tested for COVID-19?
Pregnant women with symptoms of COVID-19, including fever, cough and shortness of breath, should be tested. These same individuals should also be tested for other causes of these symptoms, like the flu. Currently, the Centers for Disease Control and Prevention (CDC) does not recommend that asymptomatic women be tested at this time. If a pregnant women has been exposed to someone with a known COVID-19 infection, they should call their doctor. In most cases, if they don’t develop symptoms, they will not be tested, but their doctor may recommend self-quarantine for 14 days.
Can I pass COVID-19 to my fetus?
Limited information suggests that COVID-19 does not cross the placenta and get to the fetus. This is similar to other viral respiratory infections, like other coronaviruses and flu.
After you give birth, if you have a known COVID-19 infection or a suspected infection, your newborn may be temporarily kept in a separate room until you are no longer considered infectious.
Is my doctor’s office still open?
LVPG Obstetrics and Gynecology and LVPG Maternal Fetal Medicine are still seeing patients, both in the office and virtually, by video or phone, and will make sure that you get the care that you need. During this time, you may need to be seen at a different location, as select sites have been temporary relocated to increase capacity for virtual visits by phone or through the MyLVHN portal. This allows LVPG health care providers to deliver the care patients need and prevent the spread of infection. Patients can learn more about temporary LVPG practice location changes by visiting LVHN.org/relocations.
Given the “Stay at Home” order by Gov. Tom Wolf, Pennsylvania, should I still go to prenatal visits?
It is still appropriate to attend medical appointments when needed, even with the “Stay at Home” order in place. Unfortunately, every time you leave your house, you are at risk for being exposed to someone with COVID-19. To minimize this risk during these extraordinary times, LVHN obstetricians and maternal fetal medicine specialists have revised our recommendations for routine care during these extraordinary circumstances.
To keep you home and keep you save while continuing to provide you with the pregnancy care you need, here’s what we’re doing:
- Changing many routine visits to virtual visits. Virtual visits, by phone or video chat, still enable your doctor to see how you are doing by asking you specific questions and listening to your concerns from the comfort and safety of your own home. You will still have some routine visits scheduled in the office, and can be seen in the office as needed for emergencies.
- Decreasing the frequency of routine ultrasounds. You will still have ultrasounds during your pregnancy, including a “level 2” ultrasound, which assesses fetal development. If needed, you will still have ultrasounds to check the growth of your fetus, although they may be less frequent than under normal circumstances.
- Changing the schedule of antenatal (during pregnancy) testing. During the COVID-19 pandemic, our maternal fetal medicine specialists and national health care societies recommend using a weekly non-stress test (NST) with a biophysical profile (BPP), a specialized ultrasound to see fetal movement, breathing and fluid. A weekly BPP has been shown to be equally effective in assessing fetal well-being as NSTs done twice a week to monitor the health of your baby. In some cases, your doctor may recommend that you wait to start antenatal testing later than originally planned.
I am worried that seeing my doctor less frequently and having fewer ultrasounds may not be safe for my baby.
LVHN obstetricians and maternal fetal medicine specialists carefully considered all aspects of your care before issuing revised guidelines, and their recommendations are similar to what other health systems are doing for all pregnant women across the country. Remember, the safest thing you can do for you and your baby is stay at home. But, be assured that you will continue to get the pregnancy care you need.
Do women with suspected or confirmed COVID-19 need to be delivered by cesarean section?
Most women with suspected or confirmed COVID-19 infection do not need to be delivered by cesarean section. In fact, vaginal delivery is preferred. Cesarean delivery is usually performed for the same reasons in women with COVID-19 as in women without COVID-19.
FOR WOMEN TRYING TO CONCEIVE
My partner and I are currently trying to conceive. Should we hold off?
It is hard to know how long the COVID-19 pandemic will last. Experts are predicting that the “peak” of the epidemic will be sometime in mid- to late-April, suggesting that cases will decrease in the months after that. Although it is likely safe to conceive during this time, it may be reasonable to wait until the number of infections in the community decreases.
FOR POSTPARTUM AND NEWBORN CARE
Can I touch and hold my newborn baby if I have COVID-19?
You can. But, it is recommended that you wear personal protective equipment (PPE), such as a gown and mask, to avoid infecting the newborn. In some cases, it may be preferable to temporarily separate the mother and newborn after birth to minimize the risk of the newborn being infected.
Can a woman with COVID-19 breastfeed?
Breastfeeding is encouraged, as antibodies in the breastmilk may protect the newborn from infection. However, it may be safer to have a woman with COVID-19 pump and have the breast milk given to the newborn by a healthy caregiver instead. It is very important that women infected with COVID-19 wash their hands thoroughly and wear a mask prior to pumping.
What is next?
The COVID-19 outbreak is rapidly evolving, and new information is becoming available every day. For the most up to date information on COVID-19 and how it can affect pregnant women, visit the CDC website or contact your health care provider. At LVHN, we will continue to provide you with the best care possible, following current state and federal guidelines. Please do not hesitate to contact your primary care physician or obstetrician with any questions.