The COVID-19 pandemic has changed the healthcare landscape for many patient populations — including pregnant women.
Altered hospital policies, concerns about contracting the SARS-CoV-2 virus, and changes to doctors’ office hours have all affected pregnancy.
Information regarding pregnancy and COVID-19 is continually evolving. This article will cover the currently available information relating to pregnancy during the pandemic.
Pregnancy can be an exciting time, but also one of uncertainty. The COVID-19 pandemic understandably adds further stress and may cause anxiety in some people.
During pregnancy, signs and symptoms of high stress include:
- changes in appetite
- frequent feelings of fear and worry about the pregnancy and delivery
- poor quality sleep
- problems concentrating
Pregnant women may wish to try the following stress-relieving practices and tips:
- Refrain from looking at physical media or watching the news around the clock. Instead, limit the news to key times of the day, such as the morning or before dinner, leaving the evenings free for unwinding and promoting sleep.
- Ask a doctor or midwife about online antenatal classes, which are excellent places to meet and talk to other pregnant women.
- Try meditating, deep breathing, or gentle stretching.
- Take care of key relationships by connecting with friends and family over the phone or through video conferences.
- Get enough sleep by going to bed at a consistent time and limiting screen time beforehand.
- Maintain a healthful diet and engage in regular exercise. Eating well and staying active can help the body stay healthy in times of mental ill health.
- Take up a new hobby or rediscover an old one, such as playing an instrument, learning a language, or reading. People may also enjoy making blankets, clothes, or handmade toys for the coming baby, or decorating a nursery.
- Make use of online support groups and forums for pregnant women and new parents.
- Consider online counseling. Therapy can be helpful for anyone experiencing anxiety, depression, or stress.
- Ask for extra help — this may mean that a partner takes a greater share of caring for the children, if applicable, or that a neighbor does the grocery shopping and drops the bags outside the door.
If a woman is experiencing significant mental distress, it is vital to speak to a doctor, midwife, or counselor.
Depression during pregnancy is common but treatable. Even if they are physical distancing, pregnant women do not have to face depression or other mental health concerns alone.
The Substance Abuse and Mental Health Services Administration (SAMHSA) have also established a Disaster Distress Helpline, which people can access by calling 1-800-985-5990 (TTY: 1-800-846-8517) or texting TalkWithUs to 66746.
Avoiding contact with others, especially large groups of people, can reduce the transmission of the coronavirus.
Many areas have enacted shelter-at-home or safer-at-home policies that discourage people from going outside except for essential travel, such as going to the grocery store or pharmacy or making other necessary visits.
It is essential to keep attending prenatal appointments, but be aware that some of these appointments may occur over the phone.
Modern technology enables doctors’ offices to change the way in which they help people, including pregnant women.
The American College of Obstetricians and Gynecologists recommend that pregnant women talk with a doctor to determine how often they should go for in-person visits.
Doctors may offer online video call visits called telemedicine. They may recommend spacing out ultrasound appointments or other in-person visits to reduce a woman’s risk for transmission.
If possible, having a partner or delivery service secure key items can help reduce a pregnant woman’s exposure to the public.
People should always wash their hands when returning from the grocery store or a walk outside.
As COVID-19 is a new and developing health crisis, experts have not yet identified its effects on pregnancy. They remain unsure whether pregnant women are more at risk of getting COVID-19 or experiencing more severe symptoms and whether they might pass the virus to the baby.
According to the World Health Organization (WHO), no evidence currently exists to suggest that pregnant women are at higher risk of experiencing severe COVID-19 symptoms than the general population.
A small study of nine pregnant women in their third trimester with COVID-19 and pneumonia symptoms in Wuhan, China, found that one baby tested positive for the virus 36 hours after birth.
However, tests of the woman’s placenta and umbilical cord were negative, which could mean that the newborn contracted the virus after birth, rather than in the womb. This sample size was very small, which makes drawing conclusions difficult.
Another study of 38 pregnant women testing positive for COVID-19 in China did not find that their symptoms were more severe than those affecting the general population.
The study did not report any maternal deaths or the transmission of COVID-19 to any babies.
A recent study from the United Kingdom, currently available online in preprint form, found that more than half of the pregnant women hospitalized with COVID-19 were black or ethnic minorities. These populations may, therefore, be at greater risk of negative effects during pregnancy.
This study fits in with a mounting body of evidence that shows how COVID-19 has a disproportionate effect on people from black, Asian, and minority ethnic (BAME) communities. Some experts believe this stems from widespread discrimination and systemic racism in healthcare. Read more here.
If a pregnant woman has symptoms that resemble those of COVID-19, such as coughing, fever, or shortness of breath, she should call a doctor.
The doctor can make recommendations about whether or not COVID-19 testing is necessary.
If the woman’s symptoms are mild, a doctor will likely recommend that she self-isolate at home.
Home treatment includes taking acetaminophen for fever relief, resting, and drinking plenty of water.
A high fever or difficulty breathing are signs that urgent care is necessary. Try to call the hospital before arriving at the emergency room so that they can take any necessary precautions.
Some hospitals in the United States have prohibited visitors for the foreseeable future — including during childbirth — to protect healthcare staff and other patients from the virus. The number of support people who may enter the delivery room can vary from hospital to hospital, however.
For example, the University of Chicago Medicine have stated that they allow one support person during a vaginal delivery but none during a cesarean delivery.
The policies for a support person can vary. It is best to contact the relevant hospital to ask about their policies for a support person in advance.
Some women may consider the option of a home birth as an alternative to ensure that they can have their partner or a family member or friend present.
While this is a possibility for some people, it is vital to remember that COVID-19 procedures could delay entry to the hospital if complications occur during the birth.
The pandemic has resulted in many pregnant women experiencing changes to their birth plan, which can cause stress and uncertainty.
Having all the necessary information may help them feel in control and reduce anxiety.
Questions to ask a doctor include:
- How may your office hours or accessibility change?
- Are there online alternatives to antenatal classes where I can meet and talk to other pregnant women?
- How can I ensure that I am safe when visiting my doctor’s office or going to the hospital?
- How can I expect COVID-19 concerns at the hospital to affect my delivery?
- Will there be changes in terms of the medications that I may receive or the number of people present in the delivery room?
A woman can also ask her doctor about any area-specific or condition-specific changes.
Pregnant women may feel additional stress, anxiety, or depression during the COVID-19 pandemic. But even if they are self-isolating, they do not have to face these problems alone.
It is best for pregnant women to focus on the elements that they can control, including self-care and physical distancing.
Keeping in regular contact with a doctor or midwife can also help alleviate worries about health and the birth.
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