About Your Pregnancy

Am I at a higher risk of getting COVID-19 because I am pregnant?

• Currently, very little is known about COVID-19 and its effect on pregnant women or if it affects the health of the baby after birth. At this time, there are no recommendations specific to pregnant women regarding COVID-19.
• Pregnant women are known to be at greater risk of severe morbidity and mortality from other respiratory infections such as influenza and SARS-CoV. BUT, based on a limited number of confirmed COVID-19 cases, pregnant women do not appear to be at increased risk for severe disease due to coronavirus.
• It is unclear if COVID-19 can cross through the transplacental route to the fetus. As of today, none of the infants born to mothers infected have tested positive for COVID-19.
• Right now, we have not evidence of it being present in the amniotic fluid or breast milk.
• Updated information as of April 3rd, some pregnant women with COVID-19 have had preterm births, but it is not clear whether the preterm births were because of COVID-19. (Information from ACOG.)

Will I be able to breastfeed if I have COVID-19?

• No evidence of virus has been found in the breast milk of women infected with COVID-19.
• But the infected mother could possibly transmit the virus through respiratory droplets (ex: by sneezing or coughing) during the period of breastfeeding.
• Specific instructions would be given if you have COVID-19 and decide to breastfeed to make it as safe as possible.

What do I do if I am a pregnant healthcare professional?

• Pregnant healthcare professionals should follow risk assessment and infection control guidelines when exposed to patients with suspected or confirmed COVID-19 (your workplace should have them in place).
• Facilities may want to consider limiting exposure of pregnant healthcare professionals to patients with confirmed or suspected COVID-19 if feasible based on staffing availability. We can provide you with a letter asking for your duties to be modified so that you do not work directly with these patients, but we can’t guarantee that your workplace will be able to do so.

Should I still get the flu vaccine?

• Influenza activity continues to be high across the United States.
• We know that influenza can cause severe respiratory distress in pregnant women.
• I encourage every pregnant woman to get the flu vaccine. We don’t have it available in our office anymore during this season but you can still get it at most major pharmacies as well as some PCP offices.

How can I prevent getting COVID-19?

• The same way as everyone else: SOCIAL DISTANCING!!!
• The best way to prevent illness is to avoid being exposed to this virus.
• It spreads between people who are in close contact (within about 6 feet) or through respiratory droplets when an infected person coughs or sneezes.
• Stay home!!! If you can work and/or study from home, do so. Don’t leave your house unless you definitely need to (ex: come to your prenatal care visit, go buy groceries, go get medications at the pharmacy, etc.).
• Avoid people who are sick.
• Wash your hands often (with soap and water or alcohol hand sanitizer).
• Try not to touch your face. That way, even if your hands are in contact with the virus, you won’t bring it into your nose or mouth.
• Clean and disinfect high-touch surfaces daily (ex: doorknobs, desks, toilets).

What symptoms should I watch out for? What should I do if I suspect I am sick?

• COVID-19 symptoms: fever more than 38 degrees Celsius (100.4 degree F), or one or more of the following: cough, difficulty breathing, shortness of breath, gastrointestinal symptoms.
• If you suspect that you are sick, please don’t come to our office. We are not able to test for COVID-19 in our office, and also, you will be putting our other pregnant and gyn patients at risk of getting infected.
• If you are sick, call the office and we will direct you to a testing facility or look online for the nearest COVID-19 testing facility.
• If you are experiencing shortness of breath or difficulty breathing, you should go directly to the emergency room.
• Being positive for COVID-19 DOES NOT MEAN YOU WILL BE HOSPITALIZED.
• Once you get tested for COVID-19, unless you have pneumonia or have other medical conditions that put you at risk for complications (ex: asthma, HIV, diabetes, hypertension, chronic lung disease, chronic liver disease, take immunosuppressive medications, chronic kidney disease, elderly, etc.), the next step is to self-isolate at home for at least 15 days so that no one else gets the virus from you.
• If you are stable, you wait for the result at home while self-isolating.

Should I wear a facemask?

• Definitely wear a facemask if you are sick (ex: if you are coughing or sneezing).
• Facemasks may be in short supply and they should be saved for caregivers.
• UPDATED INFORMATION: As of April 3, the CDC says all people, including pregnant women, can wear a cloth face covering when they are in public to prevent the spread of COVID-19. Face coverings are recommended because studies have shown that people can spread the virus before showing any symptoms.
• The cloth face coverings recommended are not surgical masks or N-95 respirators. Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance. (From CDC guidelines.)

Who can be with me during the delivery and postpartum period?

• Due to the COVID-19 pandemic, Baptist Hospital has modified its Labor and Delivery rules and right now, they allow only ONE ADULT to accompany you during your labor, delivery and postpartum period. You will not be able to receive other visits during your stay at the hospital. (Just so you have an idea, the only patients in the hospital that can have ONE companion are pregnant and pediatric patients. All other patients are currently unable to receive visits as part of the effort to stop the COVID-19 spread).

Take care, be safe and stay home!

Sincerely,
Dr. Randy A Fink, MD
Dr. Rafiné Moreno-Jackson, MD
Dr. Lauren Abern, MD
Stephanie Fink, MSN, NP, CNM

References:
ACOG (American College of Obstetricians and Gynecologists) Practice Advisory. Novel Coronavirus Covid-19. March 2020.
SMFM (Society for Maternal Fetal Medicine). Outpatient Assessment and Management of Pregnant Women With Suspected or Confirmed Novel Coronavirus (COVID-19).
CDC. Pregnancy and Breastfeeding.
CDC. Coronavirus 2019.