COVID-19 and pregnancy

COVID-19 is a real threat to anybody, including pregnant women. Pregnant women are at an increased risk for severe illness from COVID-19 and death, compared to non-pregnant people. Additionally, pregnant women with COVID-19 might be at increased risk for other adverse outcomes, such as preterm birth (delivering the baby earlier than 37 weeks).

Jade Elliott spoke with Sean Esplin, MD, Sr. Medical Director, Women’s Health, Intermountain Healthcare, to discuss COVID-19 and how it impacts pregnant women on this episode of the Baby Your Baby Podcast.

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What is the best way to protect yourself and to help reduce the spread of COVID-19?

Expectant mothers should follow CDC guidelines around mask wearing, social gathering and hand hygiene.

1. Limit interactions with people who might have been exposed to or who might be infected with COVID-19, including people within your household, as much as possible.

2. Take steps to prevent getting COVID-19 when you do interact with others.

3. Wear a mask, especially when you cannot keep distance from other people. Avoid others who are not wearing masks or ask others around you to wear a mask.

4. Stay at least 6 feet away from others outside your household.

5. Wash your hands with soap and water for at least 20 seconds. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.

6. Avoid activities where taking these steps might be difficult.

Why can it be difficult for pregnant women to distinguish between COVID-19 symptoms and pregnancy symptoms?

Pregnant women might confuse COVID-19 symptoms with the more traditional symptoms experienced during pregnancy.

People can have COVID-19 and actually be pretty sick and not know it. They can be unaware of how short of breath they actually are, or how low their oxygen levels are. During pregnancy, it’s really important to keep those oxygen levels high because if mom’s oxygen is low, then the baby’s oxygen level is even lower.

What risks are there for pregnant women if they get COVID-19?

Those with coronavirus are at higher risk for blood clots; so too are pregnant women. That’s why medication is now used to prevent blood clots in pregnant women.

Can COVID-19 affect your unborn baby?

Although the virus doesn’t cross the placenta, and get to the baby, it can get to the interface between the placenta and the lining of the uterus, where it can cause some changes in the blood vessels that changes how much oxygen and food and fluid are getting to the baby across the placenta. It can make it so that the placenta doesn’t really work as well in some women. It can age the placenta. Which may mean some pregnant women with COVID-19 may need to deliver their baby early.

What if I’m pregnant and get exposed to someone with COVID-19?

Get tested. Intermountain Healthcare recommends you get tested seven days after exposure. If someone you live with has COVID-19 have them isolate in a certain area of your home and use a separate bathroom if possible. Wear a mask, social distance and practice good hand hygiene and/or wear gloves when caring for them or handling their dishes or laundry. Have the sick person clean the areas they are using if they are well enough to do so.

What if I have COVID-19 when it’s time to deliver my baby?

Prior to giving birth, Intermountain asks that our patients are tested for COVID-19. This can be done a few days before your due date. Or if you go into labor early or need to be induced early, we can do a rapid COVID-19 test when you arrive at the hospital.

Our hospitals and labor and delivery caregivers are prepared to care for you if you are COVID-19 positive and will help inform you about special precautions that are taken about wearing a mask or personal protective equipment.

What if I have COVID-19 and want to nurse my baby?

Current evidence suggests that breast milk is not likely to spread the virus to babies. You and your healthcare provider can help decide whether and how to start or continue breastfeeding. Breast milk provides protection against many illnesses and is the best source of nutrition for most babies.

If you have COVID-19 and choose to breastfeed follow these guidelines:

  • Wash your hands before breastfeeding
  •  Wear a mask while breastfeeding and whenever you are within six feet of your baby.

If you have COVID-19 and choose to express breast milk

  •  Use your own breast pump, if possible.
  • Wear a mask during expression.
  •  Wash your hands with soap and water for at least 20 seconds before touching any pump or bottle parts, and before expressing breast milk.
  •  Follow recommendations for proper pump cleaning after each use. Clean all parts of the pump that come into contact with breast milk.
  •  Consider having a healthy caregiver who does not have COVID-19, is not at increased risk for severe illness from COVID-19, and is living in the same home feed the expressed breast milk to the baby.
  •  Any caregiver feeding the baby should wear a mask when caring for the baby for the entire time you are in isolation and during their own quarantine period after you complete isolation.

How can I keep my newborn baby safe from COVID-19?

  • Limit visitors to see your new baby

Before allowing or inviting visitors into your home or near your baby, consider the risk of COVID-19 to yourself, your baby, people who live with you, and visitors.

  • Bringing people who do not live with you into your home can increase the risk of spreading COVID-19. Some people without symptoms can spread the virus.
  • Limit in-person gatherings and consider other options, like celebrating virtually, for people who want to see your new baby.
  • If you do plan to have in-person visits, ask guests to stay home if they are sick and ask them to stay six feet away from you and your baby, wear a mask, and wash their hands when visiting your home.
  •  Ask your childcare program about the plans they have in place to protect your baby, family, and their staff from COVID-19.

What are the possible signs and symptoms of COVID-19 infection among babies?

Most babies who test positive for COVID-19 have mild or no symptoms. Severe illness in babies has been reported but appears to be rare. Babies with underlying medical conditions and babies born premature (earlier than 37 weeks) might be at higher risk of severe illness from COVID-19.

Reported signs among newborns with COVID-19 include:

  • fever
  • lethargy (being overly tired or inactive)
  • runny nose
  • cough
  • vomiting
  •  diarrhea
  •  poor feeding
  •  increased work of breathing or shallow breathing

If your baby develops symptoms or you think your baby may have been exposed to COVID-19, get in touch with your baby’s healthcare provider within 24 hours and follow steps for caring for children with COVID-19.

If your baby has COVID-19 emergency warning signs (such as trouble breathing), seek emergency care immediately. Call 911.

Where can women go for more information about pregnancy and COVID-19?

CDC coronavirus and pregnancy

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.