Pregnancy and COVID-19: Q&A With Dr. Melissa Wong
Apr 03, 2020 Cedars-Sinai Staff
"We don't recommend changing your birth plan to a home birth or birth center solely for the purpose of lowering the risk of infection by COVID-19."
Is COVID-19 more dangerous for pregnant women than nonpregnant women?
Dr. Melissa Wong: Research on pregnancy and COVID-19 is very limited, and the low rates of testing make it difficult to know how many pregnant women are infected. However, pregnant women do not seem to have had significantly worse outcomes from COVID-19 compared to nonpregnant women.
Like everyone else, it is important to follow behaviors that we know help reduce the risk of infection, such as frequent hand-washing, avoiding people who are sick, avoid touching your face and practicing social distancing.
What should I do if I think I have symptoms of COVID-19?
MW: If you develop symptoms that concern you, we recommend you contact your primary care provider or OB-GYN so they can help you clarify your actual risk.
Most patients who have flu-like symptoms or are concerned they may have COVID-19 can be evaluated at a clinic or an urgent care center. Only go to the emergency room if you have life-threatening symptoms, such as difficulty breathing or chest pain.
Do I need to take special precautions during pregnancy or if we're trying to get pregnant?
MW: There are no precautions that are unique to pregnant women or those trying to get pregnant. We recommend the same precautions being given to the general public, including frequent hand-washing, not touching your face, avoiding unnecessary travel and staying home as much as possible.
If I get COVID-19 while pregnant, can I transmit the virus to my baby during pregnancy?
MW: The virus has not been found in cord blood or amniotic fluid, which we would expect if it had been transmitted while the baby was in the uterus. We also have not seen any evidence of birth defects associated with COVID-19 infection.
That said, specific research is very limited. There have been a few babies who tested positive for the virus soon after they were born, and fortunately all did well in the newborn period.
Can I transmit the virus to my baby during breastfeeding?
MW: Current research suggests that the virus does not pass through breastmilk. However, since direct breastfeeding does involve close personal contact, I recommend taking precautions such as washing hands thoroughly prior to each feed and wearing a facemask during feeding.
In addition, Cedars-Sinai agrees with the Centers for Disease Control and Prevention (CDC) recommendation of temporary separation of the newborn immediately after birth for all mothers who test positive or are likely to have COVID-19.
This practice is intended to reduce the risk of transmission of the virus to the baby. We will assess the status of both the mother and the child to determine how quickly they can be reunited.
Should I have a home birth or deliver in a birth center to avoid infection in the hospital?
MW: We don't recommend changing your birth plan to a home birth or birth center solely for the purpose of lowering the risk of infection by COVID-19. There is no data to support the belief that giving birth outside of a hospital lowers the risk of getting COVID-19.
Hospitals are required to adhere to strict disinfection guidelines, and healthcare workers must be screened for contagious disease before working with patients. Also, labor and delivery staff are trained well for emergencies that can occur during childbirth.
Will I be tested for COVID-19 when I come to the hospital for my delivery?
MW: We only test Labor and Delivery patients for COVID-19 if they have symptoms of the virus. If a patient tests positive, the mother makes the decision on how to proceed, with guidance from medical staff. The American Academy of Pediatrics currently recommends considering temporary separation from newborns to minimize risk of infection.
What other steps is Cedars-Sinai taking to care for pregnant women in labor and delivery during the coronavirus outbreak?
MW: Cedars-Sinai follows the national CDC, American College of Obstetricians and Gynecologists, and Society for Maternal-Fetal Medicine recommendations for the highest possible safety and patient care. Additional precautions include:
- Limiting visitors to one person for each pregnant patient during labor and delivery, as well as postpartum. (Subject to change. Please see current visitor policy for updates.)
- Prohibiting visitors for patients who have been diagnosed with COVID-19 or are under investigation for infection
- Eliminating all elective surgeries and procedures throughout the hospital
- Healthcare worker health screenings
- Designated COVID-19 patient care teams and triage and labor rooms
- Pediatric protocols for babies born to suspected COVID-19 mothers
We understand that these changes will impact the birth experience, but we are committed to doing everything we can to protect your health and ensure your safety and the health of your baby. These are unprecedented times for our nation's health and wellbeing, and we hope you will partner with us to provide you and your family the best possible care.