Your questions answered
Welcoming Twins During COVID-19
In December 2019, Molly Hurley and her husband, Ryan, found out they were expecting twin boys. As first-time parents, they looked forward to baby showers, attending Missouri Baptist Medical Center's classes on childbirth and preparing for multiples, and celebrating their new arrivals with family and friends.
However, in March 2020, when Missouri started shutting down to reduce the spread of COVID-19, Molly experienced ups and downs. "Part of pregnancy is preparation, and with the changing restrictions, I was worried about our health and safety and what would happen when it came time to deliver."
Follow their journey
For most expectant parents and their families, pregnancy is a time of hopes and dreams. However, as the COVID-19 pandemic continues to impact daily life, there are many concerns about how the outbreak affects pregnancy and delivery. BJC Medical Group obstetrician and Missouri Baptist Medical Center director of maternal-fetal medicine program development Dr. Amanda Trudell answers some of the most asked questions.
Q. Am I at a higher risk of catching COVID-19 when I'm pregnant?
A. Currently, there is limited data about whether pregnant women are more susceptible to COVID-19 than non-pregnant women. We do know, however, pregnant women experience changes in their bodies that may make them more vulnerable to infections and potentially reduce the body's ability to respond. Because there is a small subset of the pregnant population that does become very ill from COVID-19 and requires hospitalization, we recommend taking precautions to avoid exposure to the virus.
Q. Should I continue my prenatal visits? I'm worried about being exposed to COVID-19.
A. Prenatal care is essential for maternal and fetal health. Because all pregnant women are at risk for complications, you should continue your prenatal visits. If you have concerns about being exposed to COVID-19, check with your obstetrician to find out if telemedicine appointments are an option or if your doctor must see you in the office. They will also be able to explain the safety measures they have in place to protect patients and staff from the virus.
What steps can I take to protect myself from the virus while I'm pregnant?
To reduce the risk of contracting the virus, we recommend following the same safety precautions and procedures recommended to the public. Social distancing and limiting the time you're around others, wearing masks in public, frequent handwashing for 20 seconds or using hand sanitizer and avoiding large groups are all important steps you can take to protect yourself.
My friends and family want to throw me a baby shower. Is that okay?
Baby showers are joyous events that everyone anticipates. However, because baby showers often involve large groups of people, we recommend canceling the traditional party. But that doesn't mean you can't celebrate. I have spoken to many patients who held drive-by baby showers, while others celebrated with a tiny group and invited others to participate on a virtual call.
What happens if I test positive or COVID-19?
If you become ill at any time during your pregnancy, keep in close contact with your obstetrician and follow their instructions. Most women with COVID-19 recover and will go on to have a normal pregnancy. If you test positive when you are ready to deliver, the MoBap health care team is here to support you with an individualized care plan and special precautions if you choose to have your newborn stay in your room. There are also special negative pressure delivery and postpartum rooms to help control virus spread.
If I contract COVID-19, what is the risk of passing the virus to my fetus or newborn?
Currently, there is limited evidence to indicate that the virus passes from mother to baby before birth (also called vertical transmission), and there is no current evidence of fetal abnormalities due to maternal infection with COVID-19. Evidence suggests that when newborns test positive for COVID-19, it is because of exposure received during the immediate postpartum period.
Is there a risk of preterm birth with COVID-19?
Given that this is a new virus, little is known about its impact on pregnant women. According to the Centers for Disease Control and Prevention (CDC), an increased risk of miscarriage has not been documented in pregnant women infected with COVID-19. There are a fraction of women who can become very sick with COVID-19 and require care in the intensive care unit (ICU) and need early delivery. However, the data on the connection between the virus and preterm birth is limited, and the infection may not be the direct cause of the preterm birth.
PREPARING FOR DELIVERY
How do I prepare for my labor and delivery with the COVID-19 restrictions?
Talk to your obstetrician about their recommendations for books and online resources like MoBap's interactive childbirth class. Also, if you have a birth plan, discuss your wishes with your doctor and talk to your obstetrician about what to do if you need to seek emergency care.
Should I self-quarantine before delivery?
We know that not everyone can stay home and shelter in place, but we recommend self-quarantining as much as possible two weeks before your due date. By doing so, you help avoid exposure in the time around your delivery.
Can I have my partner with me when I come to deliver?
Yes, your support person can be present with you for your labor, delivery and postpartum stay. While MoBap has restricted the number of visitors to one or two people to protect patients, families and staff, we encourage you to invite other family members and friends to meet your newborn through virtual visits. For more information on BJC’s visitor policy, visit BJC.org/KeepingYouSafe.
What is MoBap doing to keep patients, families and staff safe?
To help minimize the risk of virus exposure and spread, MoBap is taking many important precautions: Screening all staff and patients, thoroughly disinfecting common areas, exam rooms, and patient rooms, limiting visitors, and requiring face masks while in the building. We’ve also disabled touch screens to reduce the risk of surface contamination and practice social distancing by keeping 6 feet apart whenever possible. For more information on BJC’s visitor policy, visit the BJC.org/KeepingYouSafe.
Will I be able to breastfeed if I test positive for COVID-19?
Breastfeeding has several benefits, one of which is helping to develop your newborn's immunity. While we do not know for sure if mothers with COVID-19 can spread the virus to babies through their breast milk, the limited data available suggest this is not likely. Even if you have symptoms or test positive for COVID-19, your obstetrician can help you decide about starting or continuing breastfeeding.
Generally, if you choose to breastfeed, we recommend wearing a mask while breastfeeding and washing your hands with soap and water for at least 20 seconds before each feeding. If you choose to express breast milk for bottle feeding, use a dedicated pump and wash your hands with soap and water for at least 20 seconds before touching the pump, bottle, and expressing milk. Wear a mask when feeding your infant, or you can have a healthy family member feed the baby to minimize risks further.
Is my family at a higher risk of getting COVID-19 by staying at the hospital?
To protect parents and newborns, MoBap has safety precautions in place like mask wearing, screening all staff and patients, social distancing, and thorough disinfecting and cleaning protocols. Also, your obstetrician will discharge you as soon as possible so that you can continue your postpartum recovery in the comfort of your home.
Is my baby at risk of getting COVID-19?
Newborns have immature immune systems and are vulnerable to infections. The CDC states that newborns can be infected with the virus that causes COVID-19 after being in close contact with an infected person. Even though most newborns who have tested positive for COVID-19 had mild or no symptoms and recovered fully, there are a few reports of newborns with severe illness. Therefore, we encourage parents to limit their newborn's exposure to visitors and people outside your home to minimize the risk of exposure.
How can I protect my baby if I or anyone in the household start having COVID-19 symptoms?
COVID-19 spreads through respiratory droplets. Therefore, if you, or anyone in your household, develops symptoms or becomes COVID-19 positive, always wear a mask around your newborn to reduce exposure risk. Also, perform frequent handwashing for at least 20 seconds with soap and water.
It’s vital to note that you should never put a mask on your newborn, or any child under the age of two, because it poses a suffocation risk. An infant in a baby carrier may benefit from having a lightweight cloth or blanket draped over the carrier. An infant should always be monitored, and care taken to ensure the infant can breathe comfortably.