As the novel coronavirus COVID-19 continues to spread across the United States, there are numerous concerns about general healthcare during this time. One of the most significant concerns is prenatal and obstetrical care. More specifically, the question has been raised of whether or not coronavirus can be transmitted mother-to-baby before delivery.
New research seems to suggest the answer to this question is “yes.” But what does that mean for expecting mothers? And what about the health of the newborn? How are hospitals handling labor and delivery care during the coronavirus outbreak? These are some of the questions that we at Birth Injury Guide will attempt to answer based on current research and the opinions of experts.
Coronavirus May be Transmitted Between Mother and Infant
New research published in the Journal of the American Medical Association (JAMA) reports that women who have the coronavirus while pregnant can transmit the virus to their infants in the womb. A study of 33 pregnant women in China showed that three of the babies born to mothers with coronavirus also tested positive.
Two of the newborns were term, and one was premature. All three babies recovered without issue. The two full term babies tested negative for the coronavirus six days post-delivery. However, both full term babies had a fever and pneumonia. Infection control measures were implemented immediately, and both infants recovered.
Other research also shows that some infants born to mothers with coronavirus may develop antibodies that do not travel through the placenta. That means that the virus was transmitted in utero. Three babies in the study tested negative and had no symptoms, but they did have IgM antibodies in their blood. These antibodies are immune proteins.
According to researchers, the IgM antibody levels they reported indicate that the infants were exposed while in the womb. Researchers say,
“Although infection at delivery cannot be ruled out, IgM antibodies usually do not appear until three to seven days after infection, and the elevated IgM in the neonate was evident in a blood sample drawn 2 hours after birth.”
Researchers also note that means the infant could have been exposed to the virus for up to 23 days from the time the mother was diagnosed.
Coronavirus, Pregnancy and Delivery – What Women Should Know
The coronavirus pandemic has many expectant parents wondering about how the virus could impact pregnancy, labor and delivery. Doctors around the country report women are asking specific questions about coronavirus and pregnancy. In response, doctors and infectious disease specialists have put together a list of common questions and answers for women, based on evidence-based research. These questions and answers include:
What can I do to prevent getting the coronavirus?
Excellent hygiene and limiting social contact are the best ways of preventing the spread of the coronavirus. Wash your hands frequently, especially after being around others, shopping or handling food. Limit social contact by only going into public when absolutely necessary. If you must go out, wear a face mask and disposable gloves. Stay at least six feet away from others around you. If you are sick, stay home!
Should I cancel my baby shower?
The Centers for Disease Control and Prevention (CDC) recommends limiting gatherings to 10 people or less, and only gather in an environment where people can stay six feet away from each other. Of course, this is not typical baby shower rules, but it is necessary to prevent the spread of the coronavirus. Generally, the CDC recommends limiting social gatherings or rescheduling them.
What should I do if I have a fever and a cough?
If you have a fever and/or cough, call your doctor to discuss your symptoms. Tell him or her if you have traveled to a region hit hard by the coronavirus or have been exposed to someone who has tested positive. The American College of Obstetrician and Gynecologists has guidelines for healthcare providers in how to manage pregnant patients with symptoms of the coronavirus.
If I am pregnant, am I at a greater risk of severe illness if I get the coronavirus?
Currently, researchers do not know exactly how at risk pregnant women are. Doctors do not believe that pregnant women are at a greater risk of developing the coronavirus or a more severe form of the illness. Generally speaking, pregnant women are advised to take any risk of illness seriously. Talk to your healthcare provider about any risks associated with your pregnancy.
Does the coronavirus increase the risk of miscarriage or pregnancy complications?
The CDC is not reporting an increased risk of miscarriage or “fetal malformations” among children born to women who have the coronavirus. Other coronaviruses, such as SARS and MERS, are known to increase the risk of preterm birth and certain complications, but the data to support the risk is very limited.
I’m worried about being exposed to the coronavirus at the doctor’s office. Should I continue to attend my scheduled prenatal appointments?
Prenatal visits are extremely important to your health and that of your baby. Of course, you should not stop communicating with your healthcare team about your pregnancy, and should not simply stop going to your appointments. What you should do is talk to your doctor’s office about the best way to keep up with your care. Many healthcare providers are working remotely via telephone and video chats. There are a lot of things you can do at home to help maintain your care with the support of your healthcare team. Your doctor may recommend that you monitor fetal movement and your blood pressure from home.
Should I be concerned about doctors being available at the hospital when I go into labor?
There is no doubt you have seen reports that doctors are scarce and many are moving to the hardest hit areas to offer support. It is only natural that you are concerned about doctor availability when you go into labor. While many hospitals are utilizing doctors from other areas to help with coronavirus patients, all hospitals must have contingency plans in place. Most hospitals are not reassigning obstetricians from labor and delivery units. These doctors are considered essential to community health. Talk to your healthcare provider about your concerns.
Should I be worried about myself and my newborn being exposed to the coronavirus while in the hospital after delivery?
Many women are concerned about giving birth at hospitals while the coronavirus numbers continue to climb. Hospitals should do everything possible to minimize the number of patients exposed to the coronavirus. Patients who test positive for the coronavirus are kept in isolation from other patients. There are guidelines for hospitals to ensure minimal exposure and spreading. Researchers say that the most important thing is screening and infection control. Researchers told the Los Angeles Times that,
“It is crucial to screen pregnant women and implement strict infection control measures, quarantine of infected mothers, and close monitoring of neonates at risk of COVID-19.”
Can I breastfeed by baby if I test positive for the coronavirus?
Current research does not indicate that the coronavirus can be spread through breast milk. The virus spreads through respiratory droplets – i.e. coughing and sneezing. Proper use of face masks and good hygiene will minimize the risk of transmitting the virus to a breastfeeding newborn. Some researchers recommend using a breast pump to express milk and then feeding the baby through a bottle until the mother is well and there is no risk of transmitting the virus, however. The Royal College of Obstetricians and Gynaecologists recommends women express and allow someone else to feed the baby. Also, they recommend using good hand hygiene and ensuring that breast pump parts are clean.
Find Out More about Coronavirus and Pregnancy
If you want to learn more about coronavirus and pregnancy, there are several resources offering up-to-date information. These include:
- The CDC Pregnancy and Breastfeeding resource
- Harvard Health Publishing’s Coronavirus Resource Center
- The March of Dimes coronavirus resource
One of the best ways to learn more about your individual health and wellness is to work closely with your healthcare provider during the ongoing pandemic.
For information about coronavirus, pregnancy, birth injuries and your legal rights, you can also count on Birth Injury Guide to offer up-to-date information on our website and Facebook page. If you have specific legal questions, you can contact us by calling 1-877-415-6603, or email us via our online form.