The COVID-19 pandemic has upended everyone’s lives in different ways. For women who are expecting a baby, it’s been an especially unsettling few months. Along with the excitement of bringing new life into the world, many are experiencing uncertainty about how the virus could affect their health, their baby’s wellbeing and all the details surrounding labor and delivery.
Maternal-fetal health specialist David Lagrew, M.D., is familiar with these concerns. In his role as executive medical director of the Women’s and Children’s Clinical Institute at Providence Health for Southern California, Dr. Lagrew oversees hundreds of doctors, certified nurse-midwives and others who provide maternity care at 11 hospitals in the region. Here he shares his perspective about pregnancy and childbirth in the time of COVID-19.
What are the most common concerns pregnant women are sharing with Providence providers right now?
The concerns fall into three categories. The first is a general anxiety about being in this unprecedented time in history, an anxiety that is heightened by the experience of being pregnant. I think it’s probably similar to what people went through during World War II — we are in the midst of a protracted global event that dominates the news and our personal lives every single day.
The second area of concern is the disappointment and frustration women feel about how COVID-19 is affecting their personal experience of being pregnant and delivering a baby. Baby showers are on hold, childbirth education classes have moved online and grandparents are attending births digitally. The disappointment can feel overwhelming.
Lastly, women are worried about how COVID-19 may affect their health and their baby’s health. What if they get COVID-19 and transmit the virus to their unborn child? What if one of them contracts COVID-19 at the hospital? Moms often worry about whether their baby will be healthy, and COVID-19 adds a whole new layer of concern.
Hear directly from Dr. Lagrew on maternal safety during COVID-19 in this Facebook Live video.
Does COVID-19 pose special health risks for pregnant women and their babies?
In the early weeks of the pandemic, the data suggested that pregnant women and their babies were not in a high-risk group for COVID-19. Recent evidence continues to support that belief. From everything we can see — and we have a pretty good volume of experience with this now—the risk to mother and baby is low. Worrying about COVID-19 isn’t something that should be keeping pregnant women up at night.
What does prenatal care look like for moms and babies now?
OB/GYNs and certified nurse-midwives have shifted to telehealth for many (although not all) prenatal appointments. That presents challenges because establishing a good relationship may be more difficult when visits are happening on the phone or a video call. At Providence, our providers are learning and refining this skill.
Pregnant women still have some in-person visits, and of course we are still doing lab tests and screenings to keep an eye on concerns such as high blood pressure and gestational diabetes. Some providers are helping patients get set up with at-home monitoring equipment. This might include a blood pressure cuff so that mom can monitor her own blood pressure, or a handheld fetal doppler unit, which allows mom to listen to the baby’s heartbeat.
I suspect that some of these changes will remain in place after the COVID-19 crisis passes. Many women say they love virtual visits because they are convenient and save time. Providers appreciate some things about the shift to telehealth as well. Compared to in-person visits, there are fewer distractions and interruptions. This gives providers more time to talk with patients and answer their questions.
What practices are in place to keep people safe at the hospital?
As we learn more about COVID-19, our hospitals are adjusting their practices to ensure the health and safety of women, their babies, their families and our staff. Here are a few examples of the steps we’re taking.
- Environmental services teams at Providence are cleaning and disinfecting our facilities about three times more often than they did previously.
- Only one support person can be present during labor and delivery, and we recommend that this person remains at the hospital until mom goes home.
- We are shortening the length of time mom and baby stay in the hospital whenever possible, to limit their risk of infection.
- We are testing women for COVID-19 before they come to the hospital to deliver or immediately after they arrive. In the rare situation where mom tests positive, we take a series of precautions to limit the risk of transmission to others.
These changes are important for everyone’s health and safety, but it’s a disappointing situation for families and providers. Nobody wants to turn a beautiful and natural event like childbirth into a sterile experience. We are doing all we can to maintain that personal touch. For instance, our labor and delivery staff are becoming pros with helping families use FaceTime, Skype and Zoom to make sure grandparents and other loved ones can participate in the birth experience safely.
How can women keep their newborns safe and healthy at home?
As much as moms want to introduce their new baby to friends and family members, they also want to protect their baby from this virus. Social distancing and routine home cleaning is the best strategy for limiting the risk of infection. Also, it’s essential for everyone who comes into contact with the baby, including parents and siblings, to wash their hands frequently. If family members exhibit COVID-19 symptoms, we recommend that they isolate themselves from the baby and family as much as possible until they are past the quarantine period.
These are challenging times for everyone. At Providence, we want women and their families to know that our providers are with them every step of the way.
Welcoming a new baby is one of the most precious and incredible experiences life has to offer, and not even COVID-19 can take that away.
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