What Pregnant Women Need to Know

Being pregnant can be a daily lesson in trying not to be a hypochondriac, but it’s hard when the news is currently flooded with reports about the coronavirus, also known as COVID-19 or the novel coronavirus. The virus, which originated in Wuhan, China in January, has caused more than 185,000 cases worldwide and more than 7,000 deaths, according to data from the World Health Organization (WHO). The virus has since spread to at least 140 countries and territories.

On January 30, the U.S. reported its first case of human-to-human transmission, when an infected patient was diagnosed with COVID-19 from his wife who returned from Wuhan. Since then, the coronavirus has passed between people through community spread, meaning those who have contracted the virus while going about their daily lives and aren’t clear on how, exactly, they got the illness. In the U.S., there are now nearly 5,000 confirmed cases and, to date, 93 Americans have died of the virus.

It’s only natural to have questions about the coronavirus and what it means for your pregnancy. Here’s what you need to know.

What is coronavirus?

There are actually seven different types of coronavirus known to infect humans, according to the Centers for Disease Control and Prevention (CDC). Many are mild and cause colds, but some forms of the virus, specifically MERS-CoV and SARS-CoV, can cause severe illness.

The form of coronavirus that’s capturing headlines is 2019-nCoV. On January 30, the World Health Organization (WHO) declared the coronavirus a global health emergency. Officially known as a “Public Health Emergency of International Concern,” this term is used to describe “an extraordinary event” that constitutes a public health risk to multiple countries, potentially requiring a coordinated international response, according to WHO. On March 11, WHO said COVID-19 is officially a global pandemic.

The coronavirus was only recently found to infect humans, according to infectious disease expert Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security. There’s a lot scientists are still trying to learn about it.

How is the coronavirus spread, and what are the symptoms?

Coronaviruses typically spread from an infected person to other people via respiratory drops that get into the air by coughing or sneezing, the CDC says. Close contact with an infected person, like touching or shaking hands, or touching a surface that has been contaminated with the virus and then touching your mouth, nose or eyes before you wash your hands can also spread the virus, the CDC says.

People who have had confirmed cases of novel coronavirus have experienced the following symptoms, per the CDC:

  • Fever
  • Cough
  • Shortness of breath

Symptoms can appear anywhere from two to 14 days after a person has been exposed, and they’ve ranged from causing mild illness to severe cases.

What does the coronavirus mean for your pregnancy?

Scientists are still trying to learn more about how this virus impacts people. However, the latest data suggests that while pregnant women do have altered immune systems (which can increase their risk of developing complications from respiratory viruses like the flu), they don’t seem to have increased risk of developing severe COVID-19 symptoms.

In the U.K., the country’s Royal College of Obstetricians and Gynaecologists, Royal College of Midwives and Royal College of Paediatrics and Child Health issued new guidance last week based off of clinical observations and a report from the WHO. The report analyzed data from 147 pregnant women and concluded that moms-to-be do not seem to have a greater risk of complications than the general public.

small study of pregnant women in Wuhan, China, with confirmed COVID-19 found no evidence of the virus in their breast milk, cord blood or amniotic fluid.

Ultimately, “it’s early days,”says Rajeev Fernando, M.D., an infectious disease expert in Southampton, New York and member of the What to Expect Medical Review Board. Pregnant women are immunocompromised and are more susceptible to complications of respiratory infections like the coronavirus, so he recommends doing your best to follow certain precautions, like practicing good hand hygiene — an important step at any time.

It’s really best to stay home as much as possible right now, Dr. Fernando says. “Things are going to get a lot worse before they get better and I’m an advocate for aggressive social distancing,” he says.

What impact could the coronavirus have on a newborn?

More information is still needed about what effect, if any, the coronavirus could have on your unborn baby or newborn.

The CDC says there have been a few case reports of preterm birth among babies whose mothers were confirmed to have COVID-19 — however, it’s unclear whether the coronavirus was to blame. In general, developing a high fever early in pregnancy could increase the risk of certain birth defects.

A small study published in Frontiers in Pediatrics this week also suggested that moms-to-be may not pass the virus to their unbown babies. In the study, four pregnant women in Wuhan who had tested positive for COVID-19 were followed, and three gave consent for their babies to be tested for the virus (of the three, none tested positive). All four infants were well when they left the hospital and did not have fever, cough or diarrhea.

In mid-March news broke that a newborn born to a mother with COVID-19 also tested positive. The baby was tested for COVID-19 just minutes after being born. However, it’s unknown if the baby was born with the virus or contracted it shortly after birth. “Anyone can get COVID-19,” says Richard Watkins, M.D., an infectious disease physician in Akron, Ohio, and an associate professor of internal medicine at Northeast Ohio Medical University, adding that he “wasn’t surprised” about the news.

It’s not known whether newborns could have greater risk of complications from COVID-19. However, the CDC notes that reports from China indicate the number of children with confirmed or suspected COVID-19 is low compared to the general population. In China, nine infants were hospitalized with the virus, and no deaths have been reported in persons under 10 years of age.

The role children play in the virus’s spread remains unclear, too. It’s possible that children are able to shed the virus for longer than adults, meaning they would be contagious for longer. But again, more information is needed.

What do you need to know if you’re planning on breastfeeding?

Although small studies have not identified any evidence of COVID-19 in breast milk, it’s still not entirely clear whether breastfeeding mothers can transmit the virus to their babies.

The CDC notes that breast milk can help protect babies against many illnesses. They recommend that mothers who test positive for COVID-19 take steps to protect their infant from the virus, such as washing their hands before feeding or caring for baby and wearing a face mask while breastfeeding. If expressing breast milk, mothers should make sure to clean their breast pumps properly each time and consider letting another caregiver bottle-feed the expressed milk to the baby. 

How can pregnant women prepare for the coronavirus?

If you’re pregnant, you may be wondering if there’s anything you can do to prepare for a possible outbreak in your area.

Again, Dr. Fernando recommends that you do your best to stay home as much as possible and limit your interactions with others outside of immediate family. It doesn’t hurt to stock up on a few essential items to keep in your house in case of quarantine, such as medications, canned goods and frozen foods.

Is it still safe for pregnant women to travel?

Right now, there are no specific travel recommendations from the CDC for pregnant women, although some experts recommend that pregnant women travel with caution in general due to risk of quarantine.

The CDC is requesting that all Americans avoid non-essential travel to some parts of China, EuropeItalyIran and South Korea. Regardless of whether or not you’re pregnant, it’s smart to cancel any planned trips to one of those places. The CDC also advises against cruise ship travel.

If you’re pregnant and do have to travel, experts recommend washing your hands regularly, using hand sanitizer and avoiding “high touch” surfaces.

Should pregnant women be concerned about germs at the hospital?

Some pregnant women may worry about being exposed to the coronavirus at the hospital or doctor’s appointments.

Experts stress that it’s still very important that patients receive prenatal care during this time. William Schaffner, M.D., an infectious disease specialist and professor at Vanderbilt University School of Medicine, says moms-to-be should practice good hand hygiene and try to avoid people who appear to be ill when at doctor’s appointments or at the hospital.

“The surfaces in hospitals and many doctor’s offices are disinfected on a regular basis,” he points out.

Talk to your doctor or midwife about any concerns you have about your labor and delivery, as well as a backup plan in case one of your caregivers should become sick.

Visit whattoexpect.com/news for the latest updates on COVID-19 as it relates to pregnancy and babies

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