Covid-19 Updates for Expecting Parents

As we continue to learn more about Coronavirus each day, we’ll keep our community of expecting parents updated with the latest pregnancy and delivery related news.Check back here regularly to discover up-to-date answers to your most pressing questions.

Updates and news provided by Centers for Disease Control and Prevention, World Health Organization and NYC-based Dr. Jaqueline Worth, OBGYN and co-author of The New Rules of Pregnancy.Plus, Dr. Worth is on hand to answer your questions LIVE. Click here to register for our next Zoom Class with Dr. Worth. *April 30, 2020 Update: New York Governor Andrew Cuomo accepts full list of recommendations from COVID-19 Maternity Task Force.

Read on below for an overview and find the full report here. 

What is the current risk to pregnant women getting COVID-19?

Based on what we know about COVID-19, we believe pregnant people appear to have the same risk of COVID-19 as adults who are not pregnant. However, much remains unknown. We do know that pregnant people have had a higher risk of severe illness when infected with viruses that are similar to COVID-19, as well as other viral respiratory infections, such as influenza.

We also know that pregnant people have changes in their bodies that may increase their risk of some infections. Therefore, if you are pregnant, it is always important for you to try to protect yourself from illnesses whenever possible. (CDC). 

Update: A new study published May 22 out of Northwestern University found that placentas from 16 women who tested positive for Covid-19 while pregnant showed evidence of injury to the placentas. The studies showed abnormal blood flow between the mothers and their babies in utero thus indicating a new complication of Covid-19. All of the full-term babies in the study did test negative for coronavirus  (American Journal of Clinical Pathology). 

Risks to the Pregnancy and to the baby?

Much is still unknown about the risks of COVID-19 to the pregnancy and to the baby.

• Mother-to-child transmission of COVID-19 during pregnancy is unlikely. However, after birth, a newborn can be infected after being in close contact with an infected person, including the baby’s mother or other caregivers.
• A small number of babies have tested positive for the virus shortly after birth, according to limited published reports. However, it is unknown if these babies got the virus before, during, or after birth.
• A small number of other problems, such as preterm birth, have been reported in babies born to mothers who tested positive for COVID-19 late in their pregnancy. However, we do not know if these problems were related to the virus.

Prenatal and Postnatal Care during the COVID-19 Pandemic

It is important to take care of yourself and your baby during pregnancy and after delivery.

• Do not skip your prenatal care appointments or postpartum appointments. If you are concerned about attending your appointment due to COVID-19, talk to your healthcare provider.
• Ask your healthcare provider how they are taking steps to separate healthy patients from those who may be sick.
• Some healthcare providers might choose to cancel or postpone some visits. Others may switch certain appointments to telemedicine visits, which are appointments over the phone or video. These decisions will be based on the circumstances in your community as well as your individual care plan.
• Call your healthcare provider if you have an urgent medical question.
• In case of emergency, call 911 or go to your local emergency department. If you are not driving, call the emergency department on the way to explain that you are pregnant and have an emergency. They should have an infection prevention plan to protect you from getting COVID-19 if you need emergency care. Do not delay getting emergency care because of COVID-19. (CDC). 

Vaccines during pregnancy and the COVID-19 Pandemic

Although there is no vaccine available to protect against the virus that causes COVID-19, routine vaccines are an important part of protecting your health. Receiving some vaccines during pregnancy, such as the influenza (flu) and Tdap vaccines, can help protect you and your baby. If you are pregnant, you should continue to receive your recommended vaccines. Talk with your healthcare provider about visits for vaccines during pregnancy. (CDC)

Delivery locations during the COVID-19 Pandemic

Delivering your baby is always safest under the supervision of trained healthcare professionals. If you have questions about the best place to deliver your baby, discuss them with your healthcare provider.

Breastfeeding if you have COVID-19

• Breast milk provides protection against many illnesses and is the best source of nutrition for most infants. Learn more about breastfeeding.

• You, along with your family and healthcare providers, should decide whether and how to start or continue breastfeeding.

• We do not know for sure if mothers with COVID-19 can spread the virus to babies in their breast milk, but the limited data available suggest this is not likely.

• If you have COVID-19 and choose to breastfeed:
  • Wear a cloth face covering while breastfeeding and wash your hands before each feeding.

• If you have COVID-19 and choose to express breast milk:
  • Use a dedicated breast pump.
  • Wear a cloth face covering during expression and wash your hands before touching any pump or bottle parts and before expressing breast milk.
  • Follow recommendations for proper pump cleaning [Español] after each use, cleaning all parts that come into contact with breast milk.
  • If possible, expressed breast milk should be fed to the infant by a healthy caregiver who does not have COVID-19, is not at high-risk for severe illness from COVID-19, and is living in the same home.

Face shields for newborns and infants

Plastic face shields for newborns and infants are NOT recommended. There are no data supporting the use of infant face shields for protection against COVID-19 or other respiratory illnesses. An infant face shield could increase the risk of sudden infant death syndrome (SIDS) or accidental suffocation and strangulation. Infants, including newborns, move frequently, which could increase the possibility of their nose and mouth becoming blocked by the plastic face shield or foam components. The baby’s movement could also cause the face shield to become displaced, resulting in strangulation from the strap.

Information for how to protect newborns from becoming sick with COVID-19 while in the hospital can be found in CDC’s Considerations for Inpatient Obstetrics Healthcare Settings. Additional information on how to protect yourself and others, including newborns and infants, from COVID-19 illness is also available. (CDC)

At what age should I give my child a face mask?

CDC recommends that everyone 2 years and older wear a cloth face covering that covers their nose and mouth when they are out in the community. Because of the danger of suffocation, do NOT put cloth face coverings on babies or children younger than 2 years. Cloth face coverings should also not be worn by anyone who has trouble breathing, is unconscious, can’t move, or is otherwise unable to remove the face covering without assistance.

Parents and other caregivers should keep in mind that wearing a cloth face covering is not a substitute for social distancing, frequent hand washing, or other everyday preventive actions – please wear your cloth face covering in addition to practicing other prevention steps. A cloth face covering is not intended to protect you, the wearer, but it may prevent you from spreading the virus to others. This would be especially important if you are infected but do not have symptoms of COVID-19. Please remember that medical face masks and N95 respirators are reserved for healthcare personnel and other first responders. (CDC)

Can I have visitors after the baby is born?

Right now, if I were having a baby this week, I wouldn't have anybody over for a couple of weeks until I knew that everybody was healthy, my baby was safe and I was safe. (Dr. Jaqueline Worth on 4/5)

What are the precautions to take during a C-section in the time of coronavirus?

It’s very clear in the data so far that PPE is very protective. It protects the doctors, nurses and midwives from catching COVID-19 and it also protects the patients from catching anything from anyone who is there and that’s why everyone is wearing a mask. The doctors, nurses and staff are going to wear the N-95 mask, covered by another mask and a hat for the whole time they’re in the labor unit. That protects everyone from spreading any virus and the good news is that it’s working.  (Dr. Jaqueline Worth on 4/5)

Overall, what should parents expect when heading to the hospital to give birth?

Don't get too caught up in the details because they’re rapidly changing. This week in New York City at Mount Sinai Hospital, there is a four hour test available which is fortunate as some hospitals are offering a 24 hour test. Patients are either tested on admission in labor and their partners are also screened and tested. If a partner is found to be unhealthy on admission, then that partner would not be allowed up and the patient would be asked to find a healthy alternate partner. I’m suggesting to my patients that they have their partner and a back-up partner just in case on admission their partner isn’t well. Currently, if someone is having a C-section or the labor is being induced then the patient and the partner are being tested the day prior, in that case you would know before you come in. 

Well visits and routine visits for children during the COVID-19 Pandemic

Routine well child visits and vaccine visits are still important during the COVID-19 pandemic.

Newborn visits. Ideally, newborn visits should be done in person so that your pediatric healthcare provider can check your baby’s growth and feeding, check your baby for jaundice, make sure your baby’s newborn screening tests were done, and get any repeat or follow-up testing, if necessary. At the newborn visit, your pediatric healthcare provider will also check how you and your baby are doing overall. Newborn screening tests include a bloodspot, hearing test, and test for critical congenital heart defects. Learn more about newborn screening tests.

Well child visits. Your pediatric healthcare provider will check your child’s development at well child visits. You can track your child’s developmental milestones with CDC’s free Milestone Tracker app.

Vaccine visits. Vaccines are an important part of keeping your child healthy, especially if your child is under 2 years old. Vaccines help provide immunity before being exposed to potentially life-threatening diseases. Although there is not yet a vaccine to help protect against COVID-19, vaccines for illnesses such as measles, influenza (flu), whooping cough (pertussis), and other infectious diseases are important for your child’s health. This will help to prevent outbreaks of vaccine-preventable diseases among young children during the COVID-19 pandemic.

Ask your healthcare provider how they are taking steps to separate healthy patients from those who may be sick. Some health care providers may choose to delay visits like well child checks and routine vaccine visits. These decisions will be based on circumstances in your community and your child’s individual care plan. Call your provider’s office to ask about any upcoming appointments or about when your child’s vaccinations are due.

COVID-19 and Children

There is much more to be learned about how this disease affects children. While some children and infants have been sick with COVID-19, most illnesses have been among adults. Some reports suggest that infants under 1 year old and those with underlying medical conditions might be at higher risk of serious illness from COVID-19 than other children.

• Children with COVID-19 generally have mild, cold-like symptoms, such as fever, runny nose, and cough. Vomiting and diarrhea have also been reported in some children.
• Children with certain underlying medical conditions, such as chronic lung disease or moderate to severe asthma, serious heart conditions, or weak immune systems, might be at higher risk for severe illness from COVID-19. Call your child’s healthcare provider if you are worried about your child’s health or if your child has symptoms of COVID-19.
• In case of emergency, call 911 or go to your local emergency department. Emergency departments have infection prevention plans to protect you and your child from getting COVID-19 if your child needs emergency care. Do not delay getting emergency care for your child because of COVID-19. (CDC)

State Hospital Protocol:

*We will continue to update the below as we learn more. Please note individual hospital policies can be updated frequently throughout the day, so please make sure to review your personal hospital’s website or call their hotline.

• Los Angeles: At Cedar Sinai, a companion is allowed during labor and delivery (after delivery, companions are subject to all restrictions). Any visitors who are allowed must pass a health screening, including a temperature check. Visitors with a fever of 100 degrees and higher will not be allowed to enter. Visitors are required to wear masks at all times when on the premises.

• New York City: On April 30, 2020, Governor Cuomo accepted COVID-19 Maternity Task Force's recommendations in full and signed an executive order which (the full report can be found here): 

• Clarifies doulas as an essential support person for labor and delivery

• Extends the period of time a healthy support person can accompany a mother post delivery

• Considers expecting women priority population for testing

• Taking measures to diversity birthing site options and support patient choice

• Supports efforts to review the impact of COVID-19 on pregnancy and newborns.

• Chicago: Laboring and post-delivery mothers at Northwestern Memorial Prentice Hospital are limited to one visitor 18+ or older. All patients and visitors will be asked if they have symptoms of COVID-19 or flu. Visitors showing signs of illness during the screening process will not be allowed to visit or accompany the patient. Patients and visitors without a badge will be asked to return to the screening location to complete their screening. Northwestern Medicine will temporarily no longer allow service animals in inpatient areas.