Expecting a child during a once-in-a-generation crisis can take a pregnant woman's stress to another level.
So the Daily Herald asked Dr. Melissa Simon, an ob-gyn at Northwestern Medicine Prentice Women's Hospital, about what soon-to-be moms need to know about the coronavirus.
Q: Northwestern Medicine is allowing only one adult visitor during labor and delivery. All patients and visitors will be asked if they have symptoms of COVID-19 or flu. What are other ways your hospital is trying to limit exposure?
A: We have two separate units. We have a unit that is specific to any mom who has flu-like symptoms, including COVID. So there's a separate floor, separate space, separate health care team that does not go back and forth between the regular labor and delivery unit and postpartum and antepartum floors as well.
Q: At some hospitals in New York, women are giving birth without their partners present. Could those restrictions happen in Illinois?
A: We are really building this plane while we're flying it, and we don't know. It could, and we need to be ready for that. I know giving birth to your child is one of the most wonderful things and privileges in life, but at this moment in time we have to protect everybody, including the mom or baby.
Please bring your cellphone and a charger and do FaceTime and take pictures and capture the moment the best you can. But this is about optimizing safety for everyone.
Q: What are some coping mechanisms to deal with stress?
A: I want to make sure new moms or pregnant moms reach out if they're having any symptoms of distress or anxiety or nervousness or depression. There are many things you can do around mindfulness and mediation and yoga or just deep breathing.
But please know that you're not alone. You can reach out to your health care provider. We can put you in touch with counselors. There's video counseling that's happening through our telemedicine, telehealth services. There are hotlines. There's all kind of resources to try to surround you with or help you through this time.
Q: How are you reassuring expectant moms worried about giving birth in the hospital?
A: I want to emphasize it's still safer to give birth in the hospital than it is at home because right now, our ambulances and other health care team workers are stretched so thin that if something were to go wrong at home, trying to get to the hospital is even more challenging than in normal times.
Q: An infant is among the newly diagnosed cases in Illinois. Some studies have found no evidence that a pregnant woman with COVID-19 can pass the virus to the fetus. But is there a consensus yet?
A: We can't say either way at the moment. What we can say is from a couple, very small studies there was no coronavirus in either the amniotic fluid (or) the breast milk. So that's all we have right now.
Scientists across the country and in other countries are trying to gather information on pregnant women during COVID and really trying to get a better understanding of its impact on the fetus and if there's any impact on transmission and breast milk or amniotic fluid.
Q: What precautions should new moms take?
A: Wash your hands. Good old-fashioned soap, 20 seconds at least, all surfaces, including thumbs, and sing happy birthday twice or the ABCs twice, or whatever. Make sure you don't touch your face. Clean all surfaces.
Q: What about breast-feeding?
A: If you have any flu-like symptoms and you are breast-feeding, call your health care provider. It depends on what the provider says, but in general, if you have flu-like symptoms, you could pump instead of breast-feeding and you just have to wash the pump components or parts very well just as you would any other time.
You may have to wear a mask if you're breast-feeding and your health care provider suggests that you may have to cover your mouth because of the droplet transmission concern, but again that's on a case-by-case basis.
In general, if a woman who is giving birth tests positive for COVID-19, when the baby is born, some hospitals are restricting the baby from being in contact with the mom until she recovers, but again, that's on a hospital-by-hospital basis.
The mom could pump if she so chooses, and that's totally safe at the moment because we don't have data that show that COVID-19 is expressed in breast milk at this moment.
Q: Are pregnant women more at risk of infection?
A: To our understanding, pregnant women are not at increased risk per se. It is harder to manage, though, just like influenza, because your lung capacity is decreased due to the space the baby takes up in your belly.
Q: What can women expect during labor?
A: During labor, whether you have flu-like symptoms or COVID-19 or you're totally asymptomatic, we are not allowing any moms to use nitrous oxide, which is an inhaled gas to reduce labor pain. Instead, we are keeping the option of epidurals and spinals and IV and intramuscular pain medications. Inhaled things are not being used for pain control because of the possible COVID transmission.
The other important point is things are changing minute to minute, so it's really important that we are using the science and the data that we're learning to inform our clinical care in real time.