If you or a loved one are pregnant, you probably have questions about how COVID-19 will affect prenatal care and the delivery experience.
Melissa Terry, MD, an OB/GYN at MU Health Care’s Women’s and Children’s Hospital, has answers to frequently asked questions.
Watch the videos below or read the FAQs.
Delivery and Postpartum
How might the coronavirus affect my pregnancy?
It does not look like women who are infected with coronavirus have a higher rate of miscarriage or stillbirth than the general population. So that's very reassuring. However, we do know that other respiratory viral infections such as influenza have been associated with issues such as low birth weight as well as preterm labor and birth. It’s important to note that having a high fever during early pregnancy in the first trimester can increase the risk of certain birth defects. It is critical that you practice good hand hygiene and social distancing in order to limit your exposure to the virus and your risk for infection.
What is the visitor policy for prenatal appointments and deliveries? Does a doula count as a visitor?
The visitor policy in our outpatient clinics is we are currently allowing one person to accompany our patients for their in-person clinic appointments. Unfortunately, at this time, we are not allowing patients to FaceTime loved ones during an ultrasound. For our inpatient unit, uninfected mothers can have two support people in labor. A doula would be considered one of your two support people.
What is the postpartum visitor policy?
Once a patient delivers and goes to postpartum, there is one visitor allowed 24/7. The postpartum visitor can switch from one day to the next, but only one person per day is allowed. For example, a patient’s husband could be there on Tuesday, her mom could come on Wednesday and her husband could come back on Thursday.
Could I transmit the virus to my baby during pregnancy or delivery?
Data is changing every single day, but there have been no reports of what we call vertical transmission from mom to baby. That means transmission of the infection to the baby while mom is still pregnant. We have not found the virus in amniotic fluid. And so it looks like the baby is probably well protected during pregnancy. We have seen a few case reports out of the United Kingdom and other areas of the world where newborns have tested positive for the coronavirus. We believe that these are infections and transmissions that occurred shortly after delivery, so that makes the conversation about separating moms and babies even more important. We are fortunate at Women’s and Children’s that we have in-house pediatric infectious disease specialists, and we have been working very closely together in recent weeks to prepare for this. We have been learning new information every day, and we will continue to work closely with those pediatric specialists to keep your baby safe.
Will my doctor be available to deliver my baby?
All of our OB providers’ schedules have changed with this crisis. In order to decrease the number of people who are in the hospital, we are keeping a select number of providers in the hospital to deliver babies. One of our OB providers who is on call in the hospital is going to be there for your delivery. So what that means is it’s likely you will not see your primary OB for your delivery, but rest assured, you are in good hands.
I planned for a low-intervention delivery. Is that still an option?
Absolutely. You will still be able to receive low-intervention care. All of our physicians are able to perform unmedicated deliveries, and our labor and delivery nurses are amazing, as well, and they provide exceptional support to our low-intervention patients.
Will I still have access to other services, such as lactation consultants?
We have all services available in the hospital that we had prior to this outbreak. We have lactation consultants, we have anesthesiology, we have social work. With respect to lactation, please remember that our labor and delivery nurses and our postpartum nurses have gone through many hours of training to be able to support lactation and breastfeeding.
After I give birth, will I be able to have immediate skin-to-skin contact and room with my baby?
If you have not tested positive for COVID-19 and are not under investigation, then you will still get to do skin-to-skin and room in with your baby. However, if mom is positive or under investigation, then we will have an in-depth discussion with mom regarding current recommendations. At this time, the Centers for Disease Control and Prevention is recommending that consideration be given to separating mom and baby when the mother is positive for COVID-19. It’s important to realize that information is coming in daily from countries that are currently in the midst of this crisis, so our recommendations are also changing daily.
Has the coronavirus changed your breastfeeding recommendations?
Our breastfeeding recommendations have not changed at all. Based on data from China and from across the globe, the coronavirus has not been isolated in breast milk. So we still want every mom to consider breastfeeding, especially given the immune benefits of breast milk for the baby. Our recommendations have changed a little bit, however, for mothers who are positive for COVID-19. We would recommend that those moms strongly consider pumping for breast milk and then having an uninfected caregiver feed the baby the expressed breast milk rather than actual breastfeeding. If actual breastfeeding must occur in these patients, then mom needs to wear a mask and gloves while breastfeeding. And I also think this is an important time to just remind everyone that we recommend good hand hygiene in all situations, regardless of this virus, when handling babies.
After I have my baby, can I go home earlier than usual to avoid spending extra time in the hospital?
Yes, we absolutely are considering early discharge for many of our patients. The American College of OB GYN has recommended consideration of early discharge, so we are following those guidelines. It is important to remember that we will only consider early discharge if mom and baby are both healthy and in good, stable condition. Safety comes first. We would never put anyone at risk in order to discharge a mom and a baby faster than usual.