Spectrum Health will soon roll out virtual visits for prenatal care, reducing the need for in-person appointments.
Pregnant women should take extra care to reduce their exposure to COVID-19. (For Spectrum Health Beat)

No mom-to-be expects to add details about a global pandemic to her baby book.

But expectant moms and dads everywhere find themselves with a new what-if for their list: COVID-19.

What risks do they and their baby face?

How can they protect their child and ensure a safe delivery?

To help pregnant women as they prepare to welcome a new life into the world, we sought guidance from Spectrum Health pregnancy and childbirth experts.

Q: Do pregnant women and their unborn children face additional risks from the coronavirus that causes COVID-19?

Based on what is known at this time, pregnant women have a greater risk for severe illness with COVID-19 once it is acquired, according to the Centers for Disease Control and Prevention.

And having COVID-19 might increase the risk of adverse outcomes, such as preterm birth. Premature birth statistics are not consistent with all studies, however, and it is unknown whether this is related to the virus.

Because women experience changes in their immune system during pregnancy, it’s always important for pregnant women to protect themselves from illness, said nurse midwife Courtney Hilbert, CNM.

Q: How can I protect myself and my baby?

“Stay home and practice social distancing as much as possible. Wash hands frequently, cover coughs with your elbow, and avoid people who are sick,” Hilbert said.

Avoid events and activities where it could be difficult to take protective measures or maintain social distancing.

Michael Tsimis, MD, a Spectrum Health maternal fetal medicine specialist, adds these recommendations:

  • If it is feasible, avoid unnecessary interactions with others who are either confirmed or exposed to COVID-19.
  • When going out or interacting with others, pregnant women should wear a mask, social distance, avoid others who are not wearing a mask, and frequently wash their hands.
  • Stay up to date with the annual flu vaccine and regular follow-up prenatal appointments.
  • Every attempt should be made to avoid unnecessary travel when possible. If travel is necessary, maintain safe social distancing and other precautions.

Q: Can I still deliver my baby at the hospital?

“We continue to provide the high-quality care we are known for to those women presenting to our hospitals to give birth,” Hilbert said.

That is true even if a woman is severely ill with COVID-19.

Spectrum Health screens pregnant women for symptoms of the disease. It has plans in place to treat those who have COVID-19—while isolating them from other patients, Dr. Tsimis said.

The maternal fetal medicine team continues to update its policies, following guidelines from the American College of Obstetricians and Gynecologists, as well as the CDC.

Hilbert encouraged parents to turn to those trusted sources for information.

“Hospitals are still the safest place to have your baby,” added Suzanne West, MD, an obstetrician and division chief for women’s health at Spectrum Health. “Research from the American Journal of Obstetrics and Gynecology shows that the overall risk of neonatal death was significantly higher in planned home births compared with hospital births by certified nurse midwives or physicians.”

Q: Can a pregnant woman pass COVID-19 onto an unborn child?

COVID-19 infections in babies born to mothers with the virus are uncommon, according to the CDC. However, much is still unknown about the risks involved.

A small number of newborns have tested positive for the virus, but it is unknown if they became infected before, during or after birth from close contact with an infected person.

Most newborns with COVID-19 have had mild or no symptoms and have recovered. However, the CDC says there are a few reports of newborns with severe illness.

Q: If you are in isolation with COVID-19, how can you minimize the risk of transmitting it to your newborn?

The CDC recommends discussing with your provider the risks and benefits of having your newborn stay in your hospital room with you. If you do share a room with your newborn, take these precautions to reduce the risk of transmitting the virus to your baby:

Wash hands with soap and water for at least 20 seconds, or use hand sanitizer, before caring for your baby.

Wear a mask when you are within 6 feet of your newborn. And try to keep your infant 6 feet away from you as much as possible.

Discuss with your provider about using a physical divider, for example placing your baby in an incubator.

If you had symptoms, your isolation period ends:

  • 10 days since symptoms first appeared, and
  • 24 hours with no fever without fever-reducing medications, and
  • Other symptoms of COVID-19 are improving.

If you never had symptoms, your isolation period ends after

  • 10 days since the date of your positive COVID-19 test.

Q: Should pregnant women continue prenatal appointments?

“Prenatal care is very important to the health of mom and baby, so we ask women to come to their appointments as scheduled,” Hilbert said.

Spectrum Health offers virtual options—connecting through telehealth—that will allow patients to get some of their prenatal care from home, instead of coming to the office. Patients could receive four to six virtual visits during the pregnancy.

Get the whooping cough (Tdap) vaccine during pregnancy to protect your baby against whooping cough, which can also present with similar symptoms to COVID-19, the CDC advises.

Q: But what should a woman do if she has symptoms of a respiratory illness?

“If you have mild to moderate symptoms, stay home,” Hilbert said. “Call your obstetrical provider if you have shortness of breath, with fever and cough.”

Q: What reactions are you hearing from moms-to-be?

Many are disappointed by the restrictions on hospital visitors, but understand these measures are put in place to protect the health of the community and those within the hospital.

For the latest on visitor restrictions, visit spectrumhealth.org/covid19/family-and-visitor-restrictions. Check back often as these are updated frequently.

Q: We should skip the baby showers, right?

That’s right. Pregnant women should avoid all social gatherings, and that means no in-person childbirth classes and baby showers, Hilbert said.

Skipping those treasured rites is disappointing to many expectant mothers, she acknowledged. Some worry whether they will have everything they need when baby arrives.

She gently reminds them to think about what is truly necessary—such as diapers, a car seat and a safe place to sleep.

The other “nice-to-have” items can wait.

Q: What advice do you give moms-to-be who feel isolated during this pandemic?

“You are not alone. There are pregnant women all over the world with similar concerns,” Hilbert said. “Lean into your support network, whether that be with pregnant moms in your real or virtual community, women in your childbirth classes or CenteringPregnancy groups and your supportive friends and family.”

She encourages parents to use FaceTime, Skype or other video connections to share celebrations and childbirth and to introduce their new little one to family and friends.

Also, parents can connect with family and friends with CareCircle. The free online resource allows patients to provide updates on their health and share private information with a select audience rather than on traditional social media.