Pregnancy & COVID-19 | A Guide for Expectant Mothers

The past six months have certainly been a rollercoaster with coronavirus and all the major changes it has caused. When expecting, the health uncertainties posed by this pandemic are stressful and anxiety-provoking. We have heard the concerns and questions from our expecting mothers and families. There is ongoing research and the information we know is evolving. Here are some answers to many Frequently Asked Questions concerning COVID-19 and pregnancy. We will also address how your experience on the Family Birth Center will look during the COVID-19 pandemic. Thank you for choosing your care at Altru. We look forward to helping you welcome your sweet baby into this world!

Is a pregnant patient at increased risk if she gets COVID-19?

Many respiratory infections, such as the influenza virus for example, have historically posed increased risks to pregnant women. Very early research as COVID-19 was emerging did not suggest pregnant women were at an increased risk of severe infection or complications from COVID-19. As more patients have become infected with COVID-19, ongoing research has continued. A recent review from the Center for Disease Control (CDC) of more than 8,000 women suggests that pregnant women with COVID-19 appear to be at increased risk for admission to the intensive care unit (ICU) and needing respiratory support. This study did not show an increased risk of mortality amongst pregnant women with COVID-19. The overall risk to pregnant women with COVID-19 is still low, but there may be an increased risk of severe disease and more research is still ongoing.

Can my baby get COVID-19 from me during pregnancy?

“Vertical transmission” is the termed used to describe when an infection passes from a mother to a baby during pregnancy or shortly after. Specifically, this means passage of an infection from a mother to the baby during pregnancy, at the time of delivery, or during the first 28 days after birth. Vertical transmission of certain infections can occur through the placenta, direct contact during or after birth or from breast milk.

There have been some cases of reported vertical transmission of COVID-19. However, the research is reassuring and vertical transmission appears to be unlikely.

What can I do to stay healthy during my pregnancy in this pandemic?

First and foremost, please come to your regular prenatal appointments so we can help ensure you and your baby’s health. We offer many virtual and telemedicine options. If you are interested in this, please ask your physician or their nurse.

Follow the recommended precautions from the CDC and Public Health departments to lower your risk of exposure to COVID-19, including:

• Wearing a mask and other recommended PPE, if applicable, at work and in public
• Washing hands frequently
• Maintaining physical distancing
• Avoiding large gatherings or crowds
• Stay home if you have any signs/symptoms of illness

What is Altru doing to ensure it is safe for you to come to your appointments?

We are screening all of our patients over the phone prior to their appointments to assess for exposure and symptoms of COVID-19. This will allow us to wear appropriate PPE and coordinate care and appointments appropriately. If a patient with symptoms of COVID-19 has an appointment that cannot be delayed until a later date, we will still care for them. We have processes in place so that they will avoid contact with any other patients and not expose others. We are also screening all employees daily and have strict policies to ensure that our patients are safe when receiving care at Altru.

What should I do if I have signs/symptoms of COVID-19 or if I had an exposure to someone with COVID-19?

Please call the Altru COVID-line at 701.780.6358. They will screen and counsel you and coordinate testing, if indicated.

Who will be able to be with me during my delivery at the Altru Family Birth Center?

Currently, we have visitor limitations throughout the hospital and clinic. During your stay at the Family Birth Center, you will be limited to one support person. That person may come and go during your stay, but cannot switch off with another support person.

Do I have to wear a mask while giving birth?

Definitely not! We ask that mothers and their support person wear a mask when entering the facility and being brought to your room. Once you are in your room, you may take your mask off and keep it off. If you leave your room, we ask that you put the mask on when in the hallways.

Are you testing patients for COVID-19 upon admission to the Family Birth Center?

We are not routinely testing all patients upon admission to the Family Birth Center. If a mother is scheduled for an induction of labor or a cesarean birth, these are scheduled procedures and we do pre-procedure testing for these patients. There are many Birth Centers across the country testing all patients upon admission, but we do not have that testing ability currently. If a mother tests positive for COVID-19, then their physician would have a discussion with them about whether they would/could push their delivery date back safely. If the delivery date still needs to occur as scheduled, then we will have an extra level of protection for staff. We will also spend extra time educating the mother and her support person how to take precautions to take to ensure their newborn does not get COVID-19 from them. We would also keep the newborn out of the newborn nursery and away from other babies. These are just extra measures to ensure our and your family’s safety.

Will my baby be separated from me if I have COVID-19 at the time of delivery?

No, there is no mandated separation of a newborn from a mother who has COVID-19. As mentioned above, we will help teach you safe hand hygiene and ways to minimize the chance of passing the infection on to your newborn.

Do I have to leave the hospital early after having my baby?

No, we are not asking women to discharge earlier than they are ready to. Just as we have prior to COVID-19, if a mother feels well enough to discharge early and if there are no concerns regarding her or the baby’s health, then we can coordinate an early discharge. However, mothers are still able to stay the full 2 nights after a vaginal delivery and 3 nights after a cesarean delivery if they want for their initial postpartum recovery

Should I expect any other changes while at the Family Birth Center?

Other than wearing a mask when in public areas and the one visitor limitation, there are no other major differences you will notice. We have mothers laboring in their rooms, but you are still able to be moving, upright, on a birthing ball, in the shower or tub, as you prefer. We are strong proponents of skin to skin and delayed cord clamping and all of those practices are still the norm. We support your choice to labor with or without an epidural. At Altru, we have long encouraged the baby to room in with the mother and this is still the same. If you choose to breastfeed, you still have access to our inpatient lactation consultants and full support for your feeding goals.

Are you offering any prenatal education classes?

We definitely are! We have resumed all our prenatal education classes earlier this summer. We have large rooms where patients and their support person can socially distance from other couples in the classes. We do ask that you wear a mask to the classes. We also have options for expecting mothers to join the classes virtually if they feel more comfortable or live far from the hospital. Please see our website for a list of our classes and how to register, click here.

What breastfeeding support is available?

While inpatient, we have lactation consultants available daily to assess and help you and your baby with breastfeeding. We have also resumed our weekly free walk-in breastfeeding clinic. This has been a wonderful addition to our community’s lactation support resources. Altru’s Breastfeeding Clinic is held every Wednesday from 1-2 p.m. at Altru Family Medicine Center (1380 S. Columbia Road) in a conference room located downstairs. We also have virtual lactation visits available via MyChart. To schedule a visit, please call 701.780.5467. After you leave the hospital, you can schedule an appointment with a Lactation Consultant in person, via MyChart or by calling 701.780.5467.

Please refer to these excellent Patient Resources from the American College of Obstetricians and Gynecologists.

• For resources on COVID-19 and pregnancy and breastfeeding, click here.
• For resources on COVID-19 and women’s health care, click here.