COVID-19 Precautions During Pregnancy

The first Covid-19 case in the United States was announced back on January 21, 2020. We are now 10 months into the pandemic and many women have successfully made it through their pregnancy and given birth to healthy babies. However, that doesn’t mean your anxiety is lessened by other mothers paving the road for you in this new world we live in. Here at Boston Baby Nurse & Nanny, we want to help ease your mind by answering your questions about Covid-19 precautions. If you are an expecting parent or want to be informed to support a pregnant loved one, then these advice column interviews should help answer all your questions. We spoke with an expecting mother who will deliver at Women & Infants Hospital in Providence RI, a mother who delivered at the height of the Pandemic at Boston’s Brigham and Women’s Hospital, and a Midwife currently practicing in New England.

Dear Ashley, the Expectant Mother

Can you bring a support person to your ultrasounds?

• My OBGYN is based out of Women & Infants Hospital in Providence. At this time, due to Covid-19 precautions, you are not allowed to bring in any spouse or support person (including other children) to your appointments. Although it is a little sad to not have someone share in the special moment, it is exciting to go home with the pictures and relive the moment with your loved ones.
• Because hospitals have different policies we asked another expecting mother who is currently 18 weeks pregnant and a patient at Brigham and Women’s Hospital in Boston. She told us her husband has been able to go to ultrasounds with her but no other appointments. However, she did inform us that her OBGYN said she should call before future ultrasounds because Covid-19 cases are on the rise and the hospital policy may change.
• Another expecting mother who is 35 weeks pregnant and a patient at Mt Auburn Hospital in Cambridge, MA told us that her husband couldn’t go to the first couple ultrasounds, but luckily now has been able to.

What cleaning and Covid-19 precautions do they take when you go in for your prenatal appointments?

Everyone (staff and patients) must wear a mask throughout the entirety of the visit. They also ask that you sanitize your hands prior to entering the exam room, as well as sit every other seat in the waiting room. At my ultrasounds, they have a plexiglass separator between myself and the technician. Overall, I feel very safe and protected with the Covid-19 precautions they have in place. I know that myself and my baby are in good hands!

Are some visits virtual or even a few skipped that you may have had for a previous pregnancy?

• So far, every appointment (including all of our favorites…ultrasounds!) has been in person and I have not had to miss a single one. They do ask that you reschedule if you feel any Covid-19 symptoms or if you have been exposed to the virus in any way.
• The previously mentioned expecting mother who is a patient at Brigham and Women’s Hospital has had one in person visit and one phone call “visit” so far.

I’m nervous about opening my quarantine bubble to hire a photographer for a pregnancy photo shoot. Do you have any suggestions?

Now is a great time to have some outdoor photo shoots. Although it can get chilly, the colorful backdrop that nature provides is worth the cold! Not only will you get some beautiful photos, you will have the peace of mind in knowing that you are maintaining six feet of distance in the outdoors. Outside of the actual shoot, I would make sure that everyone is wearing a mask, of course!

Will your hospital allow visitors in after your baby is born?

Unfortunately, not at this time. I will admit that I struggled with this a bit as this is my third baby and I always had the vision of my other kiddos coming in to meet the baby with their “Big Sister” and “Big Brother” shirts on. However, after I had my pity party, I realized that this is for the benefit of EVERYONE. I will get to have special bonding time with my baby for a few days before introducing her to the rest of the family. As of right now, my husband is allowed to come to labor and delivery with me. However, he is not allowed to leave and return. Because of this, he will come to the birth and then return home with our other two kiddos until we are discharged. It is not ideal, but making sure he is home with the other two providing structure and routine will benefit us all in the long run. He will also help my children plan a coming home party for their little sister to make the experience extra special!

Dear Kelsey, the New Mother

Due to Covid-19 precautions they did not want any unnecessary people in the office, but they were very kind to offer a video call with the pediatrician we wanted to meet. He called us and spent a generous amount of time answering all our questions and offered knowledgeable facts about newborns as well as suggesting we stay at the hospital the full length of time (every pediatrician as their own preference).

Dear Kristen, the Midwife

Should I labor as long as possible at home so that I don’t come in contact with more nurses than necessary?

Regardless of the Covid-19 Pandemic, I would say all women should stay at home as long as they can when in normal labor, with no indications of complications. Feel free to labor at home as long as your baby is still moving, you are Group B Strep negative, you are not having any bleeding, and if your water broke liquids were clear. Laboring at home in your own comfort zone, with the person or people you love most, makes for a more manageable labor. Of course, still contact your provider if there are any concerns during your labor process.

Is it safe to keep my baby in my room if I test positive for Covid-19 upon arrival to the hospital?

Check with your hospital on their policy, it will depend on what the pediatricians at that facility are requiring. Most hospitals are moving towards NOT separating Mother and baby. Many hospitals are requiring a support person to handle 99% of baby duties if you test positive. Mothers will need to wear a mask at all times if baby stays in the room. Hospitals are suggesting Mom expresses her milk to provide for baby’s feedings; all data thus far has shown no traces of the Covid-19 virus in breast milk.

If I get Covid-19 while pregnant can it affect my baby in any way?

There are mixed results right now as the virus is still being studied. Most data collected thus far is pointing to, “No, your baby won’t be effected,” but there is still A LOT more to learn. There are a few rare cases where Covid-19 has been found in the placentas of a woman infected during her third trimester. Anecdotally, many practices (especially in NY) were finding that women who had Covid-19 during their pregnancy were presenting with symptoms of a dangerous condition in pregnancy called Preeclampsia. Transplacental transmission of Covid-19 is still being studied and we may not have a final verdict for years.

Is it safe, during the pandemic, to go to other appointments and errands while pregnant, such as the dentist or to the grocery store?

If you live in an area of low-incidence, yes definitely. As long as you are following Covid-19 precautions such as social distancing guidelines, wearing your mask at all times indoors, and standing 6 feet from others you can run errands. All medical facilities, including dentists and chiropractors, should be following appropriate screening and protection guidelines (i.e. temperature/symptom screening and employees wearing PPE). If they are not, then they should be reported and avoided. If you live in an area of high incidence or an area of a “spike” then it is safest to try to find someone else who can do the shopping for you or order your groceries online to be delivered.

Is it safe to have friends and family come meet the baby right after we get home?

Anyone who will be spending a significant amount of time with your baby should get an updated Tdap and yearly Flu shot. Limit visitors to a few close family and friends who have not traveled to a high incidence area and who have been very safe in performing the social-distancing guidelines. You could even ask family and friends to quarantine at home for two weeks before visiting. Of course, they should not have had any symptoms in the 2 weeks leading up to their visit. Less is more; limit the amount of people around you and your baby at any given time.

Should we go home 24 hours after delivering if our nurse thinks Mom and baby are healthy?

If you and your baby are healthy and were Group B Strep negative, or treated appropriately in labor, then yes you should be able to go home around 24 hours. Though, as I have mentioned before, this is going to be very dependent on the hospital policy dictated by the pediatricians at the facility. To make you feel more comfortable, there are birth centers all over the country where women are sent home at 8-12 hours post delivery, so 24 hours is very reasonable. Almost every pediatrician I have worked with will want to see a breastfed baby within 24-48 hours after discharge for a weight check; so they will be checking up on you and baby very soon after.

I have an older child who attends school. How can I protect my newborn without secluding my school-aged child ? Are there special precautions we should take when they get home from school as well?

Make certain that your older child understands, to the best of his ability, how to social distance and wear a mask. Most schools/teachers are doing a good job at making sure students are safe and following Covid-19 precautions. However, it is a good idea to keep their school things that they carry back and forth away from baby and if you need to use any of them (homework folders or lunch boxes) sanitize the items, the counters they touch, and wash your hands. Have your older child, at a minimum, wash his hands as soon as he gets home. If possible also have him change into “house clothes” or PJs when arriving home, that way if he plays with his newborn sibling he has clean hands and clothes.

Because newborns are born with a low immune system and their lungs are still developing, are they more likely to contract COVID-19?

Not that we have seen. However, it is still a good idea to only let people around your baby who you trust to have followed distancing guidelines and who have had zero symptoms for at least 2 weeks prior.

Are siblings allowed to come into the hospital to meet the new baby or only Fathers?

Most hospitals are allowing only 1 support person in the hospital for the entire time you are there. This means no siblings, no grandparents, no visitors. Currently, cases are spiking again in various places around the US, so keep asking your particular facility what their policy is because Covid-19 precautions can change daily.

This leads me to sharing with you the silver lining of the pandemic. While Covid-19 has been scary, frustrating, and sometimes lonely for women and their partners, I have also seen some of the most beautiful deliveries since the pandemic started. Prior to the pandemic, women might have had five people in their labor room with them, excited to meet the new baby. They would ask questions such as, “What time do you think the baby will be here?” This was incredibly counter productive for the mother. Instead of feeling supported through labor, I would see mothers stressed and anxious to please their family. Since the pandemic and the institution of only one support person, I have seen women have smoother, faster, less-stressful, and more empowering births. Hospitals have seen a decrease in C-section rates in many areas from women staying home longer during early labor and I also believe this is due to a calmer labor experience with just Mom, Dad, and their medical professional.

I have had many mothers who described the visitation policy as a blessing in disguise. Even after the baby was born, they have felt like they had a much easier and more meaningful transition into motherhood being with just their partner and newborn. I have seen couples and their newborn, during the pandemic, able to become a true family unit so much better. There has also been an increase in successful initiation of breastfeeding during the pandemic from uninterrupted mother and baby skin to skin time. Instead of just the first hour of skin to skin with Mom, baby is able to get 24-48 hours without being passed around a room all day. So, all this to say, while the pandemic is definitely scary and uncertain, I can also assure you that when it comes to the birth itself, it has led to some of the most beautiful and empowering experiences of welcoming baby into the world while also ushering you into motherhood.

Keep that silver lining in mind that Kristen Murphy, CNM shared with us as you enter into labor. Remember that each state and individual hospital has different rules, so be sure to always check with you Doctor or Midwife about the Covid-19 precautions they are taking. Now close your eyes, take a deep breath, and picture your beautiful baby wrapped in your arms because he or she will be here before you know it. You are a strong woman and Boston Baby Nurse & Nanny has every faith in you to carry and deliver your baby into this crazy world, like the rock star you are!