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Pregnancy and COVID-19

Are pregnant women more likely to become infected with COVID-19 and are they at increased risk for severe illness and mortality with COVID-19?

No, the experience in China and early experience here in the U.S. does not show that pregnant women are at a greater risk for contracting COVID-19 or at greater risk for severe illness compared to non-pregnant people in the same age group. The influenza virus and some other types of corona viruses are more likely to infect and cause severe illness in pregnant women, but this has not been seen with COVID-19.

I am pregnant. How can I protect myself from getting COVID-19?

The same general rules apply to pregnant and non-pregnant adults:

  • Avoid people who are sick.
  • Wash your hands often using soap and water for 20 seconds or alcohol-based hand sanitizer.
  • Avoid touching your face.
  • Avoid crowded places and social gatherings; avoid unnecessary person-to-person contact.
  • Practice social distancing. Try to stay around 6 feet away from other people. The airborne respiratory droplets from coughing are heavy and tend fall to surfaces within six feet of the person who has coughed.
  • Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
  • As of April 3, 2020, CDC recommends that all people wear a cloth face cover in public spaces to protect yourself and others form the spread of the virus.

Can I pass COVID-19 to my fetus during pregnancy?

The data published in scientific journals thus far does not provide clear evidence that COVID-19 can be passed from mother to the baby during pregnancy. However theoretical risk still exists.

At this point there are no data on the effects of COVID-19 in early pregnancy, but other coronaviruses have not been transmitted to or caused abnormalities in developing fetuses. This is a very different type of virus from Zika that can be transmitted to developing fetuses and affect development.

After birth, infants can acquire COVID-19 through respiratory droplet transmission (through the air), just as adults can. At Yale New Haven Health, it is recommended that COVID-19 positive mothers be separated from their newborns to avoid transmission of the disease.

The baby will stay in a room adjacent to the mother and at 24 hours of life, the baby will be tested for COVID-19. Depending on how the mother is feeling and at what point she is at in her illness, the pediatricians and obstetricians will work together to find the safest time to reunite mom with her baby. During this period of separation, we encourage mom and her family to identify a primary caregiver for the baby.

Can COVID-19 be transmitted during breastfeeding?

To date there are no data to suggest that the virus can be passed to the baby through breast milk. Moreover, breast milk remains the best source of nutrition and protection against many illnesses. However, a mother who tests positive for COVID-19, or is under investigation for COVID-19, can transmit the virus through respiratory droplets or during direct contact. Therefore, direct skin-to-skin and other close contact is discouraged. Expressing breast milk with a manual or electric breast pump, then feeding the infant by a healthy care provider using proper hand hygiene and clean bottles, is the preferred method of feeding the infant breast milk until the COVID-19 infection is resolved.

What should I do if I am pregnant and experience symptoms of a respiratory illness?

You should call your OB provider if you experience a fever of 100°F or above OR any of the following: cough, difficulty breathing, shortness of breath, new sore throat, new chills or sudden loss of taste or smell. Additional resources can be found by calling the Yale New Haven Health COVID-19 call center at 1-883-ASK-YNHH. Any persons with symptoms of viral illness should begin self-isolation to avoid exposing others.

Which symptoms of COVID19 infection are considered severe and warrant immediate evaluation?

Please seek immediate emergency assistance if you are unable to get out of bed; develop new shortness of breath; chest pain; fast heart rate; difficulty speaking in complete sentences; or become confused.

Should newborns be kept in isolation for a specific period of time?

We recommend that families with newborns stay home. The baby should only leave the home for important appointments, like their follow up pediatrician visits. It’s also recommended that families with newborns have no visitors at this time. If possible, use technology to stay in touch with family members.

Are babies more at risk of developing a serious illness from COVID-19?

Children are generally less likely than adults to have serious COVID-19 disease. However, of children infected, infants under 1 year can develop more serious illness. Families should monitor for fevers, difficulty breathing and poor feeding. These are the same recommendations given outside of a pandemic.

I have other kids – what do I do about them when I am in the hospital?

It is important to make safe childcare plans for your children, as well as backup plans in case the person you had planned to watch your children gets sick. Ideally you should choose someone who does not have any high-risk conditions for COVID-19 (lung problems, heart problems, or age over 65 years old.)

Before Delivery

How can I get tested for COVID-19?

If you are an outpatient and experience new onset symptoms concerning for COVID-19 infection, we recommend you discuss this with your primary obstetric provider to assess if outpatient testing needs to be performed. Testing in the outpatient drive through sites is done by appointment and per physician’s order only. Our COVID-19 call center is available 7 days a week from 7 am to 7 pm to answer COVID-19 related questions and may help set up outpatient testing: 833-ASK-YNHH. All women admitted to a Yale New Haven Health hospital for childbirth undergo COVID-19 testing at the time of admission. Testing guidance is evolving rapidly, and testing indications continue to change.

My OB provider has suggested less frequent prenatal visits, or visits over the phone or via video. Is this safe?

Many of the elements of prenatal care can be performed remotely. Knowing your baby is doing OK can be determined by doing fetal kick counts. Another important part of prenatal care is checking your blood pressure. If you are low risk this can be done less frequently. Also, if you have access to a blood pressure cuff this may also be done at home and results discussed with your doctor. Checking on how you are feeling and talking about your plans for delivery can easily be done via phone. Avoiding unnecessary person-to-person contact is an important part of reducing the transmission of the virus for you and your family.

For Telehealth visits, you will need the My Chart app on your phone. The office team can help you get that setup if you need help.

What should I do and what should I expect to happen if I am pregnant and have pregnancy related concerns (e.g. contractions, leakage of fluid, decreased fetal movement, vaginal bleeding, etc.)?

If you have any pregnancy-related questions, call your OB provider. If your pregnancy-related issues need evaluation, you will be invited to the hospital for an evaluation. You will be provided with a surgical mask upon arrival and you will be asked to keep it on throughout your time unless you are cleared from infection. You will be taken straight to a room which is specifically designed to contain respiratory infections. Part of your initial evaluation may be done by a video port. During your stay your providers will be wearing personal protective equipment. If you get admitted and meet specific criteria, COVID-19 confirmatory testing will be performed.

Can I bring a support person to my prenatal appointments or ultrasounds?

No, you may not bring a support person to your appointment. We are trying to limit the number of people in the office space to decrease the potential spread of the virus. During ultrasounds you will be given pictures to share with your family.

I wanted to see if I qualify for Women, Infant and Children’s (WIC) benefits for food during my pregnancy and postpartum for food and if needed, for formula, but I went by their office and they are closed – what should I do?

WIC is working remotely. They can verify your eligibility over the phone and get WIC paperwork from your providers via fax or by verifying information over the phone. They will mail you an EBT card and then reload it electronically. Choose the office you want to work with and give them a call. 

Day of Delivery

Is it safe for me to come to the hospital to give birth?

Studies show that delivery at a hospital is safest for you and baby. Extensive precautions are taken with every patient to prevent the spread of infection. Rooms and equipment are deeply disinfected after each patient. Our staff is trained on how best to prevent infection as well as be able to provide the labor support and guidance you need during your birth. In addition, we are prepared to respond to any complications that may occur during labor and birth for both healthy women and those that have higher risk pregnancies.

How is Yale New Haven Health System keeping newborns safe amid COVID-19?

Multidisciplinary teams of physicians and nurses from our nursery have been working closely with Infection Prevention to create a safe environment for newborns. In an effort to limit exposure, visitors to the nursery are being restricted to one support person (who is screened for COVID symptoms upon entry to the hospital) for each delivering mother.

Healthcare staff on the units are wearing surgical masks to limit the risk of exposure to potential asymptomatic COVID-19 carriers. We are working closely with our families and outpatient pediatricians to ensure that newborns can be discharged quickly when possible.

Are there visitor restrictions?

Yes, due to the COVID-19 pandemic, no visitors are allowed in any hospital within the Yale New Haven Health System. There are a few noteworthy exceptions to this strict policy. Women being admitted to our antepartum service, labor and birth, and the postpartum unit are allowed one visitor. Children admitted to any pediatric service are also allowed one visitor. Visitors must meet strict criteria to be eligible to pass into the hospital. All visitors must be greater than 18 years old and have no signs or symptoms of COVID-19. Once permitted into the hospital, the screening criteria will be reassessed at regular intervals. You should plan ahead and identify a backup support person in case your original visitor is not eligible for entry to the hospital. By limiting visitors into our hospital, we aim to limit the spread of the virus and protect our mothers, newborns, other visitors and health care workers from becoming ill with COVID-19.

I had been planning to work with a doula, what do I do?

Doulas and their clients have been getting very creative about working together remotely via FaceTime or Zoom. In addition, many doulas have been working with their clients prior to labor to help them prepare for the birth process. If desired, your doula is eligible to be the single visitor for your delivery hospitalization.

I was planning to deliver at Yale New Haven Hospital's Saint Raphael Campus. Can I still do it?

To optimize care of all out patients in the era of COVID-19, the Vidone Birth Center is has relocated to the York Street Campus. Although the location has changed, your Vidone Birth Center childbirth team remains the same. You will continue to experience the same attention to care you would receive at Saint Raphael campus. Please note that to increase safety, nitrous oxide will not be available to reduce labor pain.

Please call your OB providers to answer any additional questions you have regarding the move.

At Yale New Haven Hospital, there is also the Obstetric Comprehensive Care Unit (OCCU) specifically to care for women with COVID-19 and their newborns. The unit provides the full spectrum of pregnancy and post-partum related care. We are able to care for women in all stages of their pregnancy, labor and delivery as well as postpartum care and neonatal care.

Can I leave the hospital early to minimize my time there?

Yes, you can leave as early as 24 hours after delivery as long as you are recovering from childbirth as anticipated. If you had a cesarean delivery, you may be ready for discharge as early as 2-3 days after the delivery. There are some essential newborn tests that occur at 24 hours of age and we want to make sure those get done so that the need for frequent pediatric office visits can be minimized.

What else may have changed for my inpatient stay?

Unfortunately, to keep everyone safe, walking outside of your room and unit is limited. Please don’t forget to bring music that you enjoy and other things that help you relax. We have birthing balls, rocking chairs, and our rooms are bright and spacious. We continue to have the availability of narcotic and epidural analgesia for mothers who desire it as well.

 


More Resources

Highlights of YNHH Virtual Town Hall - Women's Health Services

 

Watch the Complete Town Hall Event, April 23, 2020

Watch the Complete Town Hall Event, May 7, 2020


Questions?

Call 833-ASK-YNHH (833-275-9644).

Yale New Haven Health is offering a call center for patients and the community who have questions about COVID-19. Healthcare professionals from the health system are available to answer your specific questions 7 days a week, 7 am – 7 pm. 

Yale New Haven Health includes Bridgeport Hospital, Greenwich Hospital, Lawrence + Memorial Hospital, Westerly Hospital, Yale New Haven Hospital, which includes Yale New Haven Children’s Hospital, and Northeast Medical Group.