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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?

At this time there is no evidence pregnant people are more likely to get COVID-19. However, according to the CDC, pregnant people have an increased risk of severe illness including admission to an intensive care unit, requiring a ventilator or death, if they contract the virus compared to people who are not pregnant. In addition, they could face complications such as pre-term birth. 

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

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

  • Wear a mask
  • Avoid people outside your household who are not wearing a mask
  • Avoid people who are sick.
  • Wash your hands often using soap and water for 20 seconds or alcohol-based hand sanitizer.
  • Avoid crowded places and social gatherings; avoid unnecessary person-to-person contact.
  • Practice social distancing. Stay at least six feet away from others outside your household. The airborne respiratory droplets from coughing are heavy and tend fall to surfaces within six feet of the person who has coughed.

Should I get the COVID-19 vaccine if I am pregnant?

The available data shows the Pfizer and Moderna vaccines are safe, but these vaccines were not initially studied for safety in pregnant patients. However, experts are continuing to study the impact of the vaccine and new data is developing. The Centers for Disease Control and Prevention and Advisory Committee on Immunization Practices decided the vaccine should be offered to pregnant and lactating people. If you are pregnant and considering the vaccine, you should have a conversation with your physician or midwife to weigh the benefits and risks. Learn more about the vaccine and pregnancy here.

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. The SARS-CoV-2 virus is a very different type of virus from Zika, which is known to transmit to the fetus during pregnancy and negatively affect fetal 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 take precautions to reduce the risk of transmission of the disease to their newborns.

We use shared decision-making between the patient and their care providers to determine the optimal location for the ongoing care of the newborn baby and the mother. Options include rooming-in or room separation with the newborn cared for in a separate room from the mother. In mothers who are asymptomatic, the preferred location for the neonate is rooming in with the mother while utilizing social distancing in the room. At 24 hours of life, the baby will be tested for COVID-19.

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, precautions are recommended during breastfeeding to reduce the chance of transmission from the mother to the newborn. These precautions include hand-hygiene and mask wearing while preparing to breastfeed and during breastfeeding of their infant. If an infected mother chooses not to nurse, she may pump her milk after appropriate hand hygiene.

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, fatigue, muscle pain, headache, sore throat, congestion, runny nose, nausea, vomiting, diarrhea 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; coughing more than one teaspoon of blood; unable to keep liquids down; experience signs of dehydration like dizziness with standing; or becoming less responsive or 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 successfully 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 stay in the hospital as you are able to do so.

If you have any signs or symptoms of viral infection, you will be assessed and cared for in 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 are admitted or meet specific testing criteria, COVID-19 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 working to limit the number of people in the office space to decrease the potential spread of the virus to our patients as well as our healthcare workers. During ultrasounds you will be given electronic 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 work closely with Infection Prevention to create a safe environment for newborns. In an effort to limit exposure, visitors to the postpartum unit and the neonatal intensive care unit are restricted to one support person. All visitors are screened for COVID symptoms upon entry to the hospital.

All healthcare workers and visitors wear masks at all times to limit the risk of exposure to potential asymptomatic COVID-19 carriers. We ask our adult patients to wear a mask as much as they are able to during their stay. We work closely with our families and outpatient pediatricians to ensure that newborns can be discharged safely to home in a timely manner.

Are there visitor restrictions?

We continue to monitor the amount of COVID-19 infections in and around Connecticut and we will adjust our visitor policy to reflect optimal patient support balanced with creating a hospital environment that minimizes the risk of COVID-19 spread. Women admitted to our antepartum service, labor and birth, and the postpartum unit (along with their newborns) are allowed one visitor.

Children admitted to any pediatric service are allowed one visitor. Visitors must meet strict criteria to be eligible to enter 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 COVID-19 screening 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 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 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.

Home

How can I help myself and my newborn stay safe after discharge home from the hospital?

In warmer months, many parents of newborns will want to be outside to get fresh air and exercise. We do recommend that the newborn’s primary care giver continue to socially distance and avoid being the one to go on errands and trips to the market, etc. However, there are many health and personal well-being benefits to spending time outside and incorporating regular exercise into your postpartum routine. Outdoor activities are among the safest to do during the COVID-19 pandemic. When you choose to go out, there are several things you can do to protect yourself and your newborn from COVID-19. The caregiver should always wear a mask, unless they are in a location where they are truly not going to come within 6 feet of another person. When having face to face conversations with others, everyone (except the new born) should be wearing masks. Children under the age of 2, including newborns should not use face coverings. The newborn should be kept away from all person interactions. Good hand hygiene after returning home and wiping down of the stroller with an antiseptic wipe are critical components to keep you and your new baby safe.

We continue to recommend that you avoid visiting any indoor locations or enclosed spaces with your newborn.


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

Additional YNHHS Women's Health Services Virtual Town Halls

Watch the Greenwich Hospital Town Hall Event, June 24, 2020

Watch the Bridgeport Hospital Town Hall Event, June 2, 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.