Novel Coronavirus (COVID-19) Guidance for Pregnant Women

Posted on 03/26/2020 by AHMC Anaheim Regional Medical Center

Novel Coronavirus (COVID-19)

Guidance for Pregnant Women

Los Angeles County Department of Public Health www.publichealth.lacounty.gov
There is a lot more to learn about infection with the novel coronavirus in pregnancy but the Los Angeles County Department of Public Health (DPH) wants to share the best information we have now so you can make good decisions about your own care and keep yourself and your baby healthy.

Key Points

1. Take extra care to avoid getting sick while you are pregnant.

2. We don't yet know if the virus that causes COVID-19 poses a risk during pregnancy. There have been a few reports of preterm birth in women who were infected, but it is not clear whether these cases were caused by the virus or by other causes.

3. Even though we don't fully understand the risks of the virus, most women who have become sick during pregnancy so far have gone on to have babies that don't show any signs of harm.

4. Mothers who are infected with CODIV-19 can breastfeed. If you are sick, you can take simple steps so your baby doesn't become sick.

Special concerns in pregnancy

Pregnant women are at higher risk than other people from diseases caused by infection. This is because the immune system tunes down during pregnancy so that the mother's body doesn't reject the fetus. There is no evidence so far that pregnant women are getting CODIV-19 more often than other women, but we don't know enough to say for sure. So, it makes sense to be extra careful.

One symptom of the COVID-19 infection can be a high fever. We don't know just how much of a risk fever is for human babies, but it makes sense not to take chances. If you are pregnant and you get sick, make sure you connect with your health care provider early.

How to minimize risk?

Practice every day personal protection practices. Do all the things everyone should do to avoid catching the virus, but with a little extra care:

Stay home - avoid contact with people who are sick.
          * If you are an essential employee and must continue working, ask about teleworking or flexing your hours so you are traveling and at work when there are fewer people around.
          * Talk to your doctor or midwife about your prenatal visits. They may be able to use telemedicine for some of your visits, or schedule visits when their office is not crowded.

Have food delivered to your home so you can avoid checkout lines at grocery stores. o Ask if family, social, or commercial networks can bring food to you.
          * If you are enrolled in WIC, ask your WIC program if you can participate without having to come into the WIC office or have food delivered to your home.

Take extra care with infection control
          * Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or using the restroom.
          * If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
          * To the extent possible, avoid touching high-touch surfaces in public places - elevator buttons, door handles, and handrails
          * Wash your hands after touching surfaces in public places.
          * Avoid touching objects or surfaces, then touching your mouth, nose, or eyes before washing your hands
          * Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones)
          * Avoid crowds, especially in poorly ventilated spaces.           * Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.
          * Avoid cruise travel and non-essential air travel.

What to do if you get sick while pregnant

Prepare in advance for this possibility. Make sure you'll be able to manage if you get sick.
Consult with your health care provider about symptoms of COVID-19 that you should watch for. These generally include fever, cough or difficulty breathing.
Ask your doctor what over-the-counter medications would be safest if you get sick, and then make sure to have those products on hand, along with tissues and anything else you'll need to be comfortable if you are sick at home.
Try to have important items like medications and supplies (like tissues) in advance if you can.
Stay in touch with other people by phone or email.
Let them know you are taking extra care to avoid getting sick and ask for help if you need it.
If you get sick: Stay home! Call your doctor and let them know about your symptoms. You may want to contact both your regular doctor and your obstetrician or midwife in case they have any special guidance to keep your pregnancy safe.
Most pregnant women who have gotten sick in other parts of the world have not had to go to the hospital, so if you get sick you will probably be able to stay home. Take care of yourself as you would with a cold or the flu: rest, drink liquids, use over-the-counter medications that your doctor recommends to control fever.
If you get help from a home visitor, a doula, WIC or any other pregnancy support program, be sure to call ahead and let them know you are sick and ask for help with home food delivery and other needs. You can also turn to them for emotional support and if getting sick while you are pregnant is getting you down.
Get medical attention immediately if your condition gets worse. Signs to look for are:
Very high fever
Difficulty breathing or shortness of breath
Persistent pain or pressure in the chest
Mental confusion
Bluish lips or face

When the baby comes

If you are infected at the time of delivery, current guidelines call for doctors to proceed with whatever type of delivery (vaginal or C-section)was already planned unless there is some other reason to make a change in plans. Your hospital may take extra precautions to keep you, the baby, and healthcare staff safe during the delivery.

If you are infected at the time of delivery, your doctor will also try to assure that the baby stays safe while you recover. This may mean having the baby in a separate room or taking extra care that you wash your hands and wear a mask before holding the baby.

Things to know about breastfeeding

Breast milk provides protection against many illnesses and is therefore important for your baby. In fact, as in almost all cases, breast milk is the best food you can give your baby.
If you are trying to breastfeed while you are sick, o Wash your hands before touching the baby
Wear a face mask, if possible, while feeding at the breast.
If expressing breast milk with a breast pump, wash your hands before touching any pump or bottle part and get instructions from hospital staff about cleaning the pump after each use.
If possible, consider having someone who is well feed the expressed breast milk to the infant.

Stay positive!

Use your social supports. Stay connected to friends and family and ask them for help with food needs, caring for older children and emotional support
Build and maintain your virtual community.
Enlist the help of your partner or the baby's father.
Expect to recover without lasting harm and to have a healthy baby.
If you feel panicked or anxious, seek help from friends, family, your pregnancy support program or a mental health professional.
If you need support or information of any kind during pregnancy or if you are feeling low and want to find someone to talk to, call 213-639-6439.

Resources

CDC Guidance of Pregnancy and Breastfeeding: https://www.cdc.gov/coronavirus/2019-ncov/prepare/pregnancy-breastfeeding.html
Los Angeles County Department of Mental Health Access Center 24/7 Helpline (800) 854-7771 (562) 651-2549 TDD/TTY https://dmh.lacounty.gov
Los Angeles County Department of Public Health: http://publichealth.lacounty.gov/media/Coronavirus/
Call 2-1-1 for more information