Expert summarizes the coronavirus advice for pregnant and nursing parents

Millions of pregnant women are worried and trying to understand what to do. They want to protect their babies and find out if they are at risk.

General Covid-19 information

The coronavirus is a new virus. The human race has never been exposed. We have no baseline immunity or protective antibodies. We do not have a vaccine, and there is no effective medication to treat it. We are all susceptible to becoming sick with Covid-19, the disease caused by the new coronavirus.

Covid-19 is spread through person-to-person contact via respiratory droplets. Droplets spread through coughing, sneezing, and breathing. Particles get on our clothes and hands. We then pass the virus through handshakes, hugging, kissing, and other close human contact.

Because the coronavirus is a brand-new virus, we have minimal scientifically validated information.

Labor and delivery units across the country are moving at lightning speed to ensure a safe environment for childbirth.

Current information on Covid-19 in pregnancy

We do not know definitively if pregnant women are more susceptible to becoming sick with Covid-19. Based on current data, there is no evidence at this time indicating pregnant women are more at risk than the general public.

Pregnant women have a suppressed immune system and physiologic changes in their lung function. These changes put pregnant women at a higher risk for respiratory problems when they contract other similar viruses, such as influenza or pneumonia. For this reason, pregnant women are considered an at-risk group for respiratory compromise if they contract Covid-19. Influenza vaccination is critically important.

If you have not received your annual flu vaccine, you should do so now.

Preterm labor can be a risk when pregnant women contract other viral illnesses. Preterm labor likely results from the severity of the maternal illness and not a direct link to the virus itself. Limited case reports from China indicate the risk of preterm labor in women with Covid-19 is following similar patterns.

Can Covid-19 be passed to the baby?

At the current time, there is no indication that Covid-19 is passed to the baby through vertical transmission. There is no data indicating that Covid-19 is passed to the baby through the bloodstream or the placenta. This is very encouraging news for all pregnant women.

Studies to date demonstrate the virus has not been detected in amniotic fluid or placental cord blood. It has not been detected in breast milk. No infants born to mothers with Covid-19 have tested positive for Covid-19. A small study found no evidence of Covid-19 in the amniotic fluid or cord blood of six infants from infected women. Many are aware of a case report from the U.K. of a neonatal infection. This is considered the youngest patient to contract Covid-19. The case is being monitored closely. The current evidence suggests the baby acquired it through respiratory droplets and not in utero.

The CDC, American College of Obstetrics and Gynecology, and Society for Maternal-Fetal Medicine have issued statements indicating that much is unknown regarding transmission. The data available today is encouraging that mother-to-baby transmission does not occur.

Will my prenatal care change?

The reality is that the schedule for your prenatal visit schedule will change. OB-GYNs across the world are reinventing prenatal care. The goal is to provide safe care for all pregnant women, to limit the potential for exposure, and to reduce the burden on hospitals.

Pregnant women should expect changes. Visits may be less frequent. Some appointments will convert to telehealth. Be flexible as your OB-GYN providers and midwives work to make arrangements to provide safe, high-quality care based on rapidly evolving CDC guidelines.

Will my labor and delivery experience change?

Labor and delivery units across the country are moving at lightning speed to ensure a safe environment for childbirth. Changes are necessary. Most hospitals have instituted a one-visitor policy, and some are not allowing partners to enter the delivery room. It is crucial to limit the number of people entering hospital facilities.

Limiting visitors is for your safety. Please be flexible with your birth plans. The central goal for labor and delivery is always to end the day with a healthy mom and baby.

We all must do our part to prevent the spread of the virus. Pregnant women should follow the same global recommendations.

Can I breastfeed?

Studies thus far demonstrate that the coronavirus is not present in breast milk. The CDC has not yet released a statement on the safety of breastfeeding in a known maternal case of Covid-19.

For patients without suspected Covid-19, breastfeeding should be encouraged. Breastfeeding helps build the immune system for newborns. We should encourage extra precautions when handling a newborn. Hand-washing is key. Breast pumps or bottles must be properly cleaned.

How do I protect myself?

We all must do our part to prevent the spread of the virus. Pregnant women should follow the same global recommendations.

1. Wash your hands with soap and water for at least 20 seconds.
2. Use hand sanitizer containing at least 60% alcohol.
3. Avoid touching your face.
4. Practice social distancing.
5. Cover your mouth if you cough or sneeze. Immediately discard the tissue.
6. Clean your cellphone and household surfaces.
7. Avoid travel.

Should I get a Covid-19 test?

No. Please do not overwhelm the health system. Every test takes up resources and valuable personal protective equipment. If you feel sick, you do not need a test. A negative test does not mean that you do not or will not have the virus. A positive test does not change management. Regardless of the test results, the recommendations will be two weeks of home isolation and supportive measures such as fluids, rest, and acetaminophen.

Only those experiencing severe symptoms, such as difficulty breathing, need in-person medical evaluation.

What do I do if I feel sick?

1. Stay at home and away from others, including family.
2. Wash your hands with soap and water for at least 20 seconds.
3. Cover your mouth if you cough or sneeze.
4. The sick should wear a mask. The healthy do not need one.
5. Clean surfaces in the home using household cleaning sprays or wipes.
6. Rest.
7. Stay hydrated.
8. Treat fever with Tylenol per the package instructions.
9. Monitor for worsening symptoms, and present for evaluation if you experience difficulty breathing.
10. Notify your provider before a visit so precautions can be taken.