The decision of whether to begin the journey of pregnancy is a highly personal one, shaped by considerations unique to each individual. But for those considering becoming pregnant during a pandemic, an entirely new set of concerns have been added to the list of things to obsess over. There are genuine concerns and questions surrounding the risk of infection for mother and baby alike, and uncertainty over what it even looks like to manage prenatal care, labor, and delivery in a time fraught with restrictions and exposure risks.
The evidence surrounding the novel coronavirus is new and still evolving, so it is important to stay connected to your care team as a part of your decision-making process. Axia Women’s Health remains committed to ensuring the safety and well-being of our patients and staff, and as part of this ongoing effort, we are innovating to better understand the impact of COVID-19 on pregnancy itself. This Spring, we launched a multi-state study to facilitate a better understanding of how pregnant patients with COVID-19 are impacted by the virus, and are leading the way to understand how to ensure the best care for our obstetric patients during this pandemic.
Given the stress and frustration that stems from so much still unknown and developing, we want to help. Below, we address some of the more common concerns we encounter by examining what it looks like to be pregnant in a time of COVID-19. Learn what you can expect from your caregivers as they promote the health and safety of you and your baby leading up to, during, and after birth.
Before we examine these important questions, how are you feeling about pregnancy in this time? Take our 2-question poll below:
As the information surrounding the spread, containment, and prevention of COVID-19 continues to evolve, Axia remains at the forefront of trustworthy information from global experts, and we are more prepared than ever to help ensure a safe environment for patients to access care. Our care centers have taken aggressive ongoing measures to provide safe, comprehensive care for our patients in the face of this pandemic, including measures requiring participation from patients. In addition, our AxiaConnect virtual care platform provides a convenient way to connect with your doctor from the comfort and safety of your own home.
Your care team is closely monitoring developing information and recommendations from global, national, and local health leaders to minimize exposure risk and provide the confidence that you are receiving the quality care you deserve by those who have closely considered how best to provide it.
The importance of prenatal care and the role it plays in a healthy pregnancy and the birth of a healthy baby cannot be overstated. During the pandemic and the resulting recommendations for limiting exposure risk for patients and staff, these prenatal visits will increasingly use virtual health or telemedicine options to make sure you are still getting the monitored care you need while keeping you safely distanced.
For those who will need in-office care, you’ll notice a few changes, such as waiting in your vehicle to be called in for the appointment rather than waiting in the office, COVID screenings before you enter, frequent disinfection of all areas, and increased use of personal protective equipment (PPE) by staff.
Our care teams are constantly working to find an evolving balance between the virtual healthcare needed to keep you and your baby on a safe and healthy path, with in-office visits when necessary to ensure encompassing care.
Perhaps the first change you’ll notice when discussing questions surrounding labor and delivery with your doctor is that elective deliveries or inductions for non-medical reasons are no longer an option, as resources need to remain closely aligned to medically-necessary concerns. This approach ensures that every patient is able to receive the full compliment of support needed during their care.
Since we mentioned patient support, you’ll also find some changes in the way many hospitals shape their support-partner and visitor policies during this time. While it varies slightly across our area, most hospitals are limiting support partners to one, asymptomatic person. This person should expect to be tested for COVID at least as rigorously as you are (more on that below), and should expect to have to stay in the room wearing a protective mask the entire time. In general, you should also expect limitations on the number of visitors allowed during labor, delivery, & recovery, as hospitals are trying to significantly limit the number of people on-site to only those absolutely necessary. Additional support partners must use digital or remote methods to stay in touch and receive updates.
Similar to the new protocols in place at your obstetrician’s office, you should expect to encounter widespread use of PPE (personal protective equipment) by all clinical staff. In-room clinical staff are always wearing masks, and during second stage stage labor (pushing), or in any operating room, this protection will be increased to include gowns and additional PPE.
You’ll also encounter thorough COVID testing at various intervals during your time at the hospital. Even if you arrive at labor and delivery “healthy,” you could be asymptomatic and develop symptoms in the hospital. However, currently, pregnant women don’t seem more likely than the rest of the public to contract COVID-19.
While a specific hospital’s policy may slightly affect the conditions and timing of COVID testing, you should expect to be tested for COVID…
Patients who test positive for COVID should expect to be kept in isolation with a more stringent set of rules governing access to the baby, visitors, and which will affect the duration of your recovery. Specifics of this possible outcome will be discussed with you in detail by your provider and hospital staff. Remember that you are always your own best advocate, so be sure to discuss this possibility with your support partner as a part of your birth planning and never be afraid to ask your questions as many times as you need to in order to feel confident in your care.
The data is still incredibly limited, but thus far there has been little evidence showing direct vertical transmission from a mother who has tested positive for COVID-19 either during pregnancy, delivery, or post-delivery through breastmilk. However, in cases where the mother has tested positive, increased separation from the newborn and increased precautionary measures may be put in place to further reduce risk.
To maintain a safe environment and limit exposures, you can expect the discharge process to look a little different than in the pre-pandemic era. While some hospital policies may vary slightly, in general, if the mother and baby are healthy, vaginal deliveries are generally being discharged within 24 hrs, and C-section deliveries within 48 hours. When coupled with a solid recovery plan, such as Axia’s Enhanced Recovery After Surgery protocol, you are able to receive the benefits of both enhanced care to promote a speedy recovery, as well as the comfort of returning to your own home and support network with your new addition!
Though safe, an expedited discharge process has raised concerns in some about going home “so soon”. While understandable given what you’ve just been through and the seemingly overwhelming challenges of parenting ahead of you, it’s important to understand that this is a part of active risk prevention to make sure you and your new baby avoid COVID-19 exposure. Your care team will remain active with you through telehealth checkups and communication to help you stay connected to important post-pregnancy care for things like lactation consults, wound checks, mental health (post-partum) checkups.
With respect to post-partum, it is important to note that there has been a notable increase in COVID-era post-partum depression. Many women are afraid of being infected or passing the infection, and managing these risks at a time when they are both under an immense amount of physical and emotional stress—all while being increasingly disconnected from their support networks and others who can share their experience. Your mental health is as important as your physical health, and problems should not be ignored or explained away. How you feel after giving birth may seem like it’s out of your control, but what is within your control is getting the help and guidance you need to care for yourself and your baby.
Deciding whether or not to become pregnant right now is a highly personal decision with a host of considerations. However, if both you and your care team are following prescribed safety guidelines, your risk of infection is not significantly increased simply by being pregnant or by seeking prenatal care. Connect with your care team today to discuss any concerns or questions you have around surrounding this decision, and stay connected to Axia Women’s Health as a trusted source of information on how the evolution of this pandemic shapes healthcare for you and your baby.
July 28, 2020
Coronavirus, Post-partum Health, StressRead More