Because pregnant women aren’t at a heightened risk for acquiring COVID-19, they should employ the same precautionary measures as everyone else: social distancing and isolating as much as possible, frequent and thorough hand washing; not touching your face. If you start to run a fever, says Sanghvi, don’t panic; a fever can be an indication of a number of things (like a cold or flu) that aren’t COVID-19. Her recommendation: call your doctor for guidance, but don’t just show up to their office or an ER. (Many hospitals, including Lenox Hill, have pregnancy-specific hotlines set up to field questions.) And take a Tylenol. “Tylenol is the medication of choice to treat fevers in pregnancy, and taking a Tylenol to treat one is much safer compared to the potential risks of a high fever,” says Sanghvi. If you’re pregnant and think you may have been exposed, you may still be asked to stay home and monitor symptoms as access to tests remains limited.
Pre- and Postpartum Support
The post-partum support network (doulas, lactation consultants, and yes, grandparents and family too) must, for the time being, be limited to online contact. Since doulas are no longer allowed in labor and delivery units, many of them have quickly pivoted to offer extensive virtual assistance, both during labor via FaceTime, and in the months before and after. “I’ve spoken to a number of doulas who are all bumping up their prenatal and postpartum visits virtually with their clients and are offering them a lot of support even throughout their labor,” says Lubell. Doulas like Kingston, New York-based Morgane Richardson and the bicoastal team at Carriage House Birth are already fully virtually enabled. Lactation consultants are also shifting to a virtual model to assist women with any breastfeeding issues in those first months postpartum; getboober.com offers a direct link to many virtual providers. The protocol for prenatal appointments has, of course, also changed: most doctors and midwives are drastically scaling back in-person visits, extending the interval between them, and relying heavily on telemedicine. At Sanghvi’s office, where just she and an assistant are working, appointments are significantly spaced out, patients are escorted directly into an exam room, and social distancing and disinfecting measures are being taken. “There are some time-sensitive tests that need to be done, but it’s reasonable to skip certain ultrasounds,” she says.
Pregnancy and the postpartum period have always been times of increased anxiety, so emotional support networks are still vitally important. “The emotional landscape is different for pregnant women and new mothers,” says Dr. Catherine Birndorf, a psychiatrist and medical director at The Motherhood Center of New York, which she co-founded. “It’s Darwinian that women are already in a heightened state of vigilance where they’re hyper protective of their fetus or newborn, and COVID-19 is throwing their anxiety into overdrive.” The Motherhood Center has started offering weekly webinars to offer some coping tools for these mounting anxieties and has shifted their mental health services for new and expectant moms to a tele-model.
For those who are trying to conceive, all the uncertainty around COVID-19 can feel especially unnerving. It’s not a bad idea to consider reaching out to a mental health professional for some guidance (The Motherhood Center is doing telemental health visits). Ultimately though, the decision comes down to a personal choice. “There are some couples who are incredibly risk averse who will say, ‘let’s just wait six months until we know more,’ and there are others who, perhaps because they’ve been trying for a while or are older, are not going to want to wait,” says Sanghvi. Do consider that, when it comes to resources, many healthcare providers and hospitals are stretched thin. But if personal safety is your main concern, from what we know now, as long as you follow the guidelines to protect yourself from the virus, you should be OK. As Lubell notes, “Hopefully people becoming pregnant now, by the time they give birth we will be done with all of this.”
Another concern for women amidst COVID-19 may be: will I be able to terminate a pregnancy, since abortion is considered an elective procedure? While other states are trying to restrict access, Sanghvi says that in New York, you will be able to get an abortion, just not in a hospital setting. “There are doctors who do perform elective abortions in their offices, and outpatient abortion clinics staffed with board-certified obstetricians who are still able to see patients,” she says. And if it’s early enough, access to medical termination (using medication such as Plan B to end a pregnancy) is also an option.