By Maureen Gilmer, IU Health senior journalist, firstname.lastname@example.org
Pregnant women are faced with a lot of hard questions these days.
What does labor and delivery look like during the coronavirus pandemic? Should expectant moms get the COVID-19 vaccine? Does the virus pose a more serious threat to them than other healthy individuals? Can they safely breastfeed their newborn if they have the virus?
Dr. Chemen Neal, assistant professor of obstetrics and gynecology and an attending physician for IU Health, breaks down some of these concerns for moms-to-be.
“A lot of pregnant women are worried that if they test positive for COVID at the time of delivery that they will be separated from their baby, and that is just not true,” Dr. Neal said.
“We use the testing to help keep everyone who’s caring for them safe and to cluster patients when we can. It also helps us guide parents in how to take care of their newborn and how to decrease the chance that they will transmit the virus to their baby.”
Strategies for caring for baby if a new mom is positive for the coronavirus include wearing gloves and a mask, perhaps even avoiding skin-to-skin contact for the first few days and expressing breast milk.
“Those are the conversations that we have with new parents,” Dr. Neal said. “Patients have autonomy. Our job is not to make mandates and take babies away from moms. Our job is to really give parents the information they need to decide how they’re going to handle their child if they are positive (for the virus).”
It’s really about having a conversation, she said.
“The team is there to support you and give you all the right information. Things change rapidly, and our job is to help you make good decisions.”
IU Health continues to allow a support person or partner to be with a woman during labor and delivery, Dr. Neal said, despite visitor restrictions in place to prevent the spread of COVID-19. If a woman chooses to have a doula, that person is considered part of the care team, so the patient can still have a support person with her in addition to the doula.
Support persons and everyone on the care team are required to wear masks, but women do not have to wear masks while they are laboring.
As for the vaccine itself, Dr. Neal said that while pregnant women were not included in studies of the vaccine efficacy, there is no reason to believe it poses a risk.
IU Health, along with experts from the CDC, the Society for Maternal-Fetal Medicine and the American College of Obstetricians and Gynecologists, agrees that pregnant women should have access to the COVID-19 vaccine and recommends that those who are pregnant or breastfeeding consult with their physicians on the best course of action.
Pregnant women with COVID-19 have an increased risk of severe illness compared with those of reproductive age who are not pregnant, according to the CDC. For that reason, Dr. Neal is advising her patients that if they want to get the shot, “they absolutely should get it.”
The COVID-19 vaccines do not contain the virus so there is no risk of infecting a baby through breast milk. Because our bodies make antibodies to fight the infection, these same antibodies can pass into breast milk and on to the infant and might help prevent infections.
Again, IU Health recommends that women who are pregnant or breastfeeding consult with their physicians on the right course of action.
Dr. Lana Dbeibo, medical director of infection prevention at IU Health Methodist Hospital, is breastfeeding her infant son and did receive the COVID-19 vaccine.
“There is no COVID in that vaccine, and it has no potential to cause the actual illness,” she said. “I think when I look at the risk-benefit, it is safer for me getting the vaccine rather than not.”
While pregnant women are advised to take extra precautions to stay safe from the virus, including reducing exposure to those outside their household, the miracle of birth hasn’t changed, Dr. Neal said.
“I want to reassure pregnant women that there’s not a fundamental change in the way care is being delivered when they come in to have a baby. We are working hard to make their experience still magical and positive, and we will continue to do that.”