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What extra precautions should my OB-GYN and hospital take when I deliver?
Many hospitals have new policies to limit the spread of COVID-19. The Centers for Disease Control and Prevention recommend all health care facilities screen patients and visitors – pregnant or not – for fever and other symptoms of COVID-19 before entry. The CDC says pregnant women suspected of having COVID-19 or who develop COVID-19 symptoms should be prioritized for testing.
Guidelines from the American College of Obstetricians and Gynecologists and CDC also recommend restricting visitors in obstetric settings, in many cases to one support person. Ask your hospital if a doula or birth coach would be considered a support person or part of your labor and delivery care team.
While there is a shortage of personal protective equipment (PPE) in many health care settings, OB-GYNs caring for patients with COVID-19 are recommended to wear N95 respirator masks, or facemasks if respirators are not available; goggles, face shields or other eye protection; gloves; and a gown.
The Society for Maternal-Fetal Medicine and Society for Obstetric and Anesthesia and Perinatology Labor also say OB-GYNs should wear N95 respirators during procedures more likely to generate respiratory droplets through coughing such as cesarean deliveries, twin vaginal deliveries, management of postpartum hemorrhage and intubation.
Hospitals may also require patients and visitors to wear face masks during labor and delivery. However, this could be difficult for the laboring person while pushing. Infants and children under the age of 2 should not wear face masks.
What about pregnant women who work with the public?
Recommendations for pregnant people to stay healthy during the pandemic are similar to people who aren't pregnant. This means social distancing and trying to work remotely, when possible. There isn’t data to show if pregnant women are at higher risk for severe illness than non-pregnant people, and the CDC hasn’t released specific guidelines if pregnant women shouldn’t work in public-facing jobs during the pandemic. Local and state health departments may have different employment guidelines.
Pregnant employees should regularly clean frequently-touched surfaces and equipment, wash their hands and use hand sanitizer, keep six feet of distance between themselves and other employees and customers, wear an employer-provided face mask or cloth face covering and stay home when sick.
Because limited data show pregnant women are not at higher risk for severe disease to COVID-19, ACOG does not recommend against pregnant health care employees working with patients in person. However, if there is enough available staff, clinics and hospitals may want to limit pregnant workers’ interactions with patients who have or are suspected of having COVID-19, or in procedures more at risk for respiratory droplets to spread.
Moms and breast milk bank donors and recipients want to know: Is there COVID-19 in breast milk?
Studies are limited, but right now, ACOG and the CDC say no evidence of COVID-19 has been found in the breast milk of women infected with the virus. But it isn’t known for certain that the virus doesn’t spread through breast milk. There is concern, however, that infected new mothers could pass the virus to their infants during breastfeeding through respiratory droplets.
Because of the health benefits breastfeeding offers, ACOG and the CDC are not recommending against breastfeeding by new mothers with COVID-19. Instead, those women should wash their hands and wear a facemask while breastfeeding. New mothers with COVID-19 can also consider expressing milk using a breast pump and having a well person bottle feed the infant. All breastfeeding decisions should be made by a mother and health care provider.
This is a rapidly evolving story, and we recommend checking the websites of the Centers for Disease Control and Prevention or your state health department for the latest guidelines to stay healthy.
This story was produced by Side Effects Public Media, a public media collaboration covering health care. Side Effects, Indiana Public Broadcasting and WFYI are asking Americans about health issues, as part of the America Amplified: Election 2020 initiative. If you have a question, email firstname.lastname@example.org.
America Amplified, a public media initiative funded by the Corporation for Public Broadcasting, is using community engagement to inform and strengthen local, regional and national journalism. Follow on Twitter at @amplified2020.