COVID-19 Pregnancy Advice by a Gynecologist

Are Pregnant Women More Susceptible to COVID-19?

SARS-CoV-2, the virus that causes the disease COVID-19, can affect anyone, including pregnant and postpartum women.

We are still learning many things about SARS-CoV-2, so information about how this virus affects the pregnant or postpartum woman, and not to mention newborns, is pretty limited.

Although childbearing women are assumed to be just as susceptible to SARS-CoV-2 as the general population, they may be at increased risk of worse outcomes if they do develop COVID-19 on account of certain pregnancy-related changes such as decreased air reserve in the lungs and risk of blood clots.

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Is There a Drop in Immunity During Pregnancy?

The short answer to this question is “NO!”

Emerging research has proven that the immune system in pregnancy is actually quite complex. The developing immune system of the fetus and the placenta also play a big role in how a woman’s body responds to viruses and bacteria. (1)

Depending on which trimester of pregnancy a woman is in, her immune system may respond differently to bacteria or viruses such as SARS-CoV-2.

Hospitals in some communities are universally testing all pregnant women for COVID-19, with nearly 20%–40% of them turning out positive. However, more than 80% of these mothers with COVID-19 were either asymptomatic or had mild symptoms.

This may be linked to the complex and efficient functioning of the pregnant woman’s immunity along with the fetal-placental immune complex.

We are now learning that the pregnant woman’s immune system is working synergistically with the immunity produced by the placenta and baby to form a sort of “super immunity.” Thus, researchers conclude that it is much more likely that the immune system during pregnancy is changed and enhanced, versus suppressed. (2)

What Are Some Safe Ways to Boost the Immune System While Pregnant?

Immune boosters are agents that can help boost the immune system’s response to infection and can include certain foods, vitamin or mineral supplements, herbs, and even exercises.

• I always recommend that my patients eat a very balanced diet with real food, especially plenty of fruits and vegetables, which are chock-full of vitamins and minerals that help boost immunity and improve health overall.
• For best results, childbearing women should get 30 minutes of moderate exercise most days per week, at the level that they are used to. (3) Women who lifted weights or did yoga before getting pregnant can continue the exercises that their body is used to, but those who are new to working out should build their stamina gradually and start with low-impact exercises, such as stretching, walking, or swimming. In any case, every pregnant woman must consult her OB-GYN before starting her fitness journey regardless of her exercise history.
• Other naturopathic “immune boosters” can help during pregnancy, such as supplements, essential oils, and essential oil blends with clove, orange, cinnamon bark, eucalyptus, and rosemary in a diffuser. However, since each woman’s pregnancy and health condition is unique, something that works for you may not work for someone else. Always consult your doctor before starting any such intervention to avoid any safety risks.

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How Can the Baby Be Protected From the Coronavirus During Pregnancy?

Many viruses have a hard time breaking through the maternal-placental-fetal immunity “super team” that I speak of above, but there are some viruses that have been found to pass from mother to baby.

While we are learning more and more about SARS-CoV-2 each day, so far, there have been no reports of babies being born with the virus even if the mother tested positive. (4)

The placenta may block the entry of the virus into the womb, but babies can contract the infection from their mothers shortly after birth. (5)

Many hospitals are practicing mandatory “mother-baby social distancing” to keep that from happening:

• Keeping babies of infected mothers in the nursery if there is space available, or placing the bassinet at least 6 feet away from the mother, preferably with a physical barrier between them such as a curtain.
• Strictly limiting visitors to the maternity and newborn care units. Many hospitals have limited visitors to one designated support person (the same person supports during the entire hospital stay). In some extreme, rare, cases, hospitals have implemented a “no visitor” policy on their maternity ward. There is much debate about visitor and infant separation protocols throughout the medical community. Personally, while I understand the importance of protecting newborns with fragile immunity, I also think it is very important for birthing people to have support. I am allowing one designated visitor.

What Foods Should a Pregnant Woman Eat to Build Her Immunity?

Here are some examples of foods that help boost the immune system and promote health:

What Exercise and Sleep Routine Is Recommended for Pregnant Women?

• Exercise well: 30 minutes of moderate exercise most days (at least 4 days) per week has been proven to improve overall health, especially heart and lung health. In pregnancy, I recommend exercising at the level your body was used to before being pregnant. For example, if you were walking 2 miles a day before you became pregnant, you can safely continue doing so. In addition, swimming, yoga, and dancing are great options for pregnant women at any fitness level.
• Keep sleep in check: Inadequate sleep compromises your body’s ability to repair and defend itself. Thus, getting at least 6–8 hours of sleep every day is essential for optimal health and immunity, more so during pregnancy when you are carrying another life inside you. Most pregnant women encounter sleep problems during the late second and third trimesters and are advised to seek their doctor’s help if these become a constant issue. I often recommend Sleepy Time Tea with chamomile and valerian, warm baths with Epsom salt and lavender, and online sleep stories or meditations. If these are not successful alone, I often add Benadryl or Unisom before bedtime. Both medications are safe to take during pregnancy.

How Can a Woman Prepare for a Doctor or Hospital Visits During Pregnancy?

Hospital or clinic policies about visitors, appointment availability, and ability to schedule certain surgeries may be laxer in areas with fewer COVID-19 outbreaks than in areas that are harder hit.

Nearly every hospital has temporarily disallowed visitors except for one designated visitor on the maternity floor. Most clinics are allowing limited or no visitors in the office for prenatal care.

Here’s what you can do:

• Prepare by calling ahead to find out your doctor’s office or hospital policy on visitors.
• If you have other children, make sure you arrange childcare before your appointment or hospital stay. Children under 18 have not been allowed in most offices or hospitals unless they are being seen by the doctor. Also, be prepared for the real possibility that children may not be allowed to visit while you are in the hospital.
• Choose one designated labor support person. Make sure you also have a backup support person on standby just in case your original support person becomes ill or is screened upon entry to the hospital and is found to have a fever or other COVID-19 risk factors and is unable to accompany you.
• Be prepared to have a nasal swab and be tested for COVID-19 – many labor and delivery units are moving toward rapid testing for every mom. You may also be asked to wear a mask.

Can a Mother Positive for COVID-19 Pass the Infection to Her Unborn Child?

Based on the limited data we have, it does not appear that this coronavirus is transmitted from mother to baby in the womb.

However, it is very important to make sure mothers are not potentially transmitting the virus after giving birth. That is why social distancing is so important, even if it means distancing yourself from your baby if you have the virus.

Being away from your baby for a few days is definitely painful, but certainly less painful than being away from them forever!

Can Breast Milk Help Shield Infants From the Coronavirus?

Yes! The antibodies, or proteins that fight infection are passed to newborns in breast milk. Breastfeeding is still definitely recommended. (6)

If a mother has tested positive for the coronavirus, it is important that she washes her hands, neck, and chest with soap and water or a skin-safe disinfectant before breastfeeding. She should also wear a mask while feeding her baby.

If she is continuously coughing or sneezing, it is safer to have the baby stay at a safe distance away and hand express or pump milk and feed the newborn using a bottle. Breast milk is always best!

What Home Remedies Can Lower the Risk of COVID-19?

• The best “home remedy” for lowering the risk of developing COVID-19 is social distancing as much as possible and frequent hand-washing with soap and water for at least 20–30 seconds (sing the “happy birthday” song through twice to help you keep track of the time).
• Avoid touching your face unless you have thoroughly washed your hands.
• Drink something warm daily, such as black, white, or green tea. I usually add clove, cinnamon, and orange to my tea.
• Sanitizing every frequently touched surface, such as doorknobs, fridge handles, countertops, and your phone, at least once per day (sanitize more frequently if you have guests) has also been shown to help prevent the spread of the virus.