What does it take to have a healthy pregnancy in the era of COVID-19? Answer: lots of information, preparation and a good dose of common sense.
If you’re planning a baby in the near future, know this: pregnant women are now considered an at-risk group for coronavirus complications. Based on what is known at this time, pregnancy appears to pose an increased risk for severe illness from COVID-19, according to the Centers for Disease Control and Prevention (CDC).1
But you can protect yourself. By now you’ve likely memorized the CDC’s recommendations for avoiding COVID-19 infection, but they’re especially important during pregnancy:2
- Stay home. As much as possible, limit interactions with people you don’t live with.
- Wear a mask if you go out.
- Maintain 6 feet between yourself and others.
- Avoid touching your face, eyes, nose and mouth.
- Wash your hands frequently or use a hand sanitizer.
- Clean and disinfect frequently touched surfaces daily.
- Monitor your health; call your doctor if you have symptoms.3
Protect yourself from influenza and other viruses.
I know COVID-19 avoidance is front and center right now, but it’s not the only virus that poses risks to a pregnant mom and her baby. The CDC says pregnant women should get an influenza shot (but not the nasal spray flu vaccine).4 That’s because a flu shot given during pregnancy helps protect both mom and baby from infection. Also, according to the CDC, vaccination has been shown to reduce the risk of flu-associated acute respiratory infection in pregnant women by about one-half. As always, check with your doctor to see if a flu shot is right for you during pregnancy.
In addition to avoiding infection from coronavirus and influenza, pregnant women should avoid people who have chicken pox and shingles, and protect themselves from genital herpes. The risk of passing genital herpes to the unborn baby is high (30% to 50%) when a woman is newly infected late in pregnancy. Women with an older herpes infection have antibodies against the virus, which help protect the baby. If you are pregnant and think you may have been exposed to any virus recently, tell your doctor right away.
Not pregnant yet? Consider a pre-conception checkup.
It may seem obvious, but in case it isn’t, it’s a good idea to establish a relationship with a healthcare provider before getting pregnant. Getting annual preventive screenings and exams can reveal undiagnosed conditions in their earlier and more treatable stages.
Medical experts are recommending a pre-conception doctor’s appointment with a gynecological exam and a discussion of how to manage pre-existing conditions before and during pregnancy.5 One of my friends had a preconception pap smear exam, which revealed precancerous cells on her cervix that could have led to full-blown cervical cancer. She delayed conception for six months while she received treatment and went on to enjoy a healthy pregnancy.
Other pre-pregnancy actions to consider:
- Seek genetic counseling for inherited diseases. If cystic fibrosis, Tay-Sachs, sickle cell or other inherited diseases run in your or your partner’s family, consider screening tests to assess the risk of passing the condition to a baby.
- Get a dental exam. It seems strange, but gum disease is linked to early birth and low birth weight. Research suggests that the bacteria that cause gum inflammation can actually get into the bloodstream and target the baby.6
- Quit smoking, vaping and drinking alcohol. Tobacco, nicotine and alcohol during pregnancy can impact a baby’s growth. Fetal alcohol syndrome, which occurs when the mom abuses alcohol, causes brain damage and growth problems. The impact of fetal alcohol syndrome can vary from child to child, but the defects it causes aren’t reversible.7
- Cut back on caffeine. Consuming up to 250 milligrams of caffeine or each day (the equivalent to two cups of coffee or five cans of soda), could make it harder for to conceive and raise the chances of miscarriage.
- Cut out junk food. It’s a paradox that empty calories found in chips, cookies and other junk foods are fattening. The pregnant body and growing fetus need fruit, vegetables, lean protein and whole grains for optimal health. A healthy diet can make it less likely to get gestational diabetes, which causes high blood sugar in pregnant women. (In a minute I’ll talk about the benefits of a Mediterranean diet during pregnancy).
- Shed extra weight. In additional to triggering gestational diabetes, excessive weight can lead to high blood pressure and a potentially dangerous condition in pregnancy called preeclampsia. The condition can cause kidney and liver damage, blood clots, and even death to the mother and baby.
- Get vaccinated. In addition to the flu vaccine I mentioned earlier, the CDC recommends getting the whooping cough vaccine during pregnancy to provide immunity to the baby during the first few months of life.8 (You probably have questions about the appropriateness of getting vaccines during pregnancy, so ask your doctor what’s right for you).
- Watch seafood intake. Although the mercury in seafood isn’t a concern for most adults, precautions apply if you’re pregnant or planning to become pregnant. If you regularly eat fish high in mercury (such as swordfish, tilefish, king mackerel and shark) be aware that it can accumulate in your bloodstream over time. High levels of mercury could damage your baby’s developing brain and nervous system.9
- Talk to your doc about prescribed medications, vitamins and herbal remedies. Prescriptions, over-the-counter pain relievers, vitamins and herbs all can affect the unborn baby. Provide your doctor with a list of everything you take. Many healthcare providers recommend taking a prenatal vitamin or folic acid supplement to lower the risk of birth defects, and starting the vitamin regimen prior to conception. Folic acid is a B vitamin that is critical in preventing severe birth defects in the spinal column and brain.10
Avoid dieting during pregnancy, but…
Consider the results of a recent clinical trial,11 which found that pregnant women who followed a Mediterranean-type diet (but minus the wine) were 35% less likely to develop gestational diabetes. (See the link to the research in footnote No. 11). On average, research participants gained 2.75 pounds less when compared to women who received standard prenatal care. The Mediterranean eating plan includes:
- Daily consumption of vegetables, fruits, whole grains and healthy fats (like olive oil and tree nuts)
- Weekly intake of fish, poultry, beans and eggs
- Moderate portions of dairy products
- Limited intake of red meat
You love your pet kitty, but…
Women who are pregnant should avoid changing kitty litter and contact with cat feces. Feline feces can contain the toxoplasma gondii parasite, one of the world’s most common parasites. Infection usually occurs by eating undercooked contaminated meat, exposure from infected cat feces, or mother-to-child transmission during pregnancy.12 The parasite causes toxoplasmosis, which can trigger stillbirth or harm an unborn baby. If it’s impossible to hand off litter duty to someone else, wear gloves and wash hands thoroughly when you’re done scooping the box. Consider having Fluffy tested for toxoplasmosis to put your mind at ease.
Also wear gloves when gardening and handling uncooked meat. During the COVID-19 pandemic, you’re probably scrubbing your kitchen counters anyway. But it bears repeating: after preparing raw chicken or beef for cooking, sanitize kitchen surfaces and wash your hands, even after removing gloves.
Are in-office doctor visits safe?
Pre-pregnancy and prenatal care can help prevent complications and inform women about important steps they can take to protect their infant and ensure a healthy pregnancy. With regular prenatal care women can reduce the risk of pregnancy complications.13 But it can be scary to think about sitting in a doctor’s waiting room when COVID-19 is spreading throughout much of the country. Ask your doctor’s office if they offer telehealth visits. My husband just had his annual checkup via Facetime on his iPhone and found it to be easy and less nerve-wracking than an in-person visit.
Likewise, ask your healthcare provider about the availability of online pre-natal, childbirth preparation, newborn care and breastfeeding classes.
What about giving birth in a hospital during the pandemic?
You should expect that your hospital will minimize the number of visitors, especially if you live in a COVID-19 hot zone. Many have rules to make sure that anyone who needs to evaluated for coronavirus are isolated from other patients, including pregnant women and newborns.
Hospitals are taking precautions to minimize exposure to the coronavirus. Example: it may be possible to go home sooner than you normally would after the birth, as long as you feel well and experienced no complications. Ask your doctor if this is an option for you and your baby.
It’s a weird and trying time, to be sure. If you’re planning to have a baby in the next year or so, you’ll likely face more challenges than in the ancient time of 2019. But with the help of your medical team (and armed with accurate advice) you can have a healthy pregnancy.
2CDC, “How to Protect Yourself & Others”
3CDC, “What to Do if You are Sick”
4CDC, “Flu Vaccine Safety and Pregnancy”
5WebMD, “Your Pre-Pregnancy Checklist”
6National Institutes of Health, “Periodontitis: a Risk for Premature Labor and Low Birthweight Babies”
7Mayo Clinic, “Fetal Alcohol Syndrome”
8CDC, “Protect Mom and Baby with Vaccines”
9Mayo Clinic, “Pregnancy and Fish: What’s Safe to Eat?”
10CDC, “Folic Acid”
11ScienceDaily, “Mediterranean Diet During Pregnancy Reduces Gestational Diabetes and Weight Gain”
12Mayo Clinic, “Toxoplasmosis”
13National Institutes of Health, “What Is Prenatal Care And Why Is It Important?”