pregnancy during pandemic

You Wanted to Get Pregnant—Then the Pandemic Hit. Now What?

Six OB/GYNs appraise the situation.

By: Bibi Deitz

Last year, there were a lot of think pieces floating around the internet about America’s declining fertility rate. After much hand-wringing and editorializing, some concluded that perhaps the reasons behind fewer pregnancies were complicated at best.

As The Atlantic put it, “Whatever’s going on, people decide not to have children, or to delay having them, for all sorts of reasons, not always because they’re not interested.” According to a survey of “healthy, egg-freezing women in the United States and Israel” from 2018, the number-one reason these ladies weren’t popping out babies just yet was not for lack of interest, but for “lack of a partner.”

Moreover, participants said there was a “massive undersupply” of college-educated men who are down to commit to things like marriage and kids. Well, amen to that, but in other news, this year we have bigger problems than a dearth of eligible bachelor(ette)s.

We’re not sure if you’ve checked the news lately, but there’s a pandemic swirling about, and the prospect of pregnancy might feel a bit daunting, even if you do have someone to shack up with or some other baby-producing arrangement that works for you.

So we spoke with six OB/GYNs to get their thoughts on baby making in the time of the coronavirus, as Márquez would put it.

 

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pregnancy during pandemic

If someone wanted to get pregnant right now, what would your advice be?

“If you’re under 35 and in good health, I’d suggest waiting a year. There is a lot in the works with treatments and vaccines, which could potentially make being pregnant safer for mom and baby.” —Dr. Felice Gersh, OB/GYN, founder and director of the Integrative Medical Group of Irvine and author of PCOS SOS Fertility Fast Track

“Talk to your OB/GYN about the risks of pregnancy due to COVID-19. Planning a pregnancy is a highly personal decision, and there are [many] factors that play into when a couple decides to conceive, including age, health risks, and professional and personal goals.” —Dr. Shweta Desai, OB/GYN and Love Wellness advisor

“Ensure that both partners have been tested for COVID. There are reports in the literature that COVID has been found in semen—and there’s a question as to the possibility of it being transmitted sexually.

“If there are any comorbid conditions, such as diabetes or hypertension, see a provider to ensure they are optimized, and take folic acid supplementation in the preconception period to decrease the incidence of fetal neural tube defects.

“Assess your vitamin D levels, and begin supplementation, particularly if you are a person of color—vitamin D is made in the skin in conjunction with sunlight, and people of color possess melanin, which blocks the production of vitamin D.

“Vitamin D is an essential vitamin that has a myriad number of functions in the body, boosts immunity, enhances bone metabolism in both mom and developing fetus, is good for mental and cardiovascular health, and, for pregnant women, may decrease their incidence of preterm birth.

“Observing guidelines for mask wearing, social distancing, and keeping hands clean is particularly important for pregnancy, when immunological competence declines. Eat foods which boost immune function—onions, garlic, turmeric, et cetera—and take your prenatal vitamins with Omega-3.” —Dr. Kecia Gaither, double board-certified in OB/GYN and maternal fetal medicine and director of perinatal services at NYC Health + Hospitals/Lincoln

“If you’re thinking of trying to get pregnant right now…don’t panic. I’d start by taking a good prenatal vitamin with at least 400 mcg of folate two to three months before [trying to get] pregnant. Being pregnant increases your risk of severe illness from COVID-19 compared to non-pregnant women, so it’s important to take precautions.

“Pregnant women’s immune systems are repressed, making them more vulnerable to infections. It’s recommended to limit your contact with people as much as possible to reduce exposure. You can also take steps to prevent getting and spreading COVID-19 by wearing a mask and practicing good hygiene when interacting with people.

“In addition to pregnancy, many underlying medical conditions such as diabetes, asthma, and obesity can possibly increase the severity of the disease if exposed. So before you get pregnant, make sure you are in the best possible health you can be. According to the Center for Disease Control (CDC), there’s no documentation of increased risk of miscarriage or fetal malformations in pregnant women who are infected with COVID-19.” —Dr. Jodie Horton, OB/GYN and chief wellness advisor for Love Wellness

“I would say that no one, not even your doctor, can make such an important decision for a woman. There are so many factors that go into the decision to become a parent that it’s impossible to know what any one woman and her partner may be considering.

“There are key questions that go into that decision-making process, including, age, fertility, pre-existing medical conditions, economic, geographical (living close to family or support), healthcare coverage, and career. Connecting the dots for any woman, for any one family, is complex.” —Dr. Jane van Dis, OB/GYN and medical director at Maven Clinic

“My advice is to go and get pregnant with the following precautions: Wash your hands frequently; wear a mask and other recommended PPE (if applicable) at work and in public; maintain physical distancing; and limit contact with other individuals as much as possible.

“Whether you’re pregnant or not, taking COVID precautions [is] essential. Also, it remains uncommon that COVID will affect the baby if you get the coronavirus.” —Dr. Zaher Merhi, OB/GYN and fertility expert at New Hope Fertility Center

 

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pregnancy during pandemic

What if a woman is in her thirties and feels the pressure of time?

“There’s a sense that at age 35, women’s fertility begins to fall off a cliff, but that isn’t the right image or metaphor. The change in fertility rates between, say, 34 and 38 are minimal.

“According to the American Society for Reproductive Medicine, women ages 27 to 34 have an 86 percent chance of conceiving in a year, and women ages 35 to 39 have an 82 percent chance of conceiving in one year. How many children you’d like to have matters as well.

“If a woman at age 35 tells me she would like to have three children, my answer would be: Yes, you should probably start on that journey now. Ideally, women, if they have a cesarean, should wait 18 months between pregnancies, and while three vaginal deliveries is ideal, leaving some wiggle room for unforeseen bumps on a fertility and pregnancy journey is just good planning.

“If a woman tells me she wants only one child, then that might change the pressure or calculus for how anxious she should feel. I understand the pressure of time, and I felt it poignantly myself, having had my twins at age 39. Reaching out for mental health support on this journey is also a great idea.” —Dr. Jane van Dis, OB/GYN and medical director at Maven Clinic

“Even in your thirties, my advice to you would be no different now than before the pandemic. I wouldn’t delay getting pregnant, but would [suggest that you] discuss your concerns with your doctor. Your prenatal care and delivery will look different, but the quality of the care won’t change.

“Pregnancy during a pandemic has changed what normal prenatal appointments, ultrasounds, and delivery look like. Many doctors’ offices are taking precautions to limit possible exposure. It’s possible that your partner may not be able to come to all your prenatal visits, including your ultrasounds.

Telehealth has become a popular option in many offices. In the age of technology, we can see low-risk, uncomplicated pregnant patients virtually by video or phone. When it’s time to deliver, one support person may be allowed to be with you during your hospital stay, as long as your COVID-19 test is negative. Every hospital is different, so it’s always best to check with your doctor to see the current rules on labor and delivery.” —Dr. Jodie Horton, OB/GYN and chief wellness advisor for Love Wellness

“If age is a major issue and you feel you can’t wait even a year, then get as healthy as you can and plan on socially isolating for the duration of the pregnancy and for months afterwards, depending on what happens with the pandemic.” —Dr. Felice Gersh, OB/GYN, founder and director of the Integrative Medical Group of Irvine and author of PCOS SOS Fertility Fast Track

“If someone is feeling the pressures of time, my advice would be to move forward with trying to conceive if you feel as though it’s the right time in your life.” —Dr. Shweta Desai, OB/GYN and Love Wellness advisor

What are the drawbacks of going through pregnancy at this time?

“The American College of Obstetricians and Gynecologists did release a statement in June with evidence suggesting that pregnant patients may be at increased risk for severe illness due to COVID-19, such as ICU admission and mechanical ventilation.

“They also went on to state that the overall risk of these clinical interventions remains low and that pregnant patients don’t appear to be at increased risk of death associated with COVID-19. So it’s important that pregnant patients take the appropriate precautions to prevent infection, particularly those who are at high risk of exposure.” —Dr. Shweta Desai, OB/GYN and Love Wellness advisor

“The biggest drawback right now is that, public-health-wise, we’re still in a state of flux, not knowing how long until a vaccine for COVID will be available to healthy, reproductive-age women. [On the plus side], most OB/GYN care is going smoothly, in the prenatal course and in the hospital. We know a lot more about the virus than we did in March or April.” —Dr. Jane van Dis, OB/GYN and medical director at Maven Clinic

“There are definitely risks to mom and baby with the coronavirus. There’s an increased risk of miscarriage, preterm labor, and other pregnancy complications. Pregnant women have become extremely ill, requiring intensive-care therapy.

“Pregnancy does modulate the immune system to prevent the mom’s immune system from attacking the fetus, and this can heighten her risk for a more severe case of COVID.” —Dr. Felice Gersh, OB/GYN, founder and director of the Integrative Medical Group of Irvine and author of PCOS SOS Fertility Fast Track

“Drawbacks are the inconvenience of going to the doctor’s office for your OB visits. And if you don’t drive, taking public transportation or a taxi could be stressful if not taking the right precautions. My advice is to wear a mask and gloves if you take any public transportation or a taxi.” —Dr. Zaher Merhi, OB/GYN and fertility expert at New Hope Fertility Center

 

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What are the benefits of being pregnant right now?

“Some pregnant women were able to find the silver lining while pregnant during a pandemic. Many women said they didn’t have to hide their growing belly and got to avoid unsolicited comments and advice while in quarantine.

“There were also fewer missed workdays from those suffering from nausea and vomiting, since many women are working from home. With flexible hours, women were able to adjust their schedules. Also, having a partner at home to help out was a bonus.

“Telehealth appointments were easier to schedule, and many women were happy about no longer having to wait long periods of time to see the doctor. One surprising benefit that many moms have talked about is the number of visitors allowed in the hospital.

“Having a baby can be overwhelming. New moms are exhausted and experiencing hormonal and body changes. They appreciated the quiet time to bond with their new baby without entertaining visitors in the hospital.” —Dr. Jodie Horton, OB/GYN and chief wellness advisor for Love Wellness

“Pregnancy is, fundamentally, an act of hope for the future, and I think having that sense of making room for a new life is powerful. Personally, I push through anxiety and fear that I sometimes have about the future in part because the next generation needs to see that sense of hope.” —Dr. Jane van Dis, OB/GYN and medical director at Maven Clinic

“A benefit to being pregnant right now is that if the timing is right for you and your reproductive timeline, then celebrate it! Congratulations, and don’t let the pandemic take away from the joy that is pregnancy.” —Dr. Shweta Desai, OB/GYN and Love Wellness advisor

“Working from home is now common, so getting pregnant and working from home could be a benefit. Additionally, staying at home usually means more homemade meals, which are much healthier for the pregnancy than eating in restaurants.” —Dr. Zaher Merhi, OB/GYN and fertility expert at New Hope Fertility Center

Anything in particular you would advise women to keep in mind if they do decide to go through with pursuing pregnancy right now?

“According to the American College of Obstetrics & Gynecology (ACOG), studies show that telehealth has provided similar health outcomes compared to traditional prenatal visits. The evidence suggests that the patient-physician relationship isn’t compromised, and there’s an improvement in patient engagement and satisfaction.

“So despite not having all your appointments be in-person, the quality of care you receive will still be the same.” —Dr. Jodie Horton, OB/GYN and chief wellness advisor for Love Wellness

“If you’re considering becoming pregnant right now, the most important thing you can do to prepare is to have a conversation with your OB/GYN so that you can be appropriately informed about the risks of pregnancy during this time.

“After that, it’s your reproductive choice, and you [would be] going into it with an informed decision. Personally, as an OB/GYN, I chose to become pregnant during the pandemic as it was the right time for me, and I’ve been exercising the appropriate precautions.

“I can’t wait to welcome my baby girl in December and strongly believe that every woman has the right to choose their own reproductive timeline, as long as they are making an informed decision.” —Dr. Shweta Desai, OB/GYN and Love Wellness advisor

“I’d recommend ideally getting in good shape, mentally and physically, before getting pregnant. Meet with your primary care doctor or OB/GYN to address any medical conditions you may have, like asthma, diabetes, high blood pressure, depression and anxiety, or obesity, in order to have the healthiest pregnancy possible. Making sure you have mental health support as well, I think, is key.” —Dr. Jane van Dis, OB/GYN and medical director at Maven Clinic

“Try to do as much telehealth as possible with your doctor. Go to the office only when it is necessary. [Keep in mind that] pregnant women with COVID are not at increased risk of death compared to non-pregnant women with COVID.

“If you have comorbidities such as obesity, diabetes, or hypertension, make sure you control those as much as possible before getting pregnant, because COVID in pregnant women with comorbidities can have more complications, such as ICU admission and the use of mechanical ventilation.” —Dr. Zaher Merhi, OB/GYN and fertility expert at New Hope Fertility Center

“Pregnancy unfortunately adds risk to having a coronavirus infection. If you get pregnant, even though you are young and healthy, the risk for a very serious outcome exists and is increased. Pregnancy complications are increased.

“Do all you can to avoid catching COVID while pregnant by staying healthy, getting restorative sleep, eating lots of vegetables and fruit, staying fit, and staying calm.” —Dr. Felice Gersh, OB/GYN, founder and director of the Integrative Medical Group of Irvine and author of PCOS SOS Fertility Fast Track

 

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