Are you currently pregnant during the COVID-19 coronavirus pandemic? It’s natural to feel concerned but please don’t get stressed out because you need to keep your immune system in tip top shape for the health of you and your baby. To help ease the fear, it is important to know what is coronavirus (COVID-19), what are the symptoms of coronavirus, effects of the coronavirus and pregnancy, how to manage the COVID-19 virus in pregnancy, breastfeeding recommendations, and ways to help prevent acquiring the coronavirus in pregnancy. If you want more information please listen to Pregnancy Pukeology Podcast Episode 33 Coronavirus and Pregnancy.
What Pregnant Women Need to Know about the Coronavirus
- Pregnant women do not appear to be more at risk for contracting coronavirus than the general population
- The COVID-19 virus does not pass to the baby during the pregnancy
- Pregnant women with suspected or confirmed coronavirus when they go into labor are being advised to be in an obstetric unit and a created birth plan with the OBGYN should be followed as closely as possible, but pre-term labor in a high percentage has been shown
- No evidence that the coronavirus can be carried in the breast milk so the benefits of breastfeeding with a mask outweigh the potential risk of transmission
What is Coronavirus COVID-19?
Coronaviruses (CoV) are a large family of viruses that are transmitted between animals (such as civet cats and dromedary camels) and humans. Some of the reported coronaviruses illness include Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).
Currently, there is an outbreak of a new coronavirus strain that has never been encountered before called COVID-19. This acronym COVID-19 is short for coronavirus disease 2019, which was the year it was first recorded. The word coronavirus should not be capitalized unless used in a heading or if abbreviated to COVID-19, and all the acronyms should be capitalized according to the Centers for Disease Control and Prevention (CDC). Both SARS and MERS are coronavirus strains that the world has encountered before, and can be thought of as distant cousins to COVID-19.
Coronavirus According to the Johns Hopkins University Center for Systems Science and Engineering, the global death toll due to COVID-19 was 5,547, while more than 148,930 people have been infected in more than 80 countries, as of 03/14/2020. Over 73,710 coronavirus cases have recovered. In the United States alone, there have been over 2,340 cases, doubling the number of cases daily to 93 new cases today, with a death toll of 50 here in our country. The majority of the cases and deaths are in China where the outbreak started with 3,189 total deaths recorded.
COVID-19 is a lower respiratory tract infection meaning that the symptoms are felt in the chest and lungs. The common cold is an upper respiratory tract infection showing sines of runny nose and sinus congestion that are not present in patients with the corona virus. It is easy to identify someone suspected to have coronavirus illness. They present with respiratory and other symptoms including:
- Fever - 88%
- Dry Cough - 68%
- Fatigue - 38%
- Shortness of breath - 19%
- Sore throat - 14%
- Headache - 14%
- Chills - 11%
- Nausea or vomiting - 5%
- Stuffy nose - 5%
- And have a history of travel or exposure to the coronavirus
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According to the CDC it takes about 2-14 days to show signs of the virus after you’ve been exposed. Most people are infected via respiratory droplets from close contact with someone who already has the coronavirus. In more severe cases, the infection can cause pneumonia, severe acute respiratory syndrome, kidney failure, and even death.
Not all who get infected will die. How soon you will recover if infected depends on how strong your immunity is. Those who are obese, or have low immunity (such as children and the elderly) have been reported to develop more serious sequelae and are likely to die from coronavirus infection.
Para todos los mujeres que hablan espanol, aqui son las sintomas de COVID-19, alergias, resfriado, y gripo.
Can you get Coronavirus twice?
Most people infected with the coronavirus globally have had mild viral symptoms and have recovered according to the World Health Organization (WHO). Those individuals infected with COVID-19 have developed protective antibodies but it isn’t clear how long this protective mechanism lasts. The cases who’ve acquired pneumonia as a result of the COVID-19 can get pneumonia again, and from a respiratory perspective can be more severe if the immunity is already compromised or is battling something else. Interestingly enough the University of Texas Medical School found that “children develop some short-term immunity”, but just like the flu can mutate which can make anyone susceptible for reacquiring the infection.
Effects of Coronavirus Infection on Pregnant Women
Pregnancy comes with a lot of challenges. Usually, you will experience both immunologic and physiological changes while pregnant. These changes make you more susceptible to viral respiratory infections such as COVID-19. But there is no scientific evidence that shows whether pregnancy makes you more susceptible to coronavirus as compared to the general population, but by nature of pregnancy you are already immune-compromised.
Coronaviruses infection makes you experience fevers. A high fever during the first three months of your pregnancy may increase the risks of certain birth defects. Other adverse pregnancy outcomes that have been reported with SARS-CoV and MERS-CoV include miscarriage and stillbirth. With COVID-19, no adverse pregnancy outcomes have been reported.
Pregnancy Alters the Immune System
A pregnant woman’s immune system is at a heightened state between the first 12 weeks of pregnancy. In order to become pregnant the embryo must successfully implant by the mothers flooding the mother’s immune cells into the lining of the uterus (womb) which causes inflammation and makes it sticky so the fertilized egg will hold onto the wall. Organogensis, a big word for the development of the babies vital organs, happens between the first 8 to 12 weeks of pregnancy.
The mother’s immune system after the next 15 weeks is repressed, or decreased, in order to allow the babies cells to grow and develop properly. A mom’s immune system has to relax because some of the babies cells have antigens from the dad and would be at risk for an attack by the mom if her immune system was running at full speed.
The mom’s immune system kicks back into hyper-drive for delivery as the inflammation response helps with labor and the more antibodies made by the mother, the more the baby receives via breast milk after they come into the world. Breastfeeding mothers, it is important to feed every 2 hours, because that is the length of time that the antibodies you provide after breastfeeding wear off.
Transmission during Pregnancy or Delivery
Current studies show that pregnant mother’s do not transmit the COVID-19 during pregnancy or delivery. This is an area that needs more research. Some peer-reviewed literature from 18 relevant studies has shown that mother to child transmission of coronavirus does not occur. Nineteen women with COVID-19 delivered 20 babies of these 19 women, 3 (16%) were asymptomatic (did not have symptoms), 1 (5%) admitted to the ICU, and no maternal death has been reported. Fifteen babies who were tested showed no evidence of vertical transmission (from mother to baby during the pregnancy or delivery) as the method of delivery was split 17 by caesarean and 2 by vaginal delivery. It is important to note that 42% of the women hospitalized with COVID-19 had pre-term delivery and only one neonatal death was recorded. No virus has been detected in amniotic fluid samples. So you will not pass the infection to your child while pregnant, during and after delivery. Inhaling respiratory droplets from a person infected with coronavirus remains to be the main route of spread of this infection.
Although infants born to mothers positive to coronavirus during pregnancy may have poor outcomes like prematurity syndrome, it is not clear whether these outcomes are directly associated with coronavirus infection. Besides, the long term health effects on infants born to mothers positive to coronavirus infection have not been shown.
Transmission through Breast Milk
No viruses have been detected in the breast milk of mothers positive to coronavirus. It is therefore not possible to transmit the infection to your baby while breastfeeding. Human to human transmission of coronavirus is by close contact through respiratory droplets. If you are infected with coronavirus and you cough or sneeze while breastfeeding, you put your baby at a high risk of contracting the disease.
Standard Recommendations to Prevent Infection Spread
It is recommended that you take the precautions everyone is taking if you are pregnant. The flu vaccine is also necessary if pregnant. The vaccine will not protect you against coronavirus but will boost your immunity and reduce your chances of getting the flu.
If infected while still breastfeeding always wear a mask while breastfeeding. Alternatively, express the milk to feed your baby. Remember, coronavirus has not been detected in breast milk hence there are very low chances of transmitting the virus through breast milk to your baby. If you and your baby test positive to the virus, you should be quarantined together rather than being separated.
Many schools have been closed until the end of the month, so make sure you have a plan. The following states have closed all schools: Ohio, Maryland, Oregon, New Mexico, Michigan, West Virginia, Virginia, Louisiana, Illinois, Wisconsin, Washington, and Alabama. Major cities including Atlanta, Denver, San Francisco, San Diego, Washington DC, Austin, Miami, and Tampa have all also chosen to close and have passed thru the state to remove the 180 day requirement by schools.
Get all necessary lessons from your kids teachers, get a neighborhood app so you can share updates with neighbors, and have a plan if you have a job that cannot be done remotely. Be smart and don’t expose yourself. Think of you and the safety of your unborn child, it is really not worth the spring break cruise.
Get your Household Ready for COVID-19
- Regular hand washing (scrub hand and under nails for at least 20 seconds: sing happy birthday song to make sure it’s been long enough)
- Use hand sanitizer that has at least 60% alcohol, but it is no substitute for hand washing
- Covering your mouth and nose when coughing and sneezing (use the vampire cough technique where you cough into your elbow crease)
- Immediately dispose of any body fluids in toilet paper or tissues and wash your hands immediately after
- Don’t go to work if currently sick
- Clean frequently touched surfaces (tables, countertops, light switches, doorknobs, and cabinet handles) with a detergent and water THEN apply disinfecting products. A list of Environmental Protection Agency (EPA) approved products that actually work on coronavirus has been provided by the American Chemistry Councial Center for Biocide Chemistries (CBC).
- Avoid large crowds like sporting events, airports, cruises, ect
- Avoid close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing.
- Avoid unnecessary travel especially to regions or countries where outbreaks have been reported.
- Get lots of sleep, between 8-9 hours
- Keep stress levels LOW because the stress hormone cortisol actually lowers your immune system
- Eat plant based diet full of colorful vegetables, fruits, and high fiber foods that build your gut flora and naturally increases vitamin/minerals and immune function
(for a list of What you Should be Eating during Pregnancy click Pregnancy Pukeology Podcast Episode 16 and the doctor will tell you all about it)
- Thoroughly cook meat and eggs
(for more information on what NOT to eat during pregnancy listen to Pregnancy Pukeology Podcast Episode 5)
ReferencesA special thanks to epidemiologists, health professionals, and members of congress from the National Institute of Health (NIH) and CDC with whom I had extensive meetings with.