8 Questions to Ask Your Doctor if You Are Pregnant During the Pandemic
My first prenatal appointment took place in mid-March 2020. My husband and I took public transportation from our home in New York City to my OB-GYN's office. We sat together in the doctor's office waiting area and both got to be in the room when the ultrasound technician confirmed that I was, indeed, pregnant: six weeks along!
Within a week of that appointment, everything around us changed because of the COVID-19 pandemic. The city all but shut down and we both began to work from home indefinitely. My next appointment, which was scheduled for two weeks later to help the doctor determine my estimated due date, was one I would have to go to alone. Partners were no longer allowed in the doctor's office.
I had a million questions swirling through my head for my doctor: What if I caught COVID-19? What if I started bleeding—could I go to the ER during the pandemic? What would my appointments look like moving forward? As the pandemic went on, new questions came to mind as hospital policies changed and infection counts peaked and started to come down in my state.
Though most states are in various phases of re-opening, we are far from out of the woods on the impact of COVID-19. If you are newly pregnant, you might not even know what questions to ask yet and if you are close to delivering, you probably have a ton of questions like I do. I spoke to several OB-GYNs to find out what questions we should be asking at our next appointment, whether it's on video chat or in person.
1. Does COVID-19 cause birth defects?
This is the million-dollar question, says Laura Riley, M.D., professor and obstetrician and gynecologist-in-chief at NewYork Presbyterian/Weill Cornell Medical Center and Parents advisor. The answer should help relieve your concerns. While there is not currently enough data from the COVID-19 pandemic to confirm this for sure, Dr. Riley says "we have not seen that in the people who were infected and have delivered."
2. What is the hospital's policy around COVID-19 testing?
This is an important question because every hospital has a different policy, and that policy can change week to week based on positive test numbers in the area, explains Dr. Riley. At NewYork Presbyterian/Weill Cornell Medical Center, for example, a diagnostic test is performed using a nasal swab on every person entering the labor and delivery floor. "We want to see if you are infected at the time of delivery to inform us of precautions we need to take for you such as isolating baby and testing baby," says Dr. Riley. "And we would wear a lot more personal protective equipment (PPE)."
3. Will the hospital separate me from my baby if I test positive?
This is another question that is hospital-dependent, so it's smart to ask. Dr. Riley's hospital does not isolate the baby from COVID-positive parents. Instead, they keep the baby in an isolette incubator, but still encourage breastfeeding, even if the mother is positive.
4. Will I have mostly telehealth appointments during my prenatal care?
Personally, I have been able to see my doctor in-person for all of my appointments, even if they did not include an ultrasound scan. Dr. Riley says this is likely because my doctor is in the suburbs and I can drive to my appointments. She sees patients in Manhattan, and out of concern for having them get on public transportation to meet her, she has been seeing patients through video chat and plans to continue to do so moving forward.
Jessica Shepherd, M.D., an OB-GYN and women's health expert who practices at the University of Illinois at Chicago, agrees that telehealth will soon become a major part of the health care system. "Telehealth has made great strides during the last few months and allowed medical care to be addressed in amazingly unconventional ways," says Dr. Shepherd. "The care provided can range from remote monitoring for blood pressure, glucose control, and asthma symptoms, and follow up visits to limit exposure for patients that are high risk or are at high risk for contracting COVID-19."
5. How do I make the most of these telehealth appointments?
Many of the questions you have for your doctor can be answered during your telehealth appointment, assures Alan Lindemann, M.D., an obstetrician and maternal mortality expert. Overall, he adds, the pandemic should make no difference in how often a pregnant woman sees her obstetrician. He suggests investing in specific equipment throughout your pregnancy so you have all you need to report the symptoms physicians look for in-person with COVID-19.
"I believe it is very important for pregnant women to be able to take their own blood pressure, measure their own oxygen stats, and of course, their own temperature," says Dr. Lindemann. "He recommends pregnant women purchase a good thermometer, even non-digital. A pulse oximeter to measure oxygen in a fingertip is about $80. A blood pressure cuff can be the wrist type, although some people believe the most consistent readings come from those with a cuff to be wrapped around the upper arm."
6. Should I do anything different to protect myself from COVID-19 while pregnant?
"We suggest that moms continue to do everything they have been doing to keep themselves uninfected such as wearing masks, social distancing, and washing hands," says Dr. Riley. "When your baby comes home, minimize visitors. But recognize this means you might be by yourself—just you and your partner."
7. What birthing or parenting classes are available right now?
While some hospitals are starting to offer in-person classes as states and cities begin to re-open, many classes are available to watch online. The Motherhood Center of New York offers virtual pregnancy support groups during the pandemic, and your doctor's office might even have videos on pregnancy and birth available online.
According to Dr. Shepherd, several hospitals have put information on their websites to direct patients to the virtual classes. "Labor and delivery wards also know where to find class information as well as midwife and doula sites," she says. "For fitness, there are classes online—for example, The Bloom Method has a complete online library of classes for women during pregnancy and postpartum."
Dr. Lindemann also suggests speaking to your friends, or anyone you know who gave birth who could share their experience with you. These conversations could help you learn what to expect even better than a class would.
8. Should I consider a home birth or delivery at an alternate location to my hospital?
Home births have definitely become a hot topic during this time, says Dr. Shepherd. "The conversations should be the same to those prior to COVID-19 and include a medical consult with an OB-GYN before considering a home birth," she adds.
Dr. Shepherd wants all pregnant people considering a home birth or alternative delivery options to ask questions that will help open communication and address any concerns. If you are considering delivering with a midwife, Dr. Shepherd suggests asking them how long they have been in practice, and what their formal training and certification looks like.
It's also important to find out what hospital or doctor they partner with and if they have a backup plan if a hospital visit is needed during delivery. "While some hospitals employ midwives to assist with their birthing center, most obstetricians employed by a hospital can be relatively intolerant of home births with a midwife," says Dr. Lindemann. "This is why it is so important to establish with the midwife that she has a good working relationship with a physician."