Lives impacted: Pregnancy in the age of COVID-19

This special article series features the perspective of patients who are pregnant during the COVID-19 pandemic and steps they are taking to ensure their safety and the safety of their babies. This is the first story in the series.

Jessica Iwasyk is a first-time expectant mother from Malvern, Ohio, whose daughter is due by May 30. Ms. Iwasyk, 42, shared her experiences with how COVID-19 has impacted her life.

Taking precautions
Her main concern is that she will contract COVID-19 and that her daughter will contract it after birth. “I am 42 years old,” she said, “and I have been a little nervous during my pregnancy that I will lose the baby or lose my life.” She reflects back to a childhood memory in which a friend’s sister died during childbirth, something that has stuck with her. “When I finally felt that I was in a safe zone, there is a new and much worse threat to both of our health. For this reason, I am staying away from people as much as possible. My husband works at a hospital, so he is using extra precautions to not carry the coronavirus home.”

Because Ms. Iwasyk is a first-time mother, she was planning on taking the Prepared Childbirth class at the hospital where she will deliver. The class was supposed to meet for 2 hours per week for 4 weeks. “But instead I am reading books at home to help me plan and prepare,” she said.

Her doctor’s office has made changes including taking patients’ temperature outside of the office before they can enter. They also have to fill out a small form indicating whether they have traveled out of the country or state. No longer can patients bring anyone else to prenatal appointments. “My husband is not allowed to attend doctor’s visits with me anymore,” said Ms. Iwasyk. 

“I think these measures are effective to keep the coronavirus from spreading to patients and the health care workers. I will understand but I will also be disappointed and nervous next month if my husband cannot attend my last two scheduled ultrasounds,” she said.

Ms. Iwasyk’s husband works at the hospital where she will deliver. Their understanding is that one support person will be permitted in the delivery room and that same support person will be the only one allowed to visit during the duration of her stay at the hospital.

COVID-19 risk for pregnant patients
On April 6, The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) issued a joint statement acknowledging that the Centers for Disease Control and Prevention (CDC) recently removed pregnant people from their webpage that outlines “people who are at higher risk for severe illness” from COVID-19. Consistent with available data, the CDC continues to recognize that pregnant women have been at  risk for severe illness, morbidity, or mortality compared with the general population in other related coronavirus infections (including severe acute respiratory syndrome coronavirus (SARS-CoV). ACOG and SMFM said that the CDC’s current guidance regarding COVID-19 and pregnancy is based on limited data, which, at this point, does not indicate that pregnancy alone puts people at higher risk for severe illness resulting from COVID-19 infection. Limited data, compounded by testing shortages throughout the country, make it difficult to understand the total number of cases and full import of COVID-19 on patient populations, including pregnant patients. Reliable data and testing are needed to make informed recommendations that will have a positive impact during this profound public health crisis.