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Pausing Pregnancy Plans During A Pandemic

An expert offers questions to consider before conceiving during COVID-19.
An expert offers questions to consider before conceiving during COVID-19. Photo Credit: Northwell Health

Dear Doctor,

My partner and I were planning to start trying for a baby this year—but then COVID-19 hit. Now, instead of excitement at the thought of growing our family, I find myself worrying about all of the uncertainties. Do you think it’s still safe to try and get pregnant right now?


“Pondering Parenthood”

Dear Pondering:

There's no right or wrong when it comes to family planning (even during a pandemic). It’s all about what works for you and your partner. COVID-19 has affected everyone in certain ways, and there have been different physical, emotional, and financial implications, so it’s hard to generalize what the right answer for family planning may be.

The good news: We have learned so much about COVID-19 in the past few months, including how it may impact pregnant women.

For example, since pregnancy is a period when your body lets its immune defenses down to essentially allow a stranger (the fetus!) to grow within mom’s body, we were initially worried that this immunocompromised state could cause moms to get sicker from the virus.

As it turns out, pregnant women are not at a higher risk of death from coronavirus compared with non-pregnant women. Early studies in the U.S. reported that most pregnant women with COVID-19 (about 85%) only reported mild symptoms, if any. About 10% had more severe symptoms requiring hospitalization, and less than 4% were critical enough to threaten a mother's life. More recent reports from the CDC suggest that pregnant women may be at a slightly higher risk of requiring ICU admission and receiving mechanical ventilation compared with non-pregnant women, though thankfully survival rates are similar.

Perhaps the best news for expectant mothers is that in the over 3 million cases of COVID-19 in pregnant women worldwide, we haven't seen convincing or definitive evidence that the virus can pass across the placenta from mom to fetus. Unlike the Zika virus, for example, there does not seem to be an increased risk of structural anomalies or birth defects related to the current viral pandemic. So, while we hope that pregnant women stay safe and avoid contracting the virus, the majority of those who do get infected will have mild or no symptoms, and there is virtually no risk of infecting your unborn baby.

And you don’t need to worry too much about going in for prenatal appointments, either. Throughout the pandemic, obstetricians and maternal-fetal medicine physicians have made modifications to keep patients safe and cared for like installing plexiglass borders at front desks, allowing women to wait in their cars until their appointments, mandating face coverings, and of course frequent disinfecting and hand hygiene. Telehealth has also been utilized to keep patients out of the office when possible.

The most important factor in your decision should be your own physical and emotional health. Some questions that can help guide your decision:

  • Do you have underlying medical conditions that place you at a higher risk of coronavirus complications? Have you discussed these conditions with your health care provider?
  • Would you be comfortable being pregnant if there was a second wave?
  • How would you cope if you could not bring a partner with you for office visits and sonograms, or if your partner could not be with you in the hospital throughout your postpartum stay?
  • If you had to be hospitalized for a pregnancy complication, would you be able to cope if visitation was limited?
  • Do you think you will require help at home with your new baby and potentially other children, and if so how will you handle that if your area must “pause” again?
  • If it were recommended that women isolate after giving birth, how would you feel?
  • Would you be too nervous to bring the baby to the pediatrician for necessary exams or bloodwork?

Only you and your family can answer these questions, and there are no right or wrong answers. If these potential scenarios are too upsetting, then it may be best to delay pregnancy until a time when a vaccine or proven therapy is available.

If you can see yourself content at home with a new baby and trust your providers to guide you through the medical visits you and baby may need, then COVID-19 is not something that should necessarily delay the growth of your family.