What to Expect When You’re Pregnant During COVID-19
What to Expect When You’re Pregnant During COVID-19
April 28, 2020

What to Expect When You’re Pregnant During COVID-19

What to Expect When You’re Pregnant During COVID-19

COVID-19 has impacted every aspect of life as we knew it. If you’re currently pregnant during this unprecedented time, odds are your stress level is even higher than it would be if you weren’t getting ready to welcome a little one into the world sometime soon.

Everything from prenatal care to the labor and delivery experience has been affected in these uncertain times. We believe that knowledge is power–and knowing what to expect at your OB’s office for prenatal care, understanding the role of telemedicine and learning what your labor and delivery experience may be like can help you feel better prepared and a little calmer about what’s ahead of you in the coming months.

In this article:

Prenatal Care During COVID-19

Prenatal care is an integral part of maintaining both your health and the health of your baby. Although COVID-19 has affected prenatal care, many hospitals and doctors are still following the recommended schedule–things may look just a bit different than they did prior to the pandemic.

A typical prenatal care schedule for a low-risk pregnant person includes approximately 15 in-person office visits and usually looks somewhat like this:

  • Weeks 4-28: one checkup every four weeks (about once a month)
  • Weeks 28-36: one checkup every two weeks (about twice a month)
  • Weeks 36-41: weekly checkups

During the COVID pandemic, however, many doctors are seeing pregnant people on an abridged schedule. Does this mean you will receive compromised care and put you at risk for complications? No, according to Dr. Oluwatosin Goje, Cleveland Clinic OB/GYN.

“We are still seeing patients adequately,” she says. “The schedule of in-person visits just looks a bit different now.”

Milestone visits that include things like ultrasounds, genetic and other types of testing and vaccinations are still being done in person, while telehealth appointments now take the place of all appointments in between that would previously have been done in your doctor’s office.

According to Dr. Goje, a typical prenatal visit schedule for a low-risk pregnant person during the time of COVID-19 may now look a bit like this:

  • Weeks 4-28: Instead of one checkup every four weeks during this timeframe, many practitioners are moving to two to three in-person visits and conducting the remaining visits via telehealth. The in-person visits often include an intake appointment and an ultrasound during the first trimester and an anatomy ultrasound between 18-20 weeks.
  • Weeks 28-36: One to two in-person visits will now take place during this timeframe. These appointments will include important testing such as your glucose test (a screening test to check for gestational diabetes), a fetal growth scan if your doctor is concerned with your baby’s growth, and your Tdap (tetanus, diphtheria, and pertussis) vaccine. You’ll also get a group B Strep test during this time.
  • Weeks 36-41: As you near the end of your pregnancy, you may have one additional in-person appointment with your doctor, especially if you’re having a c-section or planned induction. Otherwise, you’ll be able to conduct most other appointments via telehealth.

Dr. Goje is also quick to reference this study, conducted prior to the COVID pandemic, that investigated the association between the number of prenatal visits and pregnancy outcomes. The study found that low-risk women with more than 10 prenatal visits actually had higher rates of pregnancy interventions and no better fetal outcomes than those with fewer than 10 visits.

Why is this reassuring? Quality over quantity, Dr. Goje says. “The bottom line is both parties, as long as the visits were done properly and all questions were answered, did equally well. Using this evidence shows us that as long as you’re low-risk, we can actually do the important visits in person and the others via telehealth.”

If you’re a high-risk pregnant person, your course of care will be dependent on what the medical or fetal condition is. “For higher-risk patients, we will continue to follow the criteria for the recommended plan of care prior to COVID-19,” she says. “You can modify it based on certain factors, but otherwise you must follow the recommendations.”

Telemedicine and COVID-19

COVID has pushed telemedicine to the forefront across all sectors of care–and prenatal care is no exception. While it’s not quite the same as the real thing, many practitioners have been pleasantly surprised with how well telehealth appointments are working with their patients.

“The world in 2020 is used to talking to their friends on Facetime and other video platforms,” Dr. Goje says. “They are comfortable with technology and are adapting to it very well.”

Some doctors are noticing that patients seem to be opening up more than they would during in-person appointments. “Patients are speaking with their doctors from the comfort of their home where they’re more relaxed. It’s often less stressful since they’re in their own comfort zone,” she says.

If you’re still concerned about the lack of in-person appointments, there are a few things you can do to help feel more reassured.

  • Make a list of questions. Prepare for your telehealth appointment in the same way you would for an in-person visit with your OB. Make a list of any and all questions for your provider–don’t be shy and take advantage of the time you have with your doctor.
  • Ask about home monitoring. Some doctors are providing patients with fetal dopplers and blood pressure monitors to use at home. Depending on your personality, this can either help or hinder your stress level, but you should ask your healthcare provider about it if you’re curious.
  • Learn about fetal kick counts. Monitoring how many times your baby kicks during a specific period of time with kick counts can alert you to any significant changes and can help calm your nerves if you’re not having regular in-person visits with your OB.

Delivery During COVID-19

The experience of labor and delivery has definitely changed since the COVID pandemic began. Learning why these changes have been put into place–and what to expect in this new normal–can help you feel less anxious and more prepared when it’s time to give birth.

“No one will receive less care during this pandemic,” Dr. Goje reassures. “Everything that has been done has been for the safety of pregnant people and to help prevent newborns from acquiring COVID.”

So though these changes may feel scary and overwhelming, keeping this reason behind them in mind may help you feel better overall.

Many hospitals are now allowing only one support person to accompany a pregnant person during labor and delivery. Depending on what area of the country you’re delivering in and you and your support person’s history, you both may also be tested for COVID-19.

Here are a few things you can do to feel better prepared.

  • Talk, ask and listen. It’s more important than ever to talk with your healthcare provider about any questions and concerns you may have about delivery. Ask about your doctor and hospital’s most recent COVID-related policies and procedures. Have them walk you through what check-in may look like, what sorts of protective equipment nurses and doctors may be wearing, and ask if the labor and delivery floor may look any different than normal. Ask about availability of anesthesiologists, private rooms and guidance around laboring at home before you come to the hospital. Having answers to these questions can help you know what to expect and calm your nerves.
  • Revise your birth plan. If you wrote a birth plan prior to the COVID pandemic, odds are it will need some revising. Do your best to think through what you’ll need to feel the most relaxed and the most supported during your labor and delivery. And remember to cut yourself some slack–birth is upredictable even in normal times, so don’t set unrealistic expectations around your birth experience.
  • Remember: you can do this. Now’s the time for the best self pep talk of your life. Do whatever you need to feel confident and empowered during this uncertain time. Be gentle with yourself; trust in the medical team you’ve chosen; and take advantage of any support you can. We promise you can do this!

“Anxiety and stress is normal during this time,” Dr. Goje says. “Lean on your support people at home. Try to take your mind off of what’s going on however you can. Find ways to feel empowered. And keep going with your plan for a healthy pregnancy and a healthy delivery.”

Experts Referenced in this Article

  • Dr. Oluwatosin Goje, OB/GYN, Cleveland Clinic
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