'I'm A Pregnant Doctor, And One Of The Best Things You Can Do To Prepare For Novel Coronavirus Is To Stay Calm'

I’m about 29 weeks pregnant. Because the novel coronavirus is a completely new virus that none of us have been exposed to before, I am concerned. It doesn’t help that you get really good about worrying about things when you’re pregnant. So I’ve been worrying about my husband, who is also a physician, my daughters, and my 84-year-old father, who is living with us.

Unfortunately, we don’t know the answers to a lot of the questions surrounding COVID-19 right now. We don’t know how far-reaching this will become, throughout the United States and the rest of the world.

We know it’s here, and likely to affect more people, but how many people is still anybody’s guess.

We also don’t have a ton of information about COVID-19 and pregnancy (trust me, I’ve been looking into it!).

Hygiene, hygiene, hygiene is what I’m emphasizing for myself and my family members to stay safe.

My husband and I have talked a lot about hand washing (the right way) with my children. My kids, who are 8 and 6, have told me they know it’s important to be diligent about hand washing so they can protect me, the new baby, and their grandpa.

Aside from constant, vigilant hand washing, I’m wiping down high-touch surfaces regularly and avoiding touching things like doorknobs and handles. I have also mastered the art of using my elbows for many things.

I’m using appropriate personal protective equipment in the office, but I’m not using face masks at inappropriate times. (As a reminder, they are not recommended for people who are not healthcare workers or who are not caring for someone who is sick with novel coronavirus.) I’m also not traveling very far beyond work, picking up my kids at school, and home.

It’s also important to stay vigilant against other infections. I made sure my entire family got the flu shot, for example (it’s still not too late for those who haven’t gotten it). I also just got my third trimester Tdap vaccine today (that’s the vaccine that protects against tetanus-diphtheria-pertussis, or whooping cough). This is major to protect my new baby from whooping cough in the early weeks to months of life.

I’m board-certified in internal medicine and lifestyle medicine, so I’d be remiss if I didn’t also mention building my body’s resilience when I’m healthy to minimize risks from infections. I’m eating plenty of fruits and veggies every day, drinking lots of water, staying active throughout the day, and getting enough sleep.

I’m also planning to breastfeed. So far, the evidence doesn’t show any evidence of the virus in the amniotic fluid or in breast milk.

The other major way I’m preparing is by staying calm.

We each have to do our part to stay healthy and to protect others. It’s key to control the things you can and not panic about the things you can’t. So I’ve made sure my father has a month-long supply of extra medications, that we have food stored at home in case we need it, and that I understand what school closure policies might look like in my community. I’m in Georgia, where we have a handful of confirmed cases, and a recent school closed in a neighboring district. So, I’m just keeping an eye on our local community news to monitor that situation.

I feel strongly that we need to support our healthcare staff during this time. Unnecessarily using masks and buying out critical supplies can impact how well hospitals and clinics are able to do their jobs.

I just spent four hours in a busy ob/gyn waiting room as a patient, getting labs done to check for gestational diabetes, and I didn’t take a mask. I just practiced personal hand hygiene, cough etiquette, and sensible spacing.

The way I think about my baby’s delivery is actual quite similar to how I’m thinking about dealing with novel coronavirus as a whole right now. You have an ideal birth plan, but things can be different at the time of actual delivery as circumstances change (and luckily, the American College of Obstetricians and Gynecologists is keeping gynos informed on the latest best practices in the meantime). All you can do is prepare, stay level-headed, and hope for the best.

For other pregnant women (and honestly anyone), I would recommend the basics: hand hygiene throughout the day, avoiding sick contacts, and watching what you touch.

When in doubt, wash your hands and avoid touching your face. Eat, drink, sleep, and stay active to keep your body healthy in the event that you are exposed to any type of infection. And stay calm.

For non-pregnant women, my recommendations would be the same. If you’re healthy, you’re better able to take care of others around you if needed.

We know that the virus seems to be affecting older people, those with long-term chronic conditions (like heart disease and lung disease), and men more severely. We also know that healthcare workers are at higher risk for infection because of how many infectious people they interact with when caring for patients.

It’s not clear why, exactly, but women—including pregnant women—seem to have less severe infections. That said, complications from infections usually hit pregnant women harder because of the adjustments our immune systems have to make to protect our growing babies. Pregnant women are at risk for more severe infections from viruses like the flu, and based on limited data from outbreaks like SARS (2002-2003) and MERS (which first appeared in 2012), pregnant women had a slightly higher risk of miscarriage and stillbirth, according to the CDC.

Though COVID-19 is in the same family of coronaviruses as SARS and MERS, it does not seem to be causing such severe infections in pregnancy. Again, the data is limited. A World Health Organization report on 147 pregnant women found that only 8 percent had serious infections and only 1 percent ended up in critical condition. Other reports, like one in Lancet, reported cases of pregnant women with relatively mild to moderate symptom. None died, and their babies were born relatively healthy.

There is not enough evidence to say definitively, but what we are seeing so far is that babies appear to not be severely affected. From a JAMA study of nine babies exposed in China, none of the babies needed intensive care or had severe complications.

This seems to be the case for children, as well. There are much fewer reports of infections in children. Children that have been diagnosed have mostly had mild, cold-like symptoms (like fever, runny nose, and cough.) Though there have been limited cases of children with severe complications, this appears to be uncommon.

Remember: Most coronavirus cases are mild.

Keep in mind that this is a brand-new infection that has traveled around the world. Though the vast majority of people seem to recover without severe complications, we all have to be prepared for disruptions in our lives and to take necessary steps to protect more vulnerable people. The biggest things we can do to keep ourselves and our families safe will also protect us from other infections, so we should continue to do these things even after this current threat passes.

It’s all about preparation, not panic.

Amie Brink Neha Pathak, MD, is the medical director at WebMD. She’s currently pregnant with her third child.
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