COVID-19 Resources
***We highly recommend following Evidence Based Birth’s regular research/recommendations updates, which will help you know the most current guidelines that your OB/midwife is likely to be following.***
When thinking about stressful topics, it’s important to be proactive in reducing the stress load in your body — especially when pregnant. We recommend the meditation apps Expectful for pregnant/postpartum parents and Calm or Headspace for partners. Here’s a relaxing square breathing video from Calm’s feed on Instagram that you can use. Please also see here for recommendations of therapists and other support — most, if not all, of whom are offering virtual therapy. Also, an excellent podcast episode on dealing with anxiety in pregnancy from the BIRTHFUL podcast.
3/22/22: Coronavirus Disease (COVID-19) and Breastfeeding (CDC compilation of recommendations on this topic)
2/22/22: How COVID-19 can harm pregnancy and reproductive health (National Geographic)
2/18/22: Effectiveness of Maternal Vaccination with mRNA COVID-19 Vaccine During Pregnancy Against COVID-19 (CDC) and When moms get vaccinated during pregnancy, babies get protection too, study shows (NPR summary)
1/4/22: Covid vaccinations are not linked to pre-term births, researchers report (NY Times)
12/17/21 update to 10/29/21 report: Evidence Based Birth issues a brief summary of the current research on the Covid vaccines in pregnancy in a Q&A format
12/3/21: ACOG updated their patient reference/FAQ page on Covid-19
11/26/21: CDC update - Risk for Stillbirth Among Women With and Without COVID-19 at Delivery Hospitalization (increased risk for unvaccinated pregnant folks)
11/22/21: ACOG Statement on Latest CDC Reports on the Effects of COVID-19 on Pregnancy (Delta worsens severity for unvaccinated pregnant folks)
11/3/21: ACOG recommends booster for pregnant people (& infographic)
9/29/21: Excellent segment on WNYC’s The Brian Lehrer show (23 min), interview with two expert MFM/OBGYNs: Vaccine Hesitancy Among Pregnant People
9/29/21: CDC update - COVID-19 Vaccination for Pregnant People to Prevent Serious Illness, Deaths, and Adverse Pregnancy Outcomes from COVID-19
Sept 2021 webinar on Pregnancy & Covid with research study Zoe (research on the vaccine, weighing risks vs benefits, etc)
8/23/21: NYS DOH COVID-19 Vaccination Guidance for People who are Pregnant, Lactating, or Planning to Become Pregnant (vaccine is recommended) & NYS DOH guidance on Protocol for COVID-19 Testing Applicable for Pregnant People and Support Persons
6/7/21: You can bring a companion/partner to your hospital visits (NY State Interim health advisory: Updated Covid-19 Guidance for Hospital Visitation and Non-Hospital Employed Patient Support, updated from and supersedes 4/1/21)
5/13/21: Coronavirus Vaccines Protect Pregnant Women, Another Study Suggests (NYTimes)
4/21/21: No evidence that Pfizer or Moderna vaccines are unsafe during pregnancy, a preliminary study says
4/19/21: The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis (Canadian Medical Association Journal)
4/1/21: You can bring a companion/partner to your prenatal/healthcare visits! “Starting April 1, 2021, individuals may bring a companion with them to healthcare appointments. Companions must also wear appropriate face coverings, practice hand hygiene and respiratory etiquette, and comply with temperature checking and symptom screening.”
3/7/21: Coronavirus: Vaccinated nursing moms likely pass antibodies on to babies
2/12/21: CDC - Vaccination Considerations for People who are Pregnant or Breastfeeding
2/9/20: update from Infant Risk Center: Similar to other medications, pregnant and/or breastfeeding women have not been included in studies to determine how well COVID-19 vaccines work or how safe they are. Based on what we understand from similar vaccines, we believe the risks that come with vaccination will probably be low. Therefore, while we wait for more information, each mother and provider should discuss what choice fits their situation best. The risk and benefit of the vaccine should be compared to each mother’s individual risk for getting COVID-19 as well as how well she is expected to tolerate the disease.
12/23/20: Good news for birthing folks! NYS Executive Order now says: Birthing people have the right to a support person AND a doula. Also, doulas DO NOT have to showcase any certification documents. ***It’s recommended that birthing folks and doulas travel with this documentation to your birthing location as proof just in case there are issues upon arriving with your partner and/or doula.***.
12/14/20 update from Academy of Breastfeeding Medicine - Considerations for COVID-19 Vaccination in Lactation
12/13/20 update: American Congress of Obstetricians & Gynecologists (ACOG) says pregnant women should be prioritized to get the Covid vaccine, though there’s no safety data on this population due to it being thought to be unethical to do studies on pregnant people.
11/2/20 update: new CDC study - limited information suggests that pregnant women with COVID-19 might be at increased risk for severe illness compared with non-pregnant women.
10/12/20 update: new study by researchers at Columbia University Irving Medical Center and NewYork-Presbyterian Morgan Stanley Children's Hospital indicate mothers with Covid rarely transmit the virus to their newborns when basic infection-control practices are followed.
9/18/20 update: https://www.nytimes.com/2020/09/17/health/covid-pregnancy-premature-birth.html
8/3/20 update: The CDC currently encourages newborns to nurse (breastfeed/bodyfeed) and to stay with birthing parents as long as the newborn has no other reason to go to the NICU. Separation should not be routine when a birthing parent tests positive, but could be recommended in certain circumstances.
7/22/20 update (linked page last updated 11/19/20): American Academy of Pediatrics updated guidelines to recommend keeping COVID-positive birthing people WITH their well newborns. This reverses earlier restrictions that recommended temporary separation. The guidelines now state that "mothers and babies may room-in according to usual center practice," as the risk of transmission "appears to be no greater" with rooming-in versus separation--when infection control measures (like masking and hand hygiene) are taken.
6/27/20 update:
The CDC has released a new report stating that pregnant people might be at an increased risk for severe illness from COVID-19 compared to non-pregnant people.
Review the CDC's guidance for pregnant people (as well as parents and children), which covers tips on protecting yourself and family from coronavirus.
Want to Take Action? Here are petitions you can sign and share:
Allow Partners in postpartum units & PACU (to Gov. Cuomo, NY State); if you know your NY hospital is actively removing support after birth, please file a complaint with the DOH.
Stop Taking Babies Away from Mothers (to Surgeon General)
Keep Pregnant People Safe During COVID-19 in New York (to Gov. Cuomo) — petition w/ specific recommended strategies to move birthing people out of Covid-ridden hospitals (and this article “Failure To Act: NY Could Help Move Most Childbirths Out Of Hospitals But Won’t” written by a local doula colleague who started the petition)
Use NYC/NYS Free-Standing Ambulatory Surgical Centers As Birth Centers in COVID-19 (to Gov. Cuomo)
Trustworthy Links:
CDC’s guidance for pregnancy & breastfeeding in the time of Covid-19 (for consumers)
CDC’s guidance for pregnancy, breastfeeding & newborns in the time of Covid-19 (for clinical care providers)
CDC Tips on Managing Stress & Anxiety
WHO’s FAQ: Breastfeeding and COVID-19 for health care workers
ACOG: COVID-19 FAQs for Obstetrician-Gynecologists, Obstetrics
Giving Birth in a Pandemic: Questions to Ask Your Care Providers during COVID-19 virus (my childbirth educator & doula friend in Seattle, Alice Turner, YouTube video, posted 3/26/20)
Having a Baby During the COVID-19 Outbreak: A Mother’s Mindset Shift (Sunflower Motherhood)
Evidence Based Birth - regularly updated with research on Covid-19 as it pertains to pregnancy, birth, breastfeeding as well as links to trustworthy information
Birth Monopoly’s Covid-19 resources page (website focused on birthing rights)
KellyMom.com Covid-19 resources on breastfeeding
Resources for Skilled Lactation Providers (International Lactation Consultant Association, a lot of it also applies to birthing families)
For Parents:
American Academy of Pediatrics Covid-19 “Pediatric Collection” (updates)
A few thoughts for expectant parents, especially for those giving birth in NYC hospitals:
Prenatal Info
If you’re not comfortable with traveling to the hospital/clinician’s office for your prenatal visits, you could ask your care provider (OB or midwife) if it might be possible to have virtual visits. This is possible under certain circumstances, so you would just need to ask your care provider if it’s suitable/workable for you, and ask them what kind of basic equipment would be recommended to have on hand, such as a blood pressure monitor, thermometer, etc.
Consider requesting a copy of your records from your OB or midwife toward the end of your pregnancy just in case you decide to shift to a different birthing location
Consider being tested for Covid regularly toward the end of pregnancy and bringing your most recent negative results to the hospital in labor, which could help protocols be more normal (when they test at hospital, sometimes it takes a number of hours to get the results back and in the meantime they must act as if you’re positive so that you have to wear a mask nonstop, or some care providers are recommending non-medically indicated inductions solely for the reason of testing the day before admission and being confident of a negative test.)
Find out in the last few weeks of pregnancy (36+ weeks) if your partner will be allowed to come and go during your stay in the hospital. If they cannot, you’ll need to bring in everything you’ll need for 2-3 days including snacks & drinks for during labor, device chargers, & the baby’s car seat (if you’re bringing one)
Labor & Immediate Postpartum (check your birth location’s current policies as your due date nears)
4/29/20: Governor Cuomo accepted all the recommendations of a maternity task force. Two of the recommendations include 1) allowing partners to stay with the birthing parent not just in Labor & Delivery but also in the postpartum unit, through the duration of the stay in the hospital, and 2) doulas allowed as essential labor support in Labor & Delivery. Please note many doulas will prefer to continue to provide virtual support for the time being for everyone’s safety. Virtual support is still extremely valuable and a very safe option. (Executive Order 202.25 — note it specifies being in effect for only 30 days, so that a lot of local hospitals are making it difficult for doulas to enter.)
It’s highly recommended to hire a doula for support (virtual if preferred and/or necessary) to help you labor at home for as long as possible and minimize your time in the hospital.
If you are allowed 1-2 labor support persons, be aware they either 1) may not be allowed to leave once entering the hospital, so partner should come prepared to be there for up to ~3 days, or 2) may be required to leave soon after the birth and not return until discharge. (Check current policies from 36-37 weeks on so you know the current policy when you go into labor.)
Be aware it’s possible that hospital staff may tell you can’t use electronic devices for virtual labor support with a partner or doula. They may not like it, but if you strongly advocate for yourself and explain that you need your labor support, let’s hope they’ll be reasonable. Perhaps assure them you’re not recording, if that’s their concern. (Many hospitals aren’t comfortable with recording, particularly in the pushing stage.) If you’re hoping to have virtual support, check to be sure your hospital has a good cell and/or wifi connection as some do not.
You should not have to be separated from your baby in an uncomplicated birth, even if you test positive for Covid-19. AAP updated their recommendation to explicitly state this update on 7/22/20, to be more aligned with WHO & RCOG, and CDC has also adjusted similarly over time as more studies have been released indicating no mother-baby separation is the healthier way to go.
The best current evidence we have indicates Covid-19 is not transmitted to the baby the vast majority of the time, including through breastmilk. The risk of transmission to a newborn appears to mostly be the same method of transmission as to any other human — through respiratory droplets. So, the recommendation is to breastfeed a newborn, perhaps taking appropriate precautions to limit the respiratory transmission to baby. Consult with an IBCLC (lactation consultant) for current tips on this.