Women who were trying to get pregnant in the days, weeks, and months before the Covid-19 pandemic find themselves facing a difficult question. Should they continue to try to get pregnant in the era of Covid-19? What do the experts say? The American College of Obstetricians and Gynecologists doesn’t offer specific guidance at this time. Ultimately, “individuals need to make their own decisions based on their unique needs, desires, and values.” This means that each woman needs to evaluate, for herself, whether she wants to continue trying to have a baby at this time.
For many older women who may have limited fertile months and years left, the prospect of waiting another year to try to conceive can be devastating. Some women don’t feel they have the luxury to put off having a baby until a vaccine is developed.
In recent weeks the American Society for Reproductive Medicine recently released new recommendations regarding resuming fertility treatments. Until recently, the ASRM called for the suspension of I.V.F. and I.U.I. treatments. Currently, the new guidelines call for fertility doctors to follow local guidance regarding providing essential and non-essential medical services. The ASRM considers fertility treatment essential medical care, but each region will have its own limitations regarding hospital and medical resources. Ultimately, access to fertility treatment will depend on your regional Covid-19 caseload, your local medical resources, and your doctor’s ability to formally mitigate risk to patients and staff. If you would like to resume fertility treatment at this time, your best option is to reach out to your fertility doctor today to learn more about your options.
With most of us at home practicing social distancing, there has been some talk that we might see a baby boom in the next nine months. But research doesn’t support this. Disasters that result in high death rates result in fewer births nine months down the line. Stress can reduce fertility, resulting in changed menstrual cycles and reduced libido. Cosmopolitan magazine reported that a popular birth control app saw 2% fewer people using the application, with 3% switching their birth control plan from “plan” a pregnancy to “prevent.” High fevers have also been known to reduce male sperm counts.
If you are struggling with the idea of whether you should try to get pregnant during the Covid-19 pandemic, we’ve put together a checklist of things to consider. The American College of Obstetricians and Gynecologists notes some key considerations couples might want to take into account. These considerations include:
- Covid-19’s risk to the fetus and mother
- Limited access to prenatal care
- Financial uncertainty
- Social effects of Covid-19
Let’s explore each of these in more depth:
Covid-19’s Risk to the Fetus and mother
Unfortunately, there’s still not much data on the risks that Covid-19 might pose to the fetus, but there is some encouraging news. Let’s take a look at some myths and misinformation that has been circulating and clarify what we know and don’t know:
- Does pregnancy increase your risk of COVID-19? Ellen Schwartzbard, M.D., an obstetrician and gynecologist at Baptist Health Medical Group notes that pregnancy can weaken your immune system. But this doesn’t necessarily mean that pregnant women are at higher risk of getting the coronavirus. The American Journal of Obstetrics and Gynecology notes that there is no reason to believe pregnant women are more “susceptible to infection with coronavirus.” Pregnant women contract the coronavirus just like anyone else would contract the disease: by being exposed to droplets expelled (coughed or sneezed) by someone who is infected by the virus (whether or not the infected person is symptomatic). So this means that, like everyone else, you won’t get sick unless you get exposed to the virus. If you are pregnant, take social distancing recommendations seriously, wash your hands regularly, avoid touching your face and eyes, and avoid people who are sick. Women who become pregnant will not be able to practice as robust social distancing measures because of their need for prenatal care, something which women need to take into consideration when planning a pregnancy.
- Do pregnant women get sicker from COVID-19? A study published in the American Journal of Roentgenology noted that pregnancy and childbirth didn’t seem to worsen the course of the disease in pregnant women. All women in the study achieved full recoveries and either delivered their babies or were still pregnant at the end of the study.
- If I get the coronavirus while pregnant, will my baby be born with the virus? All data currently points to no. The Centers for Disease Control reports that transmission of the coronavirus from the mother to child during pregnancy is unlikely, and that Covid-19 has not been detected in breast milk. Babies can contract COVID-19 after delivery, though, through normal person to person transmission (when viral droplets reach the baby’s mouth, nose, or eyes through the air, or through contact infection). COVID-19 is a non-persistent virus. Unlike HIV or Herpes, it does not live in the body for years and it isn’t believed to be passed on to infants in the womb. For more information about how COVID-19 differs from other viruses visit our Flatten to Zero website.
- Does COVID-19 increase the risk of birth defects? The medical journal AOGS, notes that there is no evidence regarding what impact Covid-19 might have on pregnant women in the first and second trimester. Women who developed Covid-19 in the third trimester went on to deliver healthy babies, though some women who became very ill due to Covid-19 had to undergo C-sections or early deliveries. (The virus is so new that we only have data for how Covid-19 affects late pregnancy, and nothing on how infection impacts early pregnancy. Research indicates that high fever in the first trimester can put the fetus at risk; see Daily Wellness. But it should be noted that a high fever from any disease could pose this risk, so this is not unique to Covid-19.)
- If I get pregnant will I be able to get the Covid-19 vaccine should one become available? The Kaiser Family Foundation notes that pregnant women are often excluded from vaccine trials, meaning that pregnant women may not have access to a vaccine should one be developed in the nine months when they are pregnant.
So what are the key takeaways? If you have underlying health risks that could result in a high-risk pregnancy, you might want to speak to your doctor before trying to conceive; and it might be best to delay your pregnancy until after the coronavirus threat has passed. The CDC lists high-risk women as those with STDs, diabetes, thyroid disease, high blood pressure, and those with chronic illness.
Limited Access to Prenatal Care:
In order to prevent the spread of Covid-19, doctors are cancelling routine doctor’s visits and meeting patients through telemedicine rather than in person. This can have major implications for women who become pregnant during the Covid-19 pandemic.
- Many prenatal care appointments will be switched to telehealth appointments. Some women can monitor blood pressure and fetal heart rate at home.
- However, experts speaking to the Today Show warn that telemedicine may not be an option for high-risk pregnancies. Dr. Katherine Kohari, associate medical director of the Yale School of Medicine, spoke to the today show, noting that there isn’t research on how telemedicine can impact prenatal outcomes and there is a concern that doctors could miss key issues when seeing patients remotely.
- Even if many appointments can be performed remotely, women will still need to go in for in-person appointments.
- Hospitals have also been limiting visitors women can have in the delivery room, so women need to consider that their pregnancy plan may need to adjust.
Women who are thinking of becoming pregnant will want to take into account the reality that healthcare options may be limited or evolving in the coming months. Women who might have high-risk pregnancies may want to consider waiting until the threat has passed.
The latest reports from CNN is that 22 million Americans have filed for unemployment in just the last four weeks. It isn’t clear what long-term financial impacts Covid-19 will have on the economy. Economic uncertainty also increases uncertainty about the global supply chains. As the virus affects more food processing plants, the New York Times reports that food shortages may occur. USA Today reports on shortages of diapers. At the end of the day, couples will need to decide for themselves whether they can afford to have a baby at this time, and whether they can tolerate the financial uncertainty, along with the added expenses of having a child.
Social Effects of Covid-19:
The last thing women need to consider is the reality that social life may not return to normal for some time. Women may not be able to readily visit relatives while pregnant. Pregnancy is a time when women may experience higher levels of stress and the lack of social support during this time can have mental health effects. Couples should consider how they’ll feel about not being able to visit with older relatives or at-risk relatives during this important time in their life. Those who are planning to become pregnant should consider their mental health and the effect that social distancing might have on them while they are also pregnant.
Mental Health Effects of Covid-19:
Living in an era of global pandemic is stressful. Pregnancy can be stressful. Economic uncertainty can lead to anxiety. If you are planning a pregnancy at this time, be sure to have a mental health self-care and wellness plan in place. The Centers for Disease Control recommends the following for mental health self-care:
- Limit exposure to news stories
- Eat healthy well-balanced meals
- Meditate, practice deep breathing, stretching, or yoga
- Avoid drugs and alcohol
- Connect with others: Zoom calls, text messages, phone calls, video calls
- Make time for joy: cook a nice meal with family, go for a walk, be in nature, make art, the list goes on and on.
Still Trying to Get Pregnant?
Even though the news regarding Covid-19 remains somewhat discouraging (people are still getting sick, though we appear to be flattening the curve), the decision to keep trying to have a baby is ultimately up to each couple to decide. Much can change between now and nine months. If you do plan to try to have a baby at this time, here are some key things you can do:
- Book a telemedicine appointment. (Speak to your doctor about current medications and risks, and to check that you’re up to date on vaccines; review family history, weight, and speak to your doctor about other risk factors)
- Take folic acid.
- Consider taking a daily wellness supplement. (FertilityBlend is supported by research to improve fertility rates and can also provide you with key nutrients.)
- Stop drinking, smoking, and drug use
- Avoid toxins: BPA, fragrances, and caffeine (Daily Wellness has an excellent article on foods that are high in pesticides)
The decision to have a baby is one that is embarked on with hope. The courage to start a family in the midst of tough times and social distancing is one that isn’t taken lightly. But if you do choose to continue trying right now, there are a range of support options still available—from telemedicine to online communities that can support you in your journey.