Recommendations vs. requirements for pregnant women during COVID-19

Posted at 6:35 PM, May 14, 2020
and last updated 2020-05-14 19:35:55-04

While it's recommended that women who are pregnant get tested for COVID-19 at the time of delivery — and separated from their babies, if the test comes back positive — neither is a requirement.

The ever-changing guidelines surrounding pregnancy and COVID-19 has led to some confusion among expecting moms.

Dr. Marc Parrish, who specializes in obstetrics and gynecology at University of Kansas Health System, said the recommendations are in place to prevent the spread of infection from mother to baby.

"It is believed to be passed onto the child easily, early on in the newborn process," Parrish said. "Right now, our thought is there is more benefit than risk separating mom and baby, or at least making that recommendation to be separated, to avoid the possibility of a newborn becoming infected."

Still, Parrish said it's a personal decision that is ultimately left up to the mother to make. There are also proven health benefits that come with skin-to-skin contact and breastfeeding, which makes the decision difficult for moms, Parrish said.

"The recommendations is that mother and baby are separated, so obviously that is a big deal for mom," Parrish said. "We know that in non-pandemic time, that skin-to-skin time is very important for that bonding that occurs between mom and baby, so those things weigh heavy into the decision process."

If a mother tests positive for COVID-19 and decides she does not want to be separated from her baby, Parrish said the hospital has an alternative safety measure that can be implemented — the baby can be kept in the room in an enclosed bassinet away from other infants.

"We advise that she wear a mask clean her hands very carefully and if she's planning on breast feeding then there's additional guidance," Parrish said.

Still, some women are hesitant to give birth in a hospital setting.

Kayla Lawrance, a certified nurse midwife with New Birth Company, said more women are coming to the birthing center now than before the pandemic.

Lawrance said one of the reasons they're seeing an increase in clients, is that fewer people are involves in the delivery process at a birthing center.

"There's been a lot of fear, doubt and uncertainty with COVID," Lawrance said. "The exposure to other people is not near as the level you would have at the hospital."

Lawrance said New Birth Company screens expecting mothers for symptoms but does not test them for COVID-19.

However, if a woman shows symptoms of the virus, they are sent to the health department for testing. A mother who tested positive for the coronavirus would be sent to one of the hospitals with which the birthing center partners.

When it comes to being test for COVID-19 prior to giving birth, Parrish said it's helpful for staff to determine the level of personal protective equipment they'll wear.

"As you're getting closer to the end, there's a lot of pushing, a lot of huffing and puffing, so a lot of effort is being made there," he said. "If they happen to be positive, then there's a lot of potential there for that virus to be aerosolized into the room and infect anybody that's nearby."

The test is also beneficial for moms who want to have a plan in place, should they want to isolate from the baby if positive for the virus, Parrish said.

Current guidelines suggest COVID-19 positive mothers should separate from their newborns for up to 72 hours.

While a mom has the right to choose whether or not she'll be tested for COVID-19 or separated from her newborn, she is restricted to the policies of the hospital or birthing center when it comes to the number of people allowed in the delivery room.

Many hospitals, including University of Kansas Health System, only allow one guest in the delivery room.

New Birth Company allows two guests into the room, but at the end of May they'll begin to allow up to four people to accompany mom to the delivery room, Lawrance said.