The months of pregnancy are very exciting for mothers-to-be. But this special time has been shadowed by the fear and uncertainty of the COVID pandemic. To address these concerns and guide women through a healthy and safe pregnancy, Our Children asked Dr. Jennifer Amorosa, a maternal fetal specialist at The Center for Maternal Fetal Medicine at The Valley Hospital in Ridgewood, to share her expertise.
Our Children: There seems to be some confusion regarding one of the most pressing questions of these times – to vaccinate or not against COVID while pregnant? What are the current recommendations?
Dr. Jennifer Amorosa: The data is clear that symptomatic pregnant patients with COVID-19 are at an increased risk of severe illness and death when compared to their non-pregnant peers. Also, many pregnant women have underlying medical conditions that put them at a further increased risk of complications from COVID.
While it is true that pregnant women and young children were excluded from the U.S. clinical trials, preliminary developmental and reproductive toxity data (DART) studies for both the Pfizer-BioNtech and Moderna vaccines are reassuring. Additionally, about 20,000 pregnant women in the U.S. have been vaccinated thus far and there haven’t been any red flags.
The American College of Obstetricians and Gynecologists as well as the Society for Maternal Fetal Medicine recommend that pregnant women make their own informed decisions in terms of whether or not to get the COVID vaccine.
I look at it like this: We know that COVID in pregnancy is potentially very bad. We think that overall, the vaccine is safe. Each patient has to weigh known risks of COVID infection including personal exposure risk, level of community transmission and comorbidities to make the choice she feels the most comfortable with.
Our Children: What are some of the other precautions that the medical community is advising pregnant women in order to protect themselves and their soon-to-be-born child against COVID?
Dr. Jennifer Amorosa: Since we know that pregnant individuals have a higher risk of getting sicker from COVID than their non-pregnant peers, it is important that pregnant women protect themselves as much as possible from getting the virus in the first place. Ways to do that include:
limiting interactions with people who may have been exposed to or might be infected with COVID as much as possible
wear a mask around others who are not in your immediate household and refrain from socializing with family that don’t live with you
stay 6-feet away from people not in your immediate household
wash your hands frequently with soap and water or an alcohol-based hand sanitizer
Basically – wear a mask, avoid social gatherings in which social distancing can’t be maintained and use common sense.
Our Children: How much does stress during this pandemic impact the pregnancy?
Dr. Jennifer Amorosa: Stress is hard to quantify because in general feelings of stress are common during pregnancy, pandemic or not. Given the timeline of the pandemic, we don’t yet have specific data on the impact of stress due to the pandemic on pregnancy itself.
What we do know is that prolonged high levels of stress can be associated with health problems. Additionally, high levels of stress and anxiety can be associated with postpartum depression.
I always tell patients it is important to manage what we can, reach out for help as needed and not fixate on what can’t be controlled. This holds true, pandemic or not. Adequate sleep, a healthy diet, exercise and mediation are ways to help manage stress levels in addition to working with a mental health specialist if needed.
Our Children: Can you please share with us some other prenatal highly recommended or must-dos things a woman can do to help create a smooth pregnancy and a good birth?
Dr. Jennifer Amorosa: It is important to keep all of your healthcare appointments during and after pregnancy. Get your recommended vaccines including influenza and Tdap. Many women face social isolation during the current pandemic – it is important to maintain friendships and seek out the help of family and neighbors, albeit in a safe and socially distanced manner. Don’t ignore the power of a phone call with a friend. Don’t be afraid to ask questions along the way. Reach out to your doctor or a lactation consultant for help with breastfeeding if you need it.
Our Children: What are the newest recommendations regarding weight, diet, supplements and exercise?
Dr. Jennifer Amorosa: The institute of medicine recommends that women of a normal weight gain 25 to 35 pounds. If you are overweight, the recommendation is 15 to 25 pounds and is slightly less (11 to 15 pounds) in obese patients.
In terms of nutrition, the popular saying of “eat for two” is incorrect. Instead, women should “eat twice as well!” In general, pregnant women should consume about 300 extra calories per day from high quality sources of nutrition such as fruits, vegetables, whole grains, low fat dairy and lean sources of protein or nuts.
Women who are pregnant or planning pregnancy should take a daily prenatal vitamin. One of the important vitamins that prenatal vitamins contain are Folic Acid, a B vitamin which may help prevent neural tube defects, which are birth defects of the brain and spine.
In general, if you are healthy and your pregnancy is normal, it is safe (and encouraged!) to exercise in pregnancy. Exercising during pregnancy may reduce back pain, help with constipation, decrease risk of gestational diabetes, promote healthy weight gain during pregnancy and help you to lose weight once your baby is born. Ideally, pregnant women should get at least 150 minutes of moderate intensity aerobic activity such as brisk walking each week. If you are new to exercise, you should start out slowly and gradually increase your activity. It is always important to talk about exercise with your obstetrician or midwife however as there as some conditions in pregnancy in which exercise may not be recommended.
Our Children: Anything else you would like to add?
Dr. Jennifer Amorosa: Pregnancy and childbirth are special times in a woman’s life. I always find it reassuring to think that generations of women before us have done it and generations to come will as well.