BOSTON — As several Boston hospitals begin offering universal coronavirus testing for pregnant mothers before they give birth, many expectant moms are wondering how a positive test will affect their ability to care for their babies.
At Boston Medical Center, recent data show about 10 percent of delivering moms have been infected with COVID-19, Dr. Tina Yarrington, BMC’s Director of Labor and Delivery, told Boston 25 News Wednesday.
That number was collected before universal testing was rolled out at the hospital Monday, meaning the number of confirmed positive patients will likely increase. The hospital serves a diverse population, and research shows people of color are disproportionately affected by the virus.
Doctors have been working to implement universal testing for expecting mothers following a study published in the New England Journal of Medicine. Of 215 women who recently gave birth at two New York hospitals, 13.5 percent were asymptomatic but tested positive for the virus.
"This testing is recommended, but it’s absolutely not required," Yarrington said. "And the design of the information is not to protect us; it’s to empower the mom."
Until recently, enough test kits were not available to provide universal testing, and the turn-around wasn't quick enough.
"If I was going to recommend on my labor and delivery unit that we test every woman coming in to have her baby, it cannot possibly be with a test that would take four days," Yarrington said. "We now have a rapid assay - rapid in-house test - that will turn around within a couple of hours. And so we have the information well before she is snuggling with her newborn baby."
If an expectant mom tests positive, her medical team at BMC meets with her to inform her about the virus, how easily it is transmitted and how to protect herself and her baby, including information about physical distancing. She is also given masks and gloves to prevent the spread.
BMC doctors encourage her to decide for herself and her family how to care for her newborn - whether she wants to send her baby to the NICU for one-on-one care by a health care worker, to keep her infant beside her or six feet away, or to have a healthy partner take care of the child, among other options.
“I remember sitting with a family during this,” Yarrington said, recalling a coronavirus-positive patient who chose to take precautions and keep her baby with her. “The baby’s in an isolette, the mom is wearing a mask and she wears gloves when she breastfeeds as well. And her partner was in the room doing everything in between. She would breastfeed the baby, he would comfort [the baby], change her diaper, put her back in the isolette. It was remarkable.”
At Tufts Medical Center, universal testing for pregnant women before being admitted began on Saturday. Before the rapid coronavirus test was available, the test kits took about 12 hours and were not practical to use on the labor floor. The newer test has a 60- to 90-minute turn-around.
Tufts doctors are recommending mothers with coronavirus practice physical distancing, staying more than six feet away, as advised by the American Academy of Pediatrics. Dr. Dr. Margaret Sullivan, a Tufts OB/GYN, acknowledges separation is difficult for new moms yearning for early skin-to-skin contact.
"That is hard on moms. Basically, we recommend admission to the pediatric service, which entails physical distancing from their baby," Sullivan said. "It prevents that first golden hour that we refer to of bonding with the baby. However, it is in the best interest for the health of the baby."
But Sullivan, too, stressed that the mothers are ultimately the decision-makers when it comes to the care of their babies.
"I’ve got moms that are really torn," Sullivan said. "I even had a couple moms suggest that they might decline separation with the baby. And certainly, if the parent decides to keep the baby with them versus being admitted to the NICU, they will be allowed that option."
Because there is no evidence to suggest the virus can be transmitted through breast milk, breastfeeding and pumping are still a safe option.
At Tufts, doctors encourage moms with coronavirus to pump and give the milk to a a healthy partner or health care worker to feed the baby.
Among the new mothers who have coronavirus at both Tufts and BMC, the majority make full recoveries. What’s more, babies who have tested positive are faring exceptionally well.
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