BOSTON — Pregnant women can be at higher risk for many complications from infections because pregnancy suppresses the immune system. But the risks of COVID-19 on pregnant women and their babies are not yet clear.
OB-GYN specialists at Brigham and Women’s Hospital and at several hospitals in New York City have reported seeing patients come in with no symptoms of the coronavirus, only to show symptoms and test positive shortly after giving birth. It’s believed these women had COVID-19 and were asymptomatic, or showing no symptoms, until around the time they gave birth. And it’s one reason doctors at all Partners HealthCare hospitals, including Brigham and Women’s in Boston, are now taking proactive measures.
Since April 16, Brigham and Women’s, along with all Partners hospitals, has been screening all pregnant women who are about to go into labor at the hospital for COVID-19 - whether they have symptoms or not. But because of a lack of available tests, women giving birth at hospitals across the country aren’t being tested for COVID-19 unless they show symptoms or there’s reason to believe they’ve been exposed.
Dr. Lisa Dunn-Albanese, an obstetrician at Brigham and Women’s, says she consulted on a case prior to April 16 that involved a patient who was admitted to the labor and delivery floor with no symptoms of COVID-19 and was not tested for the virus. After giving birth, the mother suddenly had trouble breathing and needed oxygen and tested positive for COVID-19.
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Doctors don’t know why this is happening. Dunn-Albanese said it’s possible that the stress of going into labor and delivering a child could be a trigger or that women are going into labor within 14 days of contracting the virus. Symptoms of COVID-19 may not be apparent immediately after infection and may not appear for weeks.
The concern is that that a woman giving birth might be infected and not know it, spreading the virus not only to doctors, nurses and other patients, but also her newborn. The CDC says it’s unlikely a mother can pass on COVID-19 in utero, but after birth a newborn is susceptible to the virus. For mothers who should be bonding with their newborns, it makes for difficult decisions.
“If a new mother is COVID-19 positive, some of the options are to be separated from the baby to pump and express breast milk but feed the baby through a caregiver who is COVID negative, and physically distance for two weeks," Dunn-Albanese said. “The other option is to move in with the baby with some sort of physical barrier in the room like a screen or an incubator. The mother would need to wear a mask and practice good hand hygiene while breastfeeding.”
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