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Let’s be real right now. Pregnancy is a weird and scary enough process in the best of circumstances. Throw in a global pandemic, and many mamas are even more anxious than normal. Who can blame them? They’re growing humans! Anxiety abounds.

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As a result, we’ve gotten lots of questions from women at all stages of pregnancy, including:

  • Is it safe to continue trying to conceive?
  • How worried should I be now that I am pregnant?
  • What do I do once I bring baby home?

We heard your questions (thank you!) and relayed them to Dr. Chavi Eve Karkowsky, a Maternal Fetal Medicine specialist (MFM), also known as a high-risk pregnancy doctor.

We did a live interview with her on IGTV, and we’re summarizing what she taught us here.

We got cut off part of the way through, so also check out the follow-up video where Dr. Karkowsky answers the last remaining questions after my internet crapped out. (I’m coming for you, AT&T, for breaking us up!).

Introducing Dr. Karkowsky

Dr. Karkowsky graced our Instagram Live feed on June 10th with her warmth, grace, and knowledge about all things pregnancy and COVID-19. Seriously, she’s amazing, and now we want to be her best friend.

Her voice is steady and full of care as she navigates explaining the implications of COVID-19 for maternal and fetal care. With each question she answered, it was clear that her genuine concern was for the health and happiness of mamas and babies.

And even while her calm voice and friendly demeanor will likely make you fall in love just as fast as we did, there’s even more to her.

Dr. Karkowsky is an accomplished physician and writer. She recently published High Risk: Stories of Pregnancy, Birth, and the Unexpected (March 2020), a book we highly recommend to demystify the experience of going through high risk pregnancy. Especially, now, when all pregnancies feel a bit higher risk than normal.

She’s also written for publications such as Slate Magazine, The Atlantic, and Washington Post. That is to say, we can trust her.

Important Things to Remember about Dr. Karkowsky’s Talk

Before we get to your questions, we’d like to remind you that Dr. Karkowsky works on the front lines of COVID-19 in New York City.

As such, many of her answers are coming from the epicenter of the epidemic. It’s important that you make wise decisions based on where you live.

And as we see the numbers begin to rise in areas like the South (where we’re based), educate yourself and make decisions based on numbers in your own area.

You can use the World Health Organization’s Coronavirus Disease Dashboard to learn more about the status of the virus in your country, but you will need to do more outside research to learn the status of the disease in your state.

Do your homework, mamas! It’s vital, especially as information about this virus changes almost daily and very little is actually known about how COVID-19 affects pregnant women and their babies.

Preparing for Pregnancy: Is it safe to try to conceive right now?

Here’s what Dr. Karkowsky had to say:

“I spend a lot of time working with women to get their health in an optimal place before trying to conceive. This ties into reproductive justice: you deserve to have a pregnancy when you want a pregnancy; you deserve to have a child and then have them come back to you.

Um, is anyone else getting misty-eyed over here? A doctor who wants to support women’s rights to reproduce whenever we want a pregnancy? We’re here for it.

Even during a pandemic, though, there are some things you need to think through before getting pregnant, according to Chavi (we’re on a first name basis now, obviously):

  • What is your life like right now? 
  • What does your economic situation look like?

Life is stressful, and economic situations can change, especially now during COVID-related economic uncertainty. Her point here is that you need to think about the climate of your own life and finances before trying to conceive.

Ultimately, however, you deserve to have a healthy baby whenever you want the pregnancy, and even now during COVID.

Of course, with my history of infertility and recurrent miscarriage, we know it isn’t always that easy. Yet still, this doctor believes you deserve a baby when you’re ready.

 “If you want that, then I want to make that happen for you.”

Okay, now we might actually be crying.

Pregnancy & COVID-19

Some mamas-to-be became pregnant before the pandemic and are now dealing with a very different reality than they expected. In this section, Chavi answers your questions about how to protect yourself and your baby while pregnant.

pregnancy woman wearing a face mask with a pregnancy test, sonogram, and birth plan notes laying near her
Overwhelmed at the thought of having a baby during a global pandemic? You’re not alone!

How can I keep the stress of this from hurting my baby?

Many of you had questions about stress during pregnancy, which is definitely understandable. Specifically, you wondered if pregnant mothers should worry about passing their stress on to their babies.

Chavi’s answer reminds us that this is yet another question that exists outside of the pandemic: “This is in some ways another way that women blame themselves for not being perfect. Once you have a child, that’s no less true.”

In short, no matter how much you want to control your stress levels, it’s impossible to do so, especially now.

Yes, you can take measures to keep your blood pressure down and your chin up, so-to-speak, but at the end of the day, your COVID-related stress is not your fault.

“Deep within this question is a desire to control, but we have to admit that there’s only so much that we can control.”

Our best recommendation: control what you can and accept what you cannot control. You get to make decisions about your daily life, and if you keep reading, you’ll find reliable information to help you make those decisions. Those decisions are things you can control. When you feel anxious, remind yourself of all you’re controlling to care for yourself and your unborn child.

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What is safe for pregnant mothers right now?

As states open but cases continue to exist and increase, what is safe for pregnant women? How do we determine what is safe for pregnant women?

According to Chavi, “In the beginning [of the pandemic], we knew nothing about how COVID-19 affects pregnant women. Pregnant women do not seem to be more likely to get COVID, nor are they more adversely affected. It can be passed to the baby, but newborns seem to handle it okay.” [editorial note: it’s important to remember that information like this is changing almost daily as more studies are conducted and new research is published].

Ultimately, Chavi notes that we are all going to have to make choices, and we’re all going to have to make them without a lot of information.

Here’s what we do know about safety and pregnancy:

  • It’s better to be outside than inside if we’re around other people
  • We can’t spend a lot of time with people in small spaces
  • We have to figure out structures that feel safer, and within these spaces, are there things that can bring us joy? For example, if you expand your own circle of friends and family, you need to make sure that you are expanding it to only include people who have been adhering to the same levels of safety as you have.
  • Fomites aren’t really something to worry about; it doesn’t look like we can transfer COVID-19 via surfaces very easily, but it also doesn’t hurt to be careful. In other words, worry more about the air you share with people than whether you touched the same table or bag. 
  • We have to create lower and lower risk situations for ourselves–this means practicing good hygiene; avoiding groups of people; practicing social distancing; wearing a mask when in public.

What Activities Can Pregnant Women Safely Enjoy?

Of course, we’re all concerned about when we can go back to Target safely. There are summer clothes and shoes awaiting us, for god’s sake. Not that we have anywhere to wear them.

But how can we protect ourselves while we’re doing things we need to do, like grocery shopping?

Chavi notes that activities like grocery shopping aren’t terribly unsafe, as long as your face, nose, eyes are protected.

She also reminds us that many people don’t have this choice; they have to go to the store. We have to do what we have to do. But we should still stay as safe as possible while doing so.

She does caution that elective activities like pedicures and prenatal massage are off the table for pregnant women at the moment.

Right now, they feel like too much of a risk, so if you desperately need a foot massage, ask your partner to massage your feet, and if you’re in desperate need of a pedicure, you can always hand them a bottle of polish and hope for the best.

In better news, Babymoons are still on the table! Dr. Karkwosky prefers AirBnBs that have been unoccupied for 3-4 days before you arrive, as opposed to hotels.

Using an AirBnB or VRBO means that you can connect with the host before you arrive to see if anyone will have been in the unit before you. Many owners have seen huge decreases in people renting their properties, so the likelihood of finding a sympathetic owner who can assure you of things like safe cleaning practices is also higher.

Is it possible that it’d be best to get COVID while pregnant so we can pass the antibodies to our babies through breast milk?

We were fascinated by this question, but Chavi says minimizing your exposure risk is still the way to go. We can’t control how we’ll respond to COVID-19 to know if it’s “good” to get it while pregnant.

And while, theoretically, it’d be great to be exposed to a very low viral load (that’s the idea behind a vaccine, after all), we can’t control the load to which we’re exposed.

Also, she reminds us, we don’t know what level of protection antibodies provide. Can we be reinfected if we’ve had COVID once? We aren’t totally sure. So it’s definitely not worth the risk.

Ultimately, we need to wait for a safe vaccine that’s been through clinical human trials and has been tested and thoroughly vetted for the safety of pregnant moms and babies.

What is the impact of mothers getting COVID during the second and third trimesters?

Content note: this section has mention of stillbirth, though Chavi does NOT suggest a pregnant mother should be concerned about stillbirth if she contracts COVID.

That said, we’ve likely all seen the scary stories of stillborn babies where the placenta tested positive for COVID. These stories led to lots of questions about this subject.

What Chavi says is that she’s treated a lot of patients who are pregnant with COVID, and that outcomes are usually good:

“I have had patients who have had pregnancy complications from COVID,” she admits, but the biggest concern is about “blood vessel damage and clotting. As we know, pregnancy is already a time when clotting and damage happen more easily, so we’re giving blood thinners (mainly Lovenox) to patients who are pregnant and test positive for COVID.”

This is the protocol in her practice, though, not nationwide. As she explains, “We don’t have an evidence-based standard.”

She also mentions that several of her pregnant colleagues have contracted COVID and been fine.

She also took the time to reiterate that most people who contract COVID-19 do not have severe cases. The severe cases are normally among patients who develop COVID pneumonia. So if you’re sick, take care of yourself and stay in touch with your doctor.

She does have one major piece of advice, though:

While we don’t know how COVID will affect a growing baby, we do know that really high fevers can affect the fetus. Tylenol is safe in pregnancy, and it’s well worth taking to get your fever down.

What medical devices and care do I need while pregnant?

We had several questions about devices like pulse oximeters and tests such as the COVID-19 antibody test.

In terms of pulse oximeters, Chavi says that they can be helpful for women who already know they have COVID-19. This is because pulse oximeters can tell you when your blood oxygen level is dangerously low even if you don’t feel worse than “normal.”

In terms of antibody tests, some of you had questions about whether or not they are reliable and whether or not Chavi recommends that pregnant women get them.

Her answer is that it’s hard to tell. She has friends who have had COVID and were antibody negative, so the tests aren’t entirely accurate. We also don’t know if antibodies even mean that you can’t get it again.

Preparing for the Arrival of a Baby Born During a Pandemic

One thing that’s definitely on the minds of mamas who are about to give birth (or who have recently given birth) is how to handle the extra stress of your family and friends wanting to come meet your adorable new bundle. And we get it–it can be freaking agonizing to not have beloved family and friends meet them.

Chavi says that you need to consider your unique situation when trying to decide who you will let into your immediate family’s bubble (also worth considering when you aren’t giving birth during a pandemic, for the record).

So much depends on what’s going on in your own life and in the lives of those you are thinking about letting in:

  • what are your risk factors, and the risk factors of your newborn, in general; 
  • are any of you COVID positive (or have you been around someone who is); 
  • who have you been quarantining with; 
  • have they been practicing safe social distancing, etc?

As a mom herself, Chavi was very careful about who touched her newborns except immediate family in the first six weeks.

As you are likely aware, if a newborn gets a fever, this is considered a medical emergency because a newborn’s system that controls their tiny body’s temperature is not well developed.

A fever can provoke a tremendous medical workup, including a spinal tap and possible hospitalization. NOBODY wants that kind of trauma, so protecting your newborn from anything that might cause a fever is imperative.

How do you handle inviting other people into your “bubble” after the birth?

If you want to have a support person like your mom or mother-in-law come into your home after the birth, that’s okay.

BUT, you want to make sure that person has been very safe, as well, before you open up your bubble to them (no public transportation, safe social distancing, etc).

And if you’re ready to have a few people meet the baby, you can always host a “baby meet and greet” somewhere outside like your backyard or a park.

You’ll still want to keep baby close to you and outside of others’ arms, however. You might consider wearing the baby so people can “meet” them from a safe distance and while wearing a mask.

The people Chavi is worried about in this situation aren’t just the newborns, but also new moms. As a new mom, you’re probably sleep-deprived, and your immune system isn’t great.

Take care of yourself, too, and be very judicious when inviting people into your bubble.

How should we handle newborns with older siblings who are going back to school?

Chavi was actually a little shocked by this question because obviously NYC isn’t ready to think about things such as elementary-age kids going back to school.

If your area is already talking about sending kids back to school in the fall, or if you have an older sibling who is going back to daycare, Chavi suggests practicing as much good COVID-19 hygiene as possible and use your intuition: i.e. make your toddler wash their hands before touching your newborn and also immediately upon return from daycare.

We are all practicing various levels of risk assessment based on our individual circumstances. If you are able to have a grandparent watch your child (instead of sending them to daycare), then that is preferable.

However, not all parents have this kind of support, and if that’s the case, we have to weigh pros and cons and do our best to keep everyone as safe as possible.

Takeaways from Dr. Karkowsky’s Interview

  1. You deserve to have a child when you want a pregnancy, even during a pandemic, but you have to be careful and find a medical team to support your decision.
  2. It’s NEVER your fault; don’t overly worry about passing stress onto a baby during a pandemic. Do the best you can to lower your own stress levels, and let it go.
  3. It’s better to be outside right now, but we have to find spaces that bring us joy, structures that we feel safe in. This means sharing inside space with people you trust, but not large groups. 
  4. Be judicious about who you let into your bubble. If you choose to have a support person in the home (like your mother or mother-in-law) make sure that they, too, have been practicing safe COVID hygiene. If you choose to have your friends and family meet the baby, then do so while everyone is practicing social distancing and wearing masks (and you or your partner are holding baby).
  5. Electives like pedicures and prenatal massages are still off the table for pregnant women in most areas.
  6. Educate yourself. Geographic areas have been affected by COVID-19 very differently, so it’s important to do the research to see how it’s affecting your area. 
  7. Wear a mask, stay six feet away from people, wash your hands. Practice all the same safe COVID hygiene you would if you were not pregnant. 
  8. We still don’t quite know how COVID affects pregnant women and newborns, but it’s important to remember that most people don’t actually experience the worst of COVID, which is COVID pneumonia. Pregnant women don’t seem to be any more likely than anyone else to get the virus or to have more negative effects from it.

What would you ask Dr. Karkowsky? Please tell us in the comments, as we’re looking forward to hosting her again in the Fall!

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