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Emily LaSota MD (Guest): The process of giving birth this year is definitely different than it was this time a few years ago when there was no pandemic. We had many people in the delivery room. No one was wearing masks. As soon as the baby was born, everyone was hugging and kissing the baby. That's much different now.

Caitlin Whyte (Host):  You may have heard our previous episode on COVID-19 and pregnancy. But as you know, a lot has changed since that episode. So join us for an updated May, 2021 show on how the pandemic is affecting pregnant people. Joining us is Dr. Emily LaSota, a Board Certified Obstetrician and Gynecologist on the medical staff at Southwest General.

This is Southwest General Health Talk. I'm your host, Caitlin Whyte. So, Doctor start us off here. What are the effects of Coronavirus on pregnant women?

Emily LaSota MD (Guest): Pregnant women can contract coronavirus just as anyone who is not pregnant can contract coronavirus. However, the effects on a pregnant women are much more likely to be severe than their nonpregnant counterpart. So, one in 10 women who contract COVID-19 will need to be hospitalized. One in 11 will need critical care and one in 80 are at risk of dying of the disease. This is from a study that was published in Washington State earlier this year. The rate of hospitalization is three to four times higher than that of non-pregnant people. So, getting coronavirus in pregnancy is a lot more risky than just the average person walking on the street.

Host: And a broader question off that. What are the effects of Coronavirus on pregnancy in general?

Dr. LaSota: The effects on pregnancy are usually a reflection of how severely the coronavirus disease affects the mother. There is definitely an increased risk of preterm delivery with severe or critical illness. About 45% of women who are severely or critically ill will deliver preterm. The risk of preterm delivery in those with mild disease is much lower at five percent.

Host: Now can COVID-19 affect a newborn baby?

Dr. LaSota: COVID-19 can affect anyone from the newborn stage, obviously throughout their entire life. Newborns, for the most part, that are born to COVID positive mothers do not test positive or exhibit symptoms at birth. Although there are a few exceptions to that rule. Most newborns who have acquired COVID-19 presumably from their positive mothers shortly after birth, for the most part, have had mild disease, but there is the risk that a newborn baby could develop severe symptoms from a COVID 19 infection.

Host: What is it like to give birth during a pandemic? How has that process been?

Dr. LaSota: The process of giving birth this year is definitely different than it was this time a few years ago, when there was no pandemic. We had many people in the delivery room. No one was wearing masks. As soon as the baby was born, everyone was hugging and kissing the baby. That's much different now. So, for a time, our hospital was only allowing one support person in the delivery room for the baby's birth. That has now been increased to two. All women prior to admission are tested for COVID-19 so that if they are COVID positive, we take the correct precautions to protect our hospital staff and other patients when they come into the hospital. Patients who are positive for COVID-19 do not receive any different care. They are not recommended to be induced or deliver early or delay their delivery. Delivery plan is unchanged. But the protection that healthcare workers use is different. We usually isolate the mom, the baby, and the support person in a room together.

The mom and the baby are not separated, but we keep them isolated from other members of the healthcare staff that are not taking care of them and other patients to protect from spreading the infection to people around them.

Host: Now, what should I keep in mind after my baby's arrival, especially when it comes to breastfeeding?

Dr. LaSota: Breastfeeding is awesome for many reasons. One reason is that antibodies that the mother has, fresh antibodies are passed through breast milk to the baby. So, if a mom has COVID-19, she will form antibodies against coronavirus. Those antibodies have been seen in most women who are infected, passing through into the breast milk. This causes something, we call passive immunity in the baby. So, even prior to the baby becoming infected, it will have antibodies, so that if it does become infected with the virus, it can fight it off more quickly. Breastfeeding, if a mom has COVID-19 is encouraged. We encourage the mother to wear a mask and wash hands while breastfeeding. And if at all, feasible while not breastfeeding, try to stay six feet away from the baby.

I do understand. And when we all understand, this is extremely difficult. When a mom has a newborn baby, but breastfeeding is one of the best things a mom can do to protect her baby against COVID-19.

Host: Of course with a new baby, family and friends are going to want to meet them. What are some protocols I should keep in mind when it comes to letting people meet the baby? Should they wear a mask? Should they be vaccinated?

Dr. LaSota: This is an extremely difficult question to answer, because this is an extremely difficult time. This is a time that is unprecedented, that we have never dealt with before. Obviously minimizing exposure to people who could have Coronavirus and transfer it to the baby is ideal. The primary caregivers who help care for the baby, they have to be around the baby. The parents, any nannies, babysitters, healthcare providers, siblings that can not be prevented. But additional people, grandparents, aunts, uncles, cousins, friends, everyone wants to come meet the baby. That's a natural reaction to an awesome event like having a baby. Having them get vaccinated before coming is a great thing to do. Having them wear masks while being in the presence of the baby is a great thing to do. It's a very hard time to say, no, you can't come over to see my baby, but that is okay to say, if you want to protect your baby and are uncomfortable with people coming over saying no is okay until a person is vaccinated, numbers are down or the infant is a little older.

Host: Now, when it comes to the vaccine, should I receive the vaccine before, during or after my pregnancy? Is there an ideal time?

Dr. LaSota: The vaccine is the best way that we can prevent COVID-19 infection and spread. Before the vaccine had been widely studied, or even currently, many people were hesitant to get the vaccine pregnant or not. Now a lot of people are confident getting the vaccine based on the safety data available, but pregnancy safety data is a little different. So, we know that things that happen in pregnancy can affect the mom and the baby during pregnancy and even after delivery. So, we don't have long-term data, obviously. The vaccine was only widely available to the general public starting around December or January.

So, only about four or five months ago. So, we don't have a lot of long-term data, but we do have some encouraging data. So, just at the end of April, this past month, there was a study released in the New England Journal of Medicine that had data on over 35,000 pregnant women who received the vaccine either during pregnancy or 30 days before becoming pregnant.

And they found some really good results. So, in their study, they found no increased risk of preterm birth, stillbirth, miscarriage, compared to women who had not gotten the vaccine. So, this is very, very, very reassuring. When we're comparing risks and benefits, the risk of the vaccine appears very low. The benefit appears very high. Avoiding COVID-19 in pregnancy avoids those risks of hospitalization, critical care and preterm delivery. So, I'm encouraging all of my pregnant women to get their vaccine. In addition, I'm encouraging my breastfeeding moms to get the vaccine. There was a recent study that came out in JAMA, which is a scientific journal and it followed women who were breastfeeding and who had gotten the vaccine. Antibodies in moms were detected in their breast milk, as soon as two weeks after the vaccine and followed out. There were antibodies in 97% of mom's breast milk by week six. So, if you feel uncomfortable, getting the vaccine during pregnancy, that's understandable and you should do what is right for you. But after having the baby, there are still benefits to getting it if you're breastfeeding and if you're not breastfeeding, get it anyway, because if you don't get COVID-19 that prevents you spreading it to your baby.

Host: I've been seeing a lot on social media, Instagram, this myth that the vaccine will affect my fertility. Can you confirm once and for all, if that's true?

Dr. LaSota: To date, there has been no data to suggest that the vaccine can affect fertility. Sometimes things can be created by non-medical personnel and can spread very quickly on social media. So, I encourage patients while you can use social media to catch up with your friends and get news from trusted sources, don't use social media for medical advice, go to your doctor for medical advice. Talk about the risks and benefits of any treatment. But to date, there is no evidence that the vaccine can affect fertility.

Host: Well, Dr. LaSota, anything else you want to add before we wrap up here?

Dr. LaSota: I just encourage everyone to continue to do your part, to minimize the spread of the pandemic. Get your vaccine. I got my vaccine in December and January of this year and I'm happy I did. So, stay safe and support your breastfeeding moms.

Host: Dr. LaSota, thank you so much for sharing this critical information with us. I hope we've debunk some myths and put some people at ease during this crazy time. To learn more about Southwest General's Maternity Services, visit swgeneral.com. This is Southwest General Health Talk. I'm Caitlin Whyte. We'll see you next time.