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Health Education Maternal Matters

Riding the emotional roller coaster of a pregnancy in a pandemic: An essay

A mask and an expectant mother represent pregnancy and coronavirus

When you first see those two pink lines on a pregnancy test, you feel a range of emotion, from elation to terror, all at the same time. Those panicky feelings have only been exacerbated by the global pandemic happening at the same time. Now in addition to the typical worries (like making it through the first trimester and fears of the actual birth itself), there are extra factors to consider. Pregnancy and coronavirus concerns are valid (and a bit of a juggling act), but they can be dealt with.

What I learned about being pregnant during coronavirus

During the pandemic, I’ve been through a miscarriage, a long journey trying to conceive again, and recently a new pregnancy. After finally becoming pregnant again, I realized this wasn’t a typical pregnancy. Being pregnant during coronavirus  and the new normals that come with it adds a variety of additional stressors.

Pregnant women and coronavirus risks 

The first new stressor is whether pregnant patients are at a higher risk of contracting COVID-19 and if getting a COVID-19 infection during a pregnancy would pose additional complications. Scientists and healthcare providers  have been researching this topic since early 2020, but there is still somewhat limited knowledge of the true effects on a pregnant woman and a fetus. 

Based on a January to June study, the United States Centers for Disease Control and Prevention (CDC)  concludes: “Among reproductive-age women with SARS-CoV-2 infection, pregnancy was associated with hospitalization and increased risk for intensive care unit admission, and receipt of mechanical ventilation, but not with death.” The study also found that Hispanic and non-Hispanic Black pregnant women are disproportionately affected by SARS-CoV-2 infection during pregnancy. 

So, while it’s still mildly terrifying to think about being pregnant with coronavirus, at least it’s not any more deadly than normal.

 RELATED: Can I get the flu shot while pregnant?

Risk of infection for the developing baby

Additionally, I stressed about whether the coronavirus infection would be passed to my baby. After all, how can a baby with only a partially developed immune system fight a disease that’s killing adults? 

The good news is Denise Jamieson, MD, chair of the Department of Gynecology and Obstetrics at Emory Healthcare and member of the COVID-19 task force at the American College of Obstetricians and Gynecologists told NPR on All Things Considered that while COVID can cross the placenta and impact the baby, it doesn’t happen very often. She also explained that when it does happen there isn’t as much of a concern with birth defects like there was with Zika and other severe illnesses. 

But it’s more the long-term consequences that we know less about, says Erika Munch, MD, a reproductive endocrinologist and infertility specialist at Texas Fertility Center, says. “The pandemic has only been around for nine months, so we only have data available in the next year to show us any adverse pregnancy outcomes associated with [COVID-19],” she says.

For now, I’ll follow the CDC guidelines in order to help put my mind at ease a bit. Being pregnant has increased my awareness of social distancing, face coverings, and other precautions even more. 

RELATED: What to do if you get the flu while pregnant

Restrictions at prenatal appointments

Another concern—which has bothered me from the first prenatal care appointment—are the rules about visitors at providers’s offices. Partners have an integral role in pregnancies in many cases. Although my provider’s office was following best practice for social distancing to reduce the risk of COVID-19 transmission, not being allowed to have my husband present for doctor’s appointments has led to additional stress. 

This occurred when the doctor went over the details of a blood clot spotted in utero early on, which basically could have been harmless or could turn into a big problem. Normally in this situation, in which I’m already quite anxious, I’ve had my husband’s brain to pick later. I’d have asked him how serious the doctor had made the situation sound, and I’d have clarified what I’d actually heard her say. But he wasn’t allowed in. I didn’t trust my own recollection of the conversation due to the high stakes high-stress vibe in the appointment (post-miscarriage) and couldn’t ask him. 

It can be confusing sometimes. Partway through my early pregnancy, they started allowing partners into ultrasounds but not appointments. My husband wasn’t there in January when the tech couldn’t find a heartbeat, so it really mattered that he could be there for each visit. 

Restrictions during delivery

There are also limits on how many people from your support system can be present at the hospital and in the postpartum time frame. 

Many hospitals have very restrictive policies for labor and delivery, limiting support to one person, meaning that beloved sisters, mothers, and friends have not been able to be there through this transformative experience, and likely removing the option of professional support in the form of doulas,” explains Amy Lewis, a doula, lactation counselor, and childbirth educator in Florida, who has seen drastically different birth experiences in 2020. “Even choices for comfort in labor have changed—as medical options like nitrous oxide are not being offered during this time.”

I haven’t really allowed myself to picture the actual physical task of laboring with a face mask on, a precaution I plan to take and know is necessary. 

Limitations and isolation in postpartum life

Many new parents are quarantining after leaving the hospital, which is transforming what would be the first precious few weeks at home with visitors bringing muffins, hugs, and support into an isolated time. “People are connecting through Zoom and other forms of media…but it doesn’t replace face to face interaction [during the pregnancy and postpartum period],” Dr. Munch says. 

Once I’ve made it through childbirth in a pandemic and am back home with a baby, I anticipate the day-to-day looking much different from my previous postpartum experiences. Typically, the house is filled with family members wanting to hold the baby, which probably won’t happen. And, sadly, it affects much of the postpartum experience. 

Moms’ groups are suspended [or have gone virtual],” Lewis explains. “Breastfeeding support is often virtual. Parents can’t come help or have to quarantine first. Those expecting their second, or third, or more, are struggling to get care for their older children.”

Although the virtual solutions might not be ideal, they’re a safe way to introduce your little one to the friends and loved ones who have been supporting you throughout your pregnancy. The Centers for Disease Control and Prevention provide guidance on keeping newborns safe from COVID-19.

RELATED: Postpartum depression and breastfeeding: How to find a support system

Enjoying the small things and carrying on anyway

In spite of everything, it still may be reasonable to get pregnant during the pandemic—just have an open, honest conversation about your health and risks with your provider first. Women have birthed healthy babies throughout many crises in history—and will continue to. I along with those trying to conceive, those who are pregnant, and postpartum moms will try to salvage the joy and hope of a baby amid the uncertainty and anxiety.

In spite of the limitations, fears, and additional factors to consider, I’m elated to be pregnant, even in a pandemic. I know that there’s nothing more positive and powerful than the birth of a new baby even in a world that’s struggling.