Tips for Women Navigating Pregnancy During a Pandemic

Warlick

The novel coronavirus has upended nearly every part of our daily lives. From how we work, how we celebrate milestones, where we eat, how we consume information, etc. Amazingly, life goes on, and women are still having babies. As COVID-19 spreads across the country, expectant moms are confronted with new challenges as childbirth approaches – questions about staying healthy, keeping their baby safe and limiting their risk of exposure while in the hospital are all part of the discussion. 

Hospital policies and federal guidelines are constantly changing, which can add significant stress to pregnant women and their partners. As expecting moms navigate pregnancy during this pandemic, here are some ways to remain empowered, alleviate some concerns and enjoy this special time with a new baby.

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Stay informed and empowered.

We are learning more and more each day about COVID-19 and its effect on pregnant women and infants. The CDC reports “a small number of reported problems with pregnancy or delivery in babies born to mothers who tested positive for COVID-19 during their pregnancy,” such as pre-term birth. Perhaps most importantly, however, there have been no infants born to mothers with COVID-19 that have tested positive for the virus, meaning it’s unlikely that an expecting mother could pass the virus to her fetus or baby during delivery. That being said, if the mother is being treated for COVID-19 at the time of birth, it is possible she will have to practice social distancing for the recommended 14-day period to ensure she doesn’t pass the virus to her baby.

During this pandemic, anesthesiologists like myself are continuing to provide our pregnant patients, including those who have tested positive for COVID-19, with epidurals and spinal anesthesia to help manage pain during labor. In fact, the American Society of Regional Anesthesia (ASRA) guidelines recommend regional anesthesia over general anesthesia for patients with COVID-19. At my hospital in North Carolina, I use a non-opioid option called EXPAREL® (bupivacaine liposome injectable suspension) to manage patients’ pain after C-sections. EXPAREL is designed to slowly release a numbing medication over an extended period of time, meaning it starts controlling pain during surgery and continues for the first few days after surgery, when patients need it the most. See important safety information below.

Stay connected while practicing social distance. 

Due to concerns surrounding the spread of coronavirus, several hospitals are now limiting birthing partners and support persons from labor and delivery rooms. This can cause a lot of anxiety and stress for moms – especially those who may be facing a longer hospital stay due to a C-section.

Look into using technology to stay connected with loved ones while in the hospital. If you have a smartphone, tablet or a laptop, now is the time to think about how they can help you before, during and after birth.

• Use telemedicine. Many health care providers have begun working with patients virtually rather than providing in-person support. Ask questions, talk about your options and the changing environment to help ease concerns and stay connected to your doctor before you see them in the delivery room. And remember, if you are discharged from the hospital sooner than expected, remember your doctor is just a phone (or video call) away.

• Pump up the volume. Personalized playlists with songs that have special meaning to you can help you stay present and provide emotional support while in the hospital.

• See a friendly face. Technology could become even more important if you find yourself delivering somewhere with a policy that limits visitors. Call up family, friends and loved ones who have been providing support throughout your pregnancy. Introduce them to your new addition since they likely won’t be able to meet the baby in person for some time. 

Being prepared with a technology plan can help you stay connected and provide a loving support team while respecting the social distancing guidelines. It can also help relieve stress, worries and anxiety associated with a changing birth plan and limits on visitors while in the hospital.

Talk to your provider about getting home faster.

Now more than ever, women want to spend as little time as possible at a hospital. Medical societies like the American College of Obstetricians and Gynecologists (ACOG) have encouraged hospitals to explore ways to quickly discharge healthy moms and babies to help limit the risk of inadvertent exposure and infection of COVID-19.

With that in mind, physicians are implementing approaches that can help new moms and their babies get home sooner without compromising their recovery – especially after C-sections. As an obstetric anesthesiologist during this health crisis, I realize how important it is for moms to have healthy deliveries while limiting their time in the hospital. For example, my use of non-opioid options, like EXPAREL for C-section patients enabled them to return home sooner, minimized the use of opioids*, and allowed for a more positive experience with pain management.

*The clinical benefit of the decrease in opioid consumption was not demonstrated in the pivotal trials.

It’s always a good idea to have in-depth conversations with your OB/GYN or midwife about your expectations for childbirth, but you might want to ask about other aspects of birth that have changed specifically as a result of the pandemic. Ask about non-opioid options, like EXPAREL, that can help you recover and go home quicker following a C-section.

If you are being treated for COVID-19, there are some factors to be aware of once you bring the baby home as well. The American Academy of Pediatrics (AAP) released new guidelines for the care of infants whose mothers have COVID-19, and while studies have not found evidence of the virus in breast milk, it’s important to take extra precautions when breastfeeding. For example, you might consider pumping and allowing an uninfected family member to feed the baby. The virus is spread through respiratory droplets, so new moms (and dads!) should continue to wash their hands and consider wearing a face mask to minimize infants’ exposure to the virus.

The COVID-19 outbreak is an evolving pandemic, so it’s important to stay informed and up to date on recent developments pertaining to new moms and babies. Feel empowered to ask questions and seek guidance from your health care providers via telemedicine, as needed.

Important Safety Information

EXPAREL should not be used in obstetrical paracervical block anesthesia.

In studies where EXPAREL was injected into the wound, the most common side effects were nausea, constipation, and vomiting.

In studies where EXPAREL was injected near a nerve, the most common side effects were nausea, fever, and constipation.

EXPAREL is not recommended to be used in patients younger than 18 years old or in pregnant women.

Tell your healthcare provider if you have liver disease, since this may affect how the active ingredient (bupivacaine) in EXPAREL is eliminated from your body.

EXPAREL should not be injected into the spine, joints, or veins.

The active ingredient in EXPAREL:

• Can affect your nervous system and your cardiovascular system

• May cause an allergic reaction

• May cause damage if injected into your joints

• Can cause a rare blood disorder

For more information, please visit www.EXPAREL.com/patient.