As coronavirus spreads in the U.S., parents-to-be are concerned about how the outbreak will impact their birth experiences and the initial moments of their babies’ lives.
This morning, NBC News medical correspondent Dr. John Torres joined TODAY to discuss common questions expectant parents have right now — from hospital visitor policies to protocol if a mother is infected with COVID-19 before giving birth.
1. Will hospitals around the country restrict partners from being the delivery room?
On Monday, NewYork-Presbyterian hospitals in New York City enacted a no-visitor policy, which bars partners from being present for the birth of their child. Torres explained that the decision was rooted in New York City being one of the “epicenters of this outbreak.”
He added that he doesn’t believe policies this strict in nature will spread “unless there’s more hot spots across the country.” The best way to prevent this from happening, Torres continued, is for “everybody (to do) their part” by social distancing and following other practices to prevent the spread of the virus overall.
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“It’s a decision they’re not taking lightly,” Torres said. “I don’t think any expert would argue that it’s not good to have somebody there as support … But the same experts would say even more important is to make sure (the health of the staff, mother and baby are) maintained."
2. How long will these restrictions be in place?
Torres said he’s hopeful that the policies in New York City will only be in place for a few weeks.
Dr. Christian Pettker, chief of obstetrics at Yale New Haven Hospital in Connecticut and associate professor at Yale School of Medicine, told TODAY that these restrictions will likely be in effect “until we have better control over the population spread of the virus.”
The catch, he added, is “we don’t know when that will be.”
3. What happens if a woman becomes infected with COVID-19 before giving birth?
In these situations, the highest priority is to “make sure the baby doesn’t have it and make sure the mother recovers from it,” Torres explained. “The one thing (hospitals) don’t want to do is pass it on to the child because we do know that children can be at risk of this, and the younger, the worse it can be.”
While hospitals are “trying to normalize the experience” for moms with COVID-19 as much as possible, Pettker said, their current recommendation is to separate newborns from their mothers and not to promote breastfeeding. Instead, moms are encouraged to pump or hand express breast milk and bottle feed.
“But those decisions are generally made through shared decision-making with the patient and health care provider and weighing the risks and benefits,” he continued. “Women are allowed to make their own health care decisions and decisions for their children, and we give them the best available advice.”
The length of the separation is determined “on a case-by-case basis,” he added. “It’s hard to generalize about such an unusual disease.”
The Centers for Disease Control and Prevention issued a similar recommendation for mothers with confirmed COVID-19 diagnosis or under investigation for COVID-19: "Whether and how to start or continue breastfeeding should be determined by the mother in coordination with her family and health care providers."
The CDC states "we do not know whether mothers with COVID-19 can transmit the virus via breast milk."
4. Will there be operating rooms available for cesarean sections?
Moms have also expressed concern about safety of and access to C-sections, scheduled or otherwise, while hospitals are devoting resources to seriously ill patients with the coronavirus. Torres stressed that these procedures will still be “very safe.”
“The operating room where they’re doing the C-section is a sterile environment,” he said. “They’re taking extra precautions to make sure that nobody’s in there that has COVID-19 ... If you’re scheduled for a C-section or if they recommend a C-section, I think that’s one of the few things you don’t have to worry about.”
Pettker echoed this idea: “The good news is that people are paying a lot of attention to good medical practice and high standards of care.”
He added that operating rooms and beds should be available because many hospitals are canceling elective surgeries.
Maternity and newborn units are generally “separate from the activities of the rest of the hospital, so all the work that’s being done with non-obstetric, COVID cases usually doesn’t cross over with maternity care,” Pettker explained.
5. Have any babies been born with coronavirus in the U.S.?
“There have been some cases around the world of (newborns having COVID-19) but not here in particular in the U.S.,” Torres said.
Pettker added that the data from abroad addresses only single or small groups of cases.
A study published last week in Frontiers in Pediatrics, which focused on four babies born in China to COVID-19-positive mothers, found that none of the babies developed serious symptoms. The three babies whose mothers consented to testing were all negative for the virus.
Another small study published in The Lancet, which looked at six moms in China who tested positive for COVID-19 during pregnancy, showed no evidence of the virus in samples of amniotic fluid, umbilical cord blood, breast milk or the babies’ throat swabs.
According to the Centers for Disease Control and Prevention, U.S. public health officials still don’t have a definitive answer as to whether a pregnant woman with COVID-19 can pass the virus to her baby during pregnancy, delivery or breastfeeding or if the disease poses a risk to the fetus.
While some of the precautions hospitals are taking may seem extreme, they're acting in an abundance of caution and care for their patients.
This story was updated on March 26, 2020 to reflect the current recommendations on breastfeeding from the CDC. This story was updated again on March 27, 2020 to clarify Dr. Christian Pettker's comments on breastfeeding.