With couples quarantining together across the country, many have theorized about a baby boom in nine months. If you and your partner are considering trying to conceive, there are many factors to think about right now, as the coronavirus pandemic has impacted every part of our society.
According to recent guidelines from the American College of Obstetricians and Gynecologists, there is "no clear answer," as to whether or not couples should delay attempts to get pregnant. While the decision is ultimately up to you and your partner, ACOG and other experts shared advice.
Access to health care
To start, prenatal appointments are now being conducted via telemedicine as much as possible, Dr. Christian Pettker, chief of obstetrics at Yale New Haven Hospital in Connecticut and associate professor at Yale School of Medicine, told TODAY.
But these new practices don't have to "negatively" affect your care, he said, and some developments are even "exciting." For example, many patients are being prescribed at-home blood pressure monitors, which reduce the need for in-person visits.
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Still, it's unclear how these changes could affect prenatal outcomes, Dr. Katherine Kohari, associate medical director at Yale School of Medicine, who specializes in high-risk pregnancies, told TODAY.
"We are concerned that things may get missed or caught later when (patients) are already down the road and sicker," she explained.
Telemedicine aside, pregnancy still necessitates a few doctors' visits in person. Per Kohari, early ultrasounds in particular are important "to evaluate the progress of the pregnancy.”
"I would ask (patients), 'Would you want to be coming to the office, potentially exposing yourself and your developing baby to sick patients, sick providers?'" she said. "We take all precautions to prevent spreading infections in our offices ... But would you want to take that risk of potentially exposing yourself in those first few months of pregnancy?"
Having partners present for important moments
Hospitals nationwide have limited the number of visitors pregnant women can bring to appointments. So consider that your partner or other loved ones might miss exciting moments. The other side of the coin, Kohari explained, is that you might be on your own when receiving bad news.
"We're doing the best we can to maintain normalcy and to support our patients," Kohari said, adding that her facility has taken to calling partners during appointments to let them ask questions.
Seasonality of COVID-19
It’s possible the coronavirus will become a seasonal illness, like the flu. So, women who get pregnant in the coming months could give birth amid another outbreak in the winter.
"We just don't know what's going to happen," Dr. Stephanie Gaw, an associate professor of obstetrics at the University of California, San Francisco, told TODAY. She added that this strain has behaved differently from another well-known coronavirus, SARS, which petered out.
Kohari thinks the seasonality of the coronavirus is something to consider.
"I think we can assume there will be a seasonality to this," she said, offering an upside. "For people who would be having children this time next year, we would have a lot more experience under our belt, and it would be less a time of fear."
Unknowns about the coronavirus and pregnancy
If you're trying to conceive now and become sick with COVID-19, it would most likely happen during early pregnancy — but there isn't any research about what this could mean. As Gaw explained, this virus has only been circulating for four months, so any moms infected in the first trimester have yet to give birth.
According to ACOG, limited data shows pregnant women aren’t at "increased risk of infection or severe morbidity," including ICU admission and death. But pregnant women with underlying conditions may have an increased risk versus the comparable, non-pregnant population. In addition, there's no conclusive evidence that the virus can pass from mom to baby.
Other studies not specific to COVID-19 suggest that pregnant women who develop severe fever or prolonged illness in the first trimester have increased risk of miscarriage and the child developing a birth defect, according to Gaw.
"It’s not for sure. It’s still relatively low," she said. "We don’t know if it’s going to be worse, the same or maybe less for COVID-19."
Three major and urgent questions remain, Gaw said: Are pregnant women at higher risk for severe complications? Does a mom's coronavirus infection affect how the baby grows? And is there transmission from the mom to the baby?
Economic and social concerns
Getting pregnant right now means growing your family in a time where the economy and people's livelihoods are struggling.
"People should take all that into account," Pettker said.
Gaw added that getting pregnant without social support can be challenging.
"You can't tell someone not to get pregnant," she said. "My advice would be, if you had the luxury of waiting a couple months until things die down a little bit, (you) might want to do that. But we can’t say definitively that there’s an actual danger to the pregnancy itself."