The serious and sometimes deadly complications of COVID-19 on pregnancy

You've read the statistics about more severe outcomes, preterm labors and maternal deaths — but you haven't heard their stories.

By Maura Hohman
February 26, 2021

The last thing MaElena Barcenas remembers before becoming a mom is trying to get in touch with her own mother. The 36-year-old, who lives in Detroit, had gone to the hospital for a checkup. She had preeclampsia, a blood pressure disorder that can occur during pregnancy or postpartum, and her feet had become so swollen she could barely walk. She'd been admitted for 24-hour observation when a nurse noticed a "rattle in (her) cough," Barcenas told TODAY.

An X-ray revealed a pneumonia diagnosis, which led to a positive COVID-19 test when she was 30 weeks pregnant. After a week in the hospital, Barcenas' oxygen levels — and her baby's — started dropping, prompting her doctor to perform an emergency cesarean section.

Giving birth on March 23, 2020, to her daughter, MariaElena, Barcenas was in the first cohort of U.S. women to contract COVID-19 while expecting. At the time, there wasn't much research into the disease's effects on pregnancy.

A year later, we've seen the lasting and devastating damage COVID-19 can cause. When contracted while pregnant, the virus increases the risk of severe illness in the mother, including needing ICU admission or a ventilator, and adverse pregnancy outcomes, including preterm deliveries and stillbirth. Since January 2020, over 70,000 U.S. women have contracted COVID-19 while pregnant, more than 11,000 required hospitalization. Seventy-nine have died, according to the latest data from the Centers for Disease Control and Prevention.

The agency's data also indicates that Black and Latina women are more likely to contract COVID-19 in pregnancy, representing 46% of the women for which the CDC has racial data.

Despite these stats, pregnant women aren't a priority group in the CDC's vaccine rollout recommendations. But at least a few states, such as Texas and Tennessee, have bumped them toward the front of the line.

As a result, the current reality for many expecting moms is dealing with nebulous guidance about whether to get vaccinated against COVID-19. There's minimal data about the vaccines' effects on pregnancy, though Pfizer recently announced plans to start trials in pregnant women. For now, the leading U.S. group for obstetricians and gynecologists only advises that vaccines not be withheld from pregnant women, who should have access to information to make an educated decision with their health care provider.

Source: CDC

Source: CDC

These are just snapshots of the confusion and hardship that people growing their families over the past year have had to endure. Three of them shared their stories with TODAY to give others hope in challenging times.

"I tell people that I was at the very end," Barcenas said. "They told my mom on multiple occasions that she needed to ... start making arrangements. Here I am 10 months later, (my daughter's) about to be 1. She's healthy."

MaElena Barcenas, Detroit

When MaElena Barcenas had her daughter in late March 2020, not much was known about the effect of the coronavirus on pregnancy. Brittany Greeson for TODAY

When MaElena Barcenas had her daughter in late March 2020, not much was known about the effect of the coronavirus on pregnancy. Brittany Greeson for TODAY

Barcenas remembers her first few days in the hospital seeming "normal." There was constant monitoring of her baby, and she tried to stay calm to avoid swings in her blood pressure, as she'd previously been diagnosed with hypertension. But after fever set in — it reached 105 at one point — "everything got real complicated," she said.

She has no memories of being prepped for her C-section or to go on a ventilator, which she was told happened at the same time. "Apparently everything else, it just went down hill," Barcenas said. She came out of a coma in the intensive care unit 33 days later.

Today, Barcenas' daughter is a healthy, happy almost 1-year-old. Brittany Greeson for TODAY

Today, Barcenas' daughter is a healthy, happy almost 1-year-old. Brittany Greeson for TODAY

When Barcenas gave birth, she'd been in and out of consciousness due to her low oxygen levels much of that day. Hospital staff removed MariaElena, who weighed just over 3 pounds, from the room so fast that the doctor barely got to see her, Barcenas said.

Her daughter didn't get COVID-19, but she did develop a respiratory infection. MariaElena was transferred to the NICU at a hospital in Ann Arbor, Michigan, better prepared to treat infants her size. She stayed there for a little over a month and was headed home with her grandma around the same time her mother woke up on April 27.

While Barcenas was in a coma, the nurses took photos of her daughter MariaElena's first days of life. Brittany Greeson for TODAY

While Barcenas was in a coma, the nurses took photos of her daughter MariaElena's first days of life. Brittany Greeson for TODAY

"My nurse came in, she had pictures, like, 'Look at your beautiful baby,'" Barcenas said. "I'm like, 'Who had a baby?' ... She was like, 'You had a baby girl,' and I'm like, 'Really?' I just didn't remember.'"

"You have ... all these things that you plan to do with your kid, the first smile, the first time she looks at you ... the first time you look at her. I feel like I was almost robbed of those moments," she added.

The new mom stayed in the hospital for another month, until May 29. Her mother cared for her daughter as she went through intensive physical therapy. "When I woke up from the coma, I couldn't walk or anything," she said. "My body felt just completely (like) dead weight." She recalled hospital staff telling her, "We can't let you go home and you can't care for yourself or your baby."

Barcenas still has difficulty walking long distances and needs support. Brittany Greeson for TODAY

Barcenas still has difficulty walking long distances and needs support. Brittany Greeson for TODAY

Most of Barcenas' functions returned after those first four to five weeks, but as of February, she's still in physical therapy for one of her feet.

Her daughter, though, is growing right on track. "She's taken her first steps, she says a few words. Every day, she says something different. ... People are like, 'She was a preemie?' Yes, she was exactly two months early," Barcenas quipped. "I sit in awe and shock of her every day."

"I'm still kind of stuck in this little rut of trying to get my body to pull itself together."
MaElana Barcenas, one year after having COVID-19

Barcenas suspects that she got COVID-19 at her job in a manufacturing plant. She said if she'd had more information about the coronavirus a year or so ago, she likely would've taken her maternity leave earlier.

"When you don't have any information, it was, like, well, what questions do I ask? What precautions do I take? ... We were just out here blind," she recalled.

While her daughter is exceling and meeting milestones, Barcenas is still recovering one year later. Brittany Greeson for TODAY

While her daughter is exceling and meeting milestones, Barcenas is still recovering one year later. Brittany Greeson for TODAY

Now, she's focused on her daughter hitting her milestones, and her own. "She's going to be taking off, and I'm still kind of stuck in this little rut of trying to get my body to pull itself together," she said.

As her recovery continues, Barcenas thinks about the families going through similar experiences.

"Don't be afraid, let the doctors do what they need to do," she advised. "Protect yourself, and (know) there is someone who's going through the same thing you're going through, or worse. There is hope."

Alfonso Gonzalez, Los Angeles

Heaven was born in early November. Nearly a month later, her mother died of COVID-19-related causes. Alexis Hunley for TODAY

Heaven was born in early November. Nearly a month later, her mother died of COVID-19-related causes. Alexis Hunley for TODAY

Alfonso Gonzalez's wife, Vanessa Gonzalez, tested positive for COVID-19 on Nov. 4, 2020. Five days later, she gave birth to the couple's third child, a full-term baby girl named Heaven. A little over a month later, on Dec. 14, Vanessa Gonzalez died at age 33 from complications due to the coronavirus, Alfonso Gonzalez and a close family friend Desiree Vera told TODAY.

Vanessa's symptoms began in late October and initially resembled a common cold, Alfonso Gonzalez recalled to TODAY. At first, he thought her sore throat came from sleeping with the windows open and fan on, and he chalked up the weakness and body aches to the third trimester of pregnancy.

"Even through that, she was super excited to have a baby," Gonzalez, 36, said. Vanessa had packed their hospital bags and checked everything off their to-do list. But a few days after she tested positive, she started to become short of breath. He cared for her closely in their home until she went into labor.

When Gonzalez took his wife to the hospital to deliver, he wasn't allowed to join her due to COVID-19 restrictions, which likely would've required her birthing team to wear head-to-toe protective gear.

Gonzalez wears a face mask with his wife's face on it. Alexis Hunley for TODAY

Gonzalez wears a face mask with his wife's face on it. Alexis Hunley for TODAY

"For her to be on the bed and giving birth and then having those people surrounded by you with all the — the way they look, I'm sure it had to be scary, as well," he said. Vanessa was also separated from Heaven right away, which "crushed her," he added.

Gonzalez saw his daughter, who tested negative for COVID-19, for the first time over FaceTime. When he tried to speak with his wife at the hospital, he remembers her being so weak she could barely talk. But she was discharged the next day, which he finds strange looking back.

"If they were going to separate the baby and mom and then the very next day to let us all leave in the same vehicle, there's something wrong there," Gonzalez said.

“If she were to see somebody asking for change, she’d offer them money and give any resources she had to give," Gonzalez said of his late wife, Vanessa. Alexis Hunley for TODAY

“If she were to see somebody asking for change, she’d offer them money and give any resources she had to give," Gonzalez said of his late wife, Vanessa. Alexis Hunley for TODAY

When they returned home, Vanessa and Heaven stayed in separate rooms. Vera had been quarantining with the family to care for Gonzalez's sons — Ruben, 11, and Joshua, 7 — while he focused on his newborn and wife, who "wasn't getting better," he said.

The day after Vanessa was discharged from the labor and delivery ward, Gonzalez had to call an ambulance because her breathing problems had become so severe.

He estimated that 30 minutes passed between EMTs arriving and Vanessa being put into the ambulance. Vera recalled the EMTs seeming hesitant to get too close to Vanessa even though she was barely breathing.

"It was just too long for everything," Gonzalez added. "They needed to do it right away, and they just took their time." Vanessa coded in the ambulance on the way to the hospital, Vera said.

After coding again at the local hospital in Whittier, California, she was transferred to a larger facility in Los Angeles, where she spent the last month of her life.

The Gonzalez family has relied on their faith for support during this difficult time. (Pictured from left: Joshua Gonzalez, Josiah Vera, Jaleisa Vera, Heaven Gonzalez, Desiree Vera, Kaylee Vera, Ruben Gonzalez, Alfonso Gonzalez and Armando Vera) Alexis Hunley for TODAY

The Gonzalez family has relied on their faith for support during this difficult time. (Pictured from left: Joshua Gonzalez, Josiah Vera, Jaleisa Vera, Heaven Gonzalez, Desiree Vera, Kaylee Vera, Ruben Gonzalez, Alfonso Gonzalez and Armando Vera) Alexis Hunley for TODAY

"It was so shocking to us because ... she had no underlying conditions," Vera said. "Then they're telling us one thing after another — lungs are failing, kidneys are failing, her heart is not strong enough, the brain injury."

Vanessa's final week in the hospital, "they were just preparing (Alfonso) to say goodbye," Vera continued. Initially, Gonzalez could only communicate with his wife over Zoom, but he was allowed to don a full protective suit to see her for the last time in person.

Gonzalez's faith has buoyed him and his children through losing their wife and mother.

"It's time to rebuild and just love on my children and let them know that there's hope."
Alfonso Gonzalez

"I do have my moments, I'm still human," he said. "My children, as well, they're going through changes."

Vanessa's passion as a Christian youth leader has also given them some peace.

"She would teach (our children) the things of God, and really just not to be mad about anything or angry," Gonzalez said.

Watching his healthy baby girl grow helps, too. She's already mimicking her mother's distaste for excessive kisses, Gonzalez joked.

"(Heaven's) that joy in the morning," he said. "She might be crying, but I still have that joy because what was meant for bad, Vanessa getting COVID and dying, God turned it around. ... I see so much of Vanessa in Heaven. It's so awesome."

Russell Powell, Charleston, South Carolina

Russell Powell's daughter Millie arrived two months early, after Powell was sick with COVID-19. Nora Williams for TODAY

Russell Powell's daughter Millie arrived two months early, after Powell was sick with COVID-19. Nora Williams for TODAY

When Russell Powell showed up at the hospital experiencing contractions at 33 weeks pregnant, a nurse comforted her by suggesting they were merely Braxton Hicks. A day and a half later, Powell delivered her daughter Millie nearly two months early.

Powell, 35, had tested positive for COVID-19 two and a half weeks before, on Thanksgiving Day.

"I was in bed for two straight weeks, and it was this horrible sickness," she told TODAY of her symptoms. "I didn't have a fever, and I could always breathe ... but every 24 to 36 hours, it would be something terrible and new: chills, loss of taste and smell, sweating in the night soaking through the bed sheets, nausea, vomiting, diarrhea. It came in waves."

"I'd just sit there with my big, ol' pregnant belly and just cry," she added. "I was so worried about the baby."

Powell spoke with a specialist doctor over Zoom every other day for two weeks until she felt better, which, at the time, meant she could sit up and keep down a bowl of soup. But after just 24 hours of being slightly more comfortable, she woke up with heavy cramping, similar to a menstrual cycle.

"I was like, this feels so strange ... there's no way I'm going into labor, this is ridiculous," Powell recalled.

The specialist told her to get checked out at the hospital to make sure it wasn't preterm labor. Staff gave her two pills to stop the contractions, which didn't work, but she was told it was Braxton Hicks contractions (commonly referred to as false labor) and went home. Two hours passed. Her contractions started to come every 10 minutes and "were so painful," she said.

Powell returned to the hospital around midnight and was admitted. She was given two shots in her legs 12 hours apart to support her baby's lung function in case she did give birth, she said.

When Powell woke up the following morning, she was told she was 7-centimeters dilated and would have to start pushing in 30 minutes.

“I just started taking these deep breaths, and I’m like, 'I’m 33 weeks ... I don’t think I’m ready for this,'”
Russell Powell recalled thinking at the time

"I had no idea that I was going to be giving birth," she recalled. "The night nurse had told me all night, 'Don't worry, this is just precautionary. We're gonna get you home. You got to let that baby cook for seven more weeks.' ... Not her fault at all ... but this baby had other plans."

Powell could not hold her newborn daughter for an entire day following her birth. Nora Williams for TODAY

Powell could not hold her newborn daughter for an entire day following her birth. Nora Williams for TODAY

Doctors told Powell that COVID-19 pushed her into preterm labor, she said. "The doctors also said while she was still inside, my body had done everything it could to protect her. So even though she was born with the antibodies ... my body was just not the happiest place for her to be anymore."

Millie was born on Dec. 15, 2020, weighing 5 pounds 10 ounces. But she'd had a bowel movement before birth and ingested the substance, called meconium, Powell recalled.

"(Hospital staff) said ... 'That's really no good because it's toxic, and it's just because she was so stressed,'" Powell added. "They said she'd been anxious to be born and just escape the womb for, like, the past two days."

Millie was quickly whisked away to the NICU — no ceremonial cutting the umbilical cord or skin-to-skin bonding — where she stayed for almost two weeks so she could learn to swallow and breathe on her own. She was also treated with special lights for jaundice.

Later that day, Powell met her daughter and held her hand through a glass box. The following day, she got to hold her for the first time, but it felt like a week had passed. "I (was) just like a complete mess, crying. It was wonderful," she said.

She and her husband, Taylor, spent Christmas in the NICU, away from their 4-year-old daughter, Georgia.

"Whenever I was at the hospital, I felt guilty that Georgia wasn't getting this Christmas experience," Powell recalled. "Then I would leave (the NICU) and I would just go into hysterics with these bad feelings ... for leaving Millie at Christmas time, as well."

"It was just really rough because I'd gone from these two weeks straight of not sleeping and just being so sick, to then going into preterm labor and everything that comes with that, and then being in the hospital and still not really fully recovered from COVID," she added.

The family finally reunited the day after Christmas, "the best present ever," according to Powell. "We all just cried for hours. It was so special ... having them together under one roof."

The Powell family is happy to be home together after a difficult holiday season. Nora Williams for TODAY

The Powell family is happy to be home together after a difficult holiday season. Nora Williams for TODAY

Powell is able to laugh about certain parts of her story now. Her husband even wanted to laminate the instructions the nurses gave her to cope with her not-so-false contractions. (They're extremely grateful for the top-notch care she and Millie received, though.)

"This girl ripped out her feeding tube and decided to enter the world as soon as she wanted to," Powell quipped. "She's going to be a very, very sassy lady."

Looking back on the months before she gave birth, Powell said the unknowns of COVID-19 and pregnancy made an already difficult pregnancy even harder. She wanted to share her story to help families dealing with the same challenges a year into the pandemic.

"It was so nerve-wracking and unsettling to know you were constantly in this state of evolving information," she said. "Your body is going through this huge change and creating this human being, and you just flat-out don't know what's next."