What Pregnant People Should Know About Labor & Delivery During COVID-19

Preparing to give birth under normal circumstances can be stressful and a little frightening, but when you throw a viral pandemic—like the one happening right now with COVID-19—into the mix, things start to feel really intense. 

If you’re pregnant and your due date is fast approaching, you probably have a lot of questions about what your labor and delivery is going to look like, and we wish we had all the answers.

Unfortunately, because the pandemic is an evolving situation, there are a lot of things we don’t yet know…and even the things we do know are subject to change as we continue learning about the virus and its effects on pregnant people, newborn babies, and the general population.

That doesn’t mean you have to spend your third trimester in a panic, though. There are experts out there working to establish the best possible guidelines for pregnant women and their babies. This means keeping them safe from COVID-19 but also making sure they receive the birth and postpartum support they need, too. 

Here is everything we know right now about how labor and delivery procedures have changed because of COVID-19, plus instructions for finding the most updated info on your own.

Will I Have to Deliver My Baby Alone?

Many hospitals have been considering limits on how many support people pregnant women can have with them during labor and delivery. Some hospitals, like those in virus-stricken New York City, initially implemented bans in recent weeks that forced women to go through labor and delivery with only their healthcare provider.

Thankfully, those initial bans were reversed after patients, providers, and advocacy groups voiced concerns about the physical and emotional dangers of requiring women to give birth alone. 

Unfortunately, this means that if you were planning to have more than one support person present at your baby’s birth, you’ll have to make some tough choices. The more people in the delivery room, the higher the risks to you, your baby, and the healthcare providers helping you deliver.

If you had hired a doula or wanted your mom to attend the birth along with your spouse, you’ll likely have to communicate with those additional people virtually.

Other Precautions

Additional safety measures being implemented for labor and delivery may include:

• Heightening the infection control measures performed by healthcare staff
• Screening laboring women for COVID-19 symptoms so confirmed or presumed positive patients can deliver in a separate area
• Restricting visitors during and after birth (depending on the hospital, extended family and even older siblings may not be able to meet your little one right away)
• Reducing the length of postpartum stays, limiting viral exposure to moms and babies
• Restricting pregnant people from walking the halls during labor
• Restricting certain labor interventions, like nitrous oxide
• Performing early inductions, when medically appropriate, to limit the number of pregnant women delivering babies at a time when healthcare systems are expected to be overwhelmed with COVID-19 patients

Will My Baby Be at Risk for COVID-19 If I Have It When They Are Born?

Many expectant parents are worried that if they have COVID-19 when they give birth, they could pass the virus to their newborn. There are a few things to unpack here, because more than one possible transmission route exists.  

Vertical Transmission

According to the Centers for Disease Control and Prevention (CDC), some infections can be passed from mother to baby during pregnancy or during labor. This is called vertical transmission, and it involves the spread of infection through the placenta or maternal bodily fluids. 

Breastfeeding

You pass on lots of good things to your baby through breastfeeding—but some pathogens, drugs, and substances (like medications) can pass through your breast milk and affect your baby, too. 

There’s potentially good news here: the American College of Obstetricians and Gynecologists (ACOG) says COVID-19 has not been detected in breast milk as of yet. Plus, your breast milk may contain antibodies if you’ve been exposed to or infected with the virus, so breastfeeding is still a healthy option for your baby.

Close Contact

Let’s be honest: Social distancing with a newborn may not be feasible. Can all your skin-to-skin contact, frequent breastfeeding, and postpartum snuggling make your baby sick?

In theory, yes. COVID-19 spreads through close, person-to-person contact, traveling on infected respiratory droplets, and can also live on some surfaces for varying amounts of time. Some experts are suggesting the separation of mom and baby as much as possible, recommending breast milk be pumped and bottle-fed and discouraging skin-to-skin contact.

Other experts believe that skin-to-skin contact and direct breastfeeding are in the best interest of newborns, even if their mothers are sick. How you, personally, proceed in this scenario will likely depend on your healthcare provider’s recommendations. 

At this time, ACOG doesn’t recommend separation but instead suggests moms practice good respiratory hygiene during breastfeeding (by wearing a mask) and wash their hands before touching their baby or any items their baby uses (like bottles, pump parts, or pacifiers). 

Should I Consider a Home Birth?

If you’re dreading the thought of entering a hospital full of sick people to deliver a healthy baby, we don’t blame you! Many expectant parents are thinking about switching their planned hospital birth to a home birth to avoid infection. 

But most experts are warning against making such a dramatic, bottom-of-the-ninth change—especially if COVID-19 fears are the only reason you’re considering it. Choosing a home birth requires a lot of education and planning; third-trimester women changing their minds at the last minute may not be able to find the resources needed for a healthy at-home delivery. And ACOG says that, in spite of infection concerns, a hospital is still the safest place for you to deliver your baby.

Home Birth Precautions

People with high-risk or geriatric pregnancies are generally excluded from home birthing because of the medical interventions that may be required for a healthy delivery. If something were to happen during your home birth, it may be harder for you to receive medical care in an overwhelmed system not prepared for your emergency needs.

What's more, most insurance companies don’t cover the healthcare costs of home birth, including paying for a midwife or other trained professional to attend.

Where to Find the Most Up-to-Date Info About Labor and Delivery Protocols

As infection rates change over the next several months, so will many of the existing guidelines around how best to help pregnant people and newborns. Many of the rules being put into place now will be temporary, or at least subject to change depending on the prevalence of COVID-19 in your area. Other rules, though, may need to be adopted on a long-term or semi-permanent basis (possibly until a vaccine is widely administered and the virus is better controlled). 

In the meantime, you can continue finding current recommendations about safety procedures during labor and delivery by reviewing your local hospital’s website, contacting your maternity care provider, or visiting any one of these reliable sources, which are all offering up-to-date guidelines on caring for pregnant women and newborns during the COVID-19 pandemic:

• World Health Organization
• Centers for Disease Control and Prevention
• American College of Obstetricians and Gynecologists 
• American Academy of Pediatrics
• American College of Nurse-Midwives

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.