You’ve thought about baby names, crunched the numbers financially, and mentally decorated the nursery. This was going to be the year you started trying to get pregnant.
And then COVID-19 happened.
For years, people have pondered when is the "best" time to have a baby. But as the pandemic continues to grip the country – with Texas as a hotspot – the right answer may seem more elusive than ever.
In May, a survey of 2,000 women found that 34% wanted to delay pregnancy or have fewer children because of the pandemic. Now, many patients are asking whether waiting is the safest choice.
Even before the pandemic, we've advised women to talk with their doctor before becoming pregnant. Underlying health conditions, such as diabetes or heart disease, can increase your risk for complications. Some of these issues also increase the risk of poor outcomes with COVID-19.
The decision to become pregnant is personal, and there are no right or wrong answers. If you are planning to conceive during the pandemic – naturally or with fertility treatment options – use these questions and answers to help guide your decision.
What is the risk to your health and your baby?
There’s still a lot we don’t know about COVID-19, particularly when it comes to pregnancy. The Centers for Disease Control and Prevention (CDC) in June released a report that suggested pregnant women with COVID-19 might be at higher risk for severe illness. However, it also found that pregnant women with COVID-19 appear at no greater risk of dying from the virus than nonpregnant women their age.
So far, COVID-19 infections do not appear to cause complications similar to Zika infection, which causes significant brain damage. New evidence suggests the virus can pass from mother to fetus before birth via the placenta. However, we don’t yet have data on outcomes for women who had infections early in pregnancy, since many of these patients haven’t delivered yet.
Pregnant women haven’t been included in COVID-19 vaccine trials. None of the trial vaccines I have seen use a live virus, which means the final vaccine should be safe for pregnant patients. Once vaccination becomes an option, talk with your doctor about whether it's recommended for you.
Take a virtual tour of our labor & delivery suites
Before your big day arrives, get a preview of the accommodations for new moms at UT Southwestern's Clements University Hospital. From the chef-prepared meals to the roomy, high-tech labor and delivery suites, we want to make sure that you, your baby, and your family have the opportunity to bond in a safe and soothing environment.
Are you taking necessary precautions to avoid COVID-19?
Each person's actions play a significant role in their risk of contracting COVID-19. We’ve all had to make adjustments to stay safe – physical distancing, wearing a mask, and washing your hands.
During pregnancy or when trying to conceive, you should become even more diligent about COVID-19 prevention. Avoid large crowds and opt for video chats instead of in-person socializing. If you have visitors in your home, ask them to wear a mask, wash their hands when they arrive, and keep at least six feet of distance between you.
CDC guidelines state that pregnant women should not skip prenatal or postpartum appointments. Ob/Gyn offices around the country have transitioned to telehealth for many services, including prenatal classes.
We ask patients to come to the clinic only for physical exams, lab work, and ultrasounds. When you do visit, we’re taking extra precautions to keep you and your baby safe.
Is pandemic-related stress a concern in pregnancy?
Nearly 10% of women experience anxiety during pregnancy. During the pandemic, rates of anxiety during pregnancy and postpartum have more than doubled.
While 29% of pregnant women reported having anxiety prior to the pandemic, a staggering 72% are dealing with anxiety during the pandemic. Anxiety can lead to depression and isolation, which makes it difficult to have a healthy pregnancy or care for a newborn.
Before conceiving, talk with your doctor about options to manage new or worsening anxiety during pregnancy.
Related reading: Pregnancy, anxiety, and the pandemic: 4 ways to manage symptoms
Ask the Experts: COVID-19 and pregnancy
Dr. Shivani Patel and Dr. Robyn Horsager-Boehrer answer some of the most frequently asked questions about pregnancy and the novel coronavirus during a recent Facebook interview.
What is your financial outlook?
Even if your or your partner’s job has not been affected by the pandemic, it's worth planning how you'll manage the costs of a baby on one income or a reduced one if something unexpected happens.
If you do lose your job, you may have to interview for a new one while pregnant, which can be stressful. Also, you may not qualify for leave under the Family and Medical Leave Act (FMLA) if you haven’t worked at a new job long enough.
Related reading: FMLA and maternity leave: What you need to know
What will work and childcare look like?
Childcare may be a dilemma during the pandemic. If you plan to work from home with your newborn, you'll need to plan ahead to handle both responsibilities.
You might have to consider different options, such as in-home childcare or a nanny. Or you might try to coordinate work schedules with your partner or a loved one to care for the baby.
Some patients have taken a more extreme route, relocating to live with or closer to family members. Multigenerational households must take special precautions to avoid COVID-19.
How do age and family planning factor in?
Timing often plays a role when it comes to pregnancy. If you’re in your 20s or early 30s, you may feel comfortable waiting before having a child. If you’re in your late 30s, you may not want to delay.
While the average age of first-time motherhood has increased in the past decade, women older than 40 still have increased risks associated with pregnancy.
Perhaps the biggest factor with age is whether waiting to get pregnant creates a risk that your window of natural fertility will close. Some fertility treatments were put on hold this spring as hospitals limited elective procedures due to the pandemic. Now that many limits have been lifted, women are trying to decide whether to start in vitro fertilization or other treatments.
A few closing thoughts
Patients who are reasonably healthy and can manage the financial and emotional challenges of pregnancy should not allow the pandemic to derail their family planning.
We don’t know how long COVID-19 will be with us, or when a vaccine will be ready. The decision to become pregnant is personal, but your Ob/Gyn can help you consider the best options.
If you are concerned about your fertility or risk factors for COVID-19, schedule an Ob/Gyn appointment. Whether you choose to try for a baby or wait out the pandemic, our goal is to help you make the best decision for your health and happiness.