By Kai Curry
NORTHWEST ASIAN WEEKLY
A lot has changed since COVID-19 came on the scene in late 2020. Regulations in place for over two years—wear a mask, get tested—have eased slightly. But it is important to remember that the virus still poses significant risks to everyone. In addition to the impact on the general public, it is crucial that we continue address concerns specific to various demographic groups, including women, the elderly, and individuals with preexisting conditions. Furthermore, we must recognize the vulnerability of pregnant women due to their weakened immune systems and do our best to protect them.
While we have gained more knowledge and experience in dealing with COVID-19, it is essential to remain cautious. Dr. Krissy Yamamoto, an OB/GYN at the University of Washington Medicine Valley Medical Center, emphasizes that the medical community has observed a decline in anxiety surrounding COVID-19, even during childbirth. However, this does not imply that pregnant women should disregard the risks associated with the virus.
Yamamato, who trained in Texas, graduated from her residency in 2011, and has been at Valley Medical since 2014, said, “We have the same precautions. If you test positive [for COVID-19], we are doing the full N95 [masks]. We’ll take precautions for that patient. If you arrive at Valley Medical’s Birth Center in labor and with COVID-19, they will put a sign up on the door indicating these precautions, and they do ask patients to wear masks when in the corridors. However, people considered to be in your core support group are allowed as visitors (no more expectant dads sitting in the parking lot), and pre-appointment, pre-surgery, or pre-delivery COVID-19 testing is not currently required.
COVID-19 can have negative effects on unborn babies, particularly concerning blood clotting. Yamamoto explains that the virus can trigger a thrombotic response, potentially leading to blood clots that impede the fetus’s access to nutrients and hinder its growth. To address this, doctors closely monitor both the expectant mother and the baby throughout the pregnancy.
“If a pregnant patient is symptomatic…[and] tests positive [for COVID-19], we would recommend Paxlovid.”
Should someone who has not yet been vaccinated for COVID-19 get vaccinated when pregnant? While this subject is still under study, the generally accepted research on any vaccine, not just the COVID-19 vaccine, is that it will have an effect on the unborn baby—a good effect.
In the case of women vaccinated for COVID-19 during pregnancy, “There have been some studies that tested babies to see if they had antibodies against COVID-19,” Yamamoto said. “There is this thing in pregnancy when the mom’s immune system ramps up and produces antibodies.” Some of these antibodies are small enough to pass through the placenta, and are why most obstetricians recommend a TDAP in the third trimester (tetanus, diphtheria, pertussis). Otherwise, Yamamoto continued, kids “can’t be vaccinated until they are two months old, and that can be devastating. We vaccinate against TDAP…so the baby is born with the antibodies, so that baby has protection.” Similarly, when the COVID-19 vaccine is given to pregnant women, preliminary studies have found that antibodies stay in the baby’s blood up to six months after delivery.
Although COVID-19 symptoms have become milder in many cases, it is crucial to recognize that pregnant women who contract the virus are still at a higher risk of complications during pregnancy. A study by the Centers for Disease Control (CDC) conducted from 2020 to 2021 found that pregnant women with COVID-19 had a significantly increased risk of ICU admission and invasive ventilation or advanced life support. The Delta variant, identified in June 2021, was found to be even more dangerous, leading to an increased number of maternal deaths. While data beyond 2022 is still being analyzed, the risks associated with COVID-19 for both mothers and unborn children persist.
Overcoming vaccine hesitancy, particularly among pregnant individuals, remains a significant challenge. Yamamoto notes that cultural factors play a role, with certain countries advising against COVID-19 vaccination during pregnancy, including China and India. This advice may influence individuals from these regions who reside elsewhere. However, it is important to emphasize the safety and effectiveness of COVID-19 vaccines, including during pregnancy, as evaluated by the CDC. Vaccination is strongly recommended by the CDC for those who are pregnant, breastfeeding, trying to conceive, or may become pregnant.
“Overwhelmingly, there is a mistrust of vaccines. Vaccines are our friends,” said Yamamoto. “This is how we have children that are alive now instead of 40% to 60% passing away in childhood,” like they used to in prior centuries. The CDC has evaluated that the COVID-19 vaccination is safe, including during pregnancy, and for those concerned about taking it who are not pregnant, the vaccine does not cause infertility.
“Thank goodness for vaccines and that we live in a time when we have an ability to protect ourselves,” Yamamoto said.
Kai can be reached at email@example.com.
Made possible in part by the Washington State Department of Health through a grant from the Centers for Disease Control and Prevention. This information does not necessarily reflect the official policies of the Washington State Department of Health or the Department of Health and Human Services.