Pregnancy, Chronic Illness, and Covid-19| Update

Pregnancy, Chronic Illness, and Covid-19

Since starting our podcast, I have started looking back at older articles I’ve written, especially this one on pregnancy.

After rereading it, one, I feel like I should expand some more on how chronic illnesses affect pregnancy. Two, as I promised when I originally published that article, I will give you a few updates on new Covid-19/pregnancy studies that have been published since.

Chronic Illness and Pregnancy

Firstly I want to expand on some things to do and/or consider before trying to conceive (TTC)

Because people with chronic illness may have higher risks for complications than the general public, it is extremely important to “pre-game”, as it were. Ideally at least 3 months in advance.

  1. Gather yourself a team of experts you trust
    • Get a primary care physician you trust (if you don’t have one already) and get a thorough pre-natal check-up. Also ask for folic acid, B12, and vitamin D levels on top of the usual labs (CBC, CMP, etc). Deficiencies in those can lead to birth defects in baby. This gives you time to start taking supplements that you need more of.
    • Talk to your chronic illness specialist about your plans. This can be your endocrinologist, oncologist, rheumatologist, gastroenterologist, you get the idea. Is your illness under control? Are you in remission or flaring? Are there medications that aren’t safe? Some medications take a long time to flush out, so time things accordingly. Alternative medications that are safe? Does your insurance cover it? What about side effects? These are things to consider. Do you need to see a Maternal Fetal Specialist? I was referred to one right away, so find out if that is an option for you.
    • Of course, find an OB/GYN if you don’t already have one. Get a full exam and make sure your plumbing is healthy and ready. Get a check up on your hormone levels. Ask for tools you can use to track ovulation (like ovulation sticks, basal body temps, phone apps), or, come up with plans on how you are comfortable conceiving. There are many ways to skin this cat.
  2. Get your nutrition right
    • Consider seeing a registered dietician. Nutrition is super important. I now have a dietician I’m working with and she is covered by my insurance. Check with your insurance provider to find out if one is covered for you.
    • Are you taking prenatal vitamins? Supplements? Probiotics? Did your labs say you need more vitamin D? It may sound excessive, but remember, you have to make sure your body is 1000% ready for the very complicated and resource intensive process.

Have you succeeded? Yay for you!

At this point, it’s important to keep an eye on things and continue planning ahead!

  1. Make sure to get regular check-ups with both your OBGYN and specialists. Make sure your whole team is on the right page and everyone knows what medications, vitamins, supplements you are taking
  2. Come up with a birth plan. Where will you give birth? In a hospital? Do you want a home birth or maybe use a labor pool/tub? Would this be safe for you given your conditions? Should you plan the day and get induced? Or schedule a C-section? Epidural? Talk to your specialists to come up with the safest way to welcome baby to the world.
  3. Start thinking about how you would like to feed your newborn. Are the medications you are taking safe for breastfeeding? Will you instead formula feed? Are you interesting in feeding your baby donor breast milk? Talk to your specialists about your options. Either is absolutely fine/healthy for baby and totally your choice. Don’t let anyone let you feel otherwise.

After labor:

Unfortunately, there is a high prevalence of maternal and pregnancy related death in America which is unfortunately also related to health discrepancies. Because of this, it is extremely important to get regular health care before, during, and after pregnancy.

  1. Continue getting checkups with all specialists, even if you are tired from caring for a newborn, even if you feel fine. This is the best way to check on how things are going and make sure you are safe. Tell your doctor about any and all discomfort or pain, even if you think it is nothing. Chronic illness already causes pain and fatigue, so this may seem like “complaining” but it doesn’t hurt to check in with a medical professional
  2. Continue with all your medications that your specialists approved for you
  3. Don’t forget to start your preferred birth control again! I mean, unless you want to get pregnant again… (do you boo)

As I mentioned in the previous article, chronic health issues can cause a slew of issues in pregnancy, so feel free to go back and read about how certain illnesses can throw a wrench in things. I will also link a study done on how autoimmune disease effects pregnancy.

Now on to Covid-19:

Some updates that I wanted to point out:

The CDC has noted that although a lower risk, pregnant people are at an increased risk for severe illness from Covid-19 while pregnant and up to 42 days post pregnancy. In this case “severe” illness means hospitalization, intensive care and being placed on a ventilator for assisted breathing.

Factors that increase the risk, besides being pregnant are:

  • being over 25
  • having underlying medical conditions
  • being part of some racial and ethnic minority groups
  • living/working in a community that has high infection and/or low vaccination

They also note that pregnant people with Covid-19 are more likely to experience pre-term birth (earlier than 37 weeks) but not more likely to experience miscarriage.

UpToDate has an extremely informative page on pregnancy issues and antenatal (pre-birth) Covid-19 data. I definitely recommend giving the page a good and thorough read, but I will include some interesting points here:

  • There is an increased risk for preeclampsia whether or not the pregnant person is symptomatic or not
  • (In the US)Pregnant patients hospitalized because of Covid had a stillbirth rate of ~3%, higher than the 0.4-0.5% rate among the overall pregnant population with confirmed Covid-19
  • 95% of newborns of Covid-19 positive parents have been born on good condition.

Overall it appears that the most risk involved with pregnant persons and Covid-19 is the potential effect on the pregnant person and not the children.

So please get the vaccine if you haven’t done so

There are surveillance systems and studies proving that the vaccine is beneficial for everyone, including those who are pregnant or planning on getting pregnant. In fact, a study was recently updated, as of 2 days ago, with more recent data to show there is more mounting evidence that the vaccine is safe for pregnant persons and does not increase risk of spontaneous abortion or still birth.

So go do the right thing and protect yourself.

For your health <3

Send you warm light, and gentle hugs,

Lunabug

P.S. If you like this article and would like to support my research, please feel free to comment, subscribe, or if you are feeling SUPER generous, buy me a Coffee!

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