Pregnant and stressed to the max

Melanie and Kris Lambert and their sons Connor, 5, and Harrison, 2, spend some family time in their backyard while preparing for the birth of their third son. Melanie says that worrying about COVID-19 became a part of her pregnancy. “I am a mask wearer and use hand sanitizer and we do things we need to do, but I just went into hyperdrive,” she said. (Curtis Compton / Curtis.Compton@ajc.com)
Melanie and Kris Lambert and their sons Connor, 5, and Harrison, 2, spend some family time in their backyard while preparing for the birth of their third son. Melanie says that worrying about COVID-19 became a part of her pregnancy. “I am a mask wearer and use hand sanitizer and we do things we need to do, but I just went into hyperdrive,” she said. (Curtis Compton / Curtis.Compton@ajc.com)

Credit: Curtis Compton / Curtis.Compton@ajc.com

Credit: Curtis Compton / Curtis.Compton@ajc.com

COVID-19 brings new worries about both pregnancy and efforts to conceive

At the start of last year, Maggie and Russell Buchanan decided they would try one more time to expand their family.

They set their sights on Maggie getting pregnant by March 2020, but that target date was postponed when the coronavirus began spreading across the globe. With two late-term miscarriages behind them and both well into their 30s, they didn’t feel like they could wait too long.

So over the summer, when there was a lull in the pandemic, Buchanan got pregnant and prayed that the spread of the virus was abating.

Instead, the number of infections reached new highs.

The Buchanans’ joy of expecting a baby quickly gave way to gripping anxiety. Instead of the support of friends and extended family, there was social distancing and long periods of isolation. Trips to the store or doctor’s office, even playdates for their other children, were carefully assessed for potential dangers.

ExploreHow the COVID pandemic has altered our daily lives

“Every decision felt weighty and heavy,” she said.

Though it’s not unusual for a pending birth to bring a certain level of stress, the pandemic is inducing new layers of worry. It’s now understood that pregnant women are at higher risk for severe illness and complications, but there’s still a lot that’s up in the air.

Many have been unnerved by the contradictory messaging, especially early on in the pandemic when little was definitively known about whether pregnant women were more susceptible to COVID-19, if they were more likely to become seriously ill if infected and what the long-term effects might be on newborns.

With COVID-19 vaccines rolling out, mothers-to-be now face difficult decisions about whether to get inoculated when there is scant data specifically on the safety and effectiveness of the vaccines in pregnant women.

With so much uncertainty, some couples who are planning to have children have decided to put things on hold during the pandemic.

Connor (left), 5, and Harrison Lambert, 2, are eager for the arrival of their baby brother Hank. Their baby brother's crib has been set up in their bedroom. (Curtis Compton / Curtis.Compton@ajc.com)
Connor (left), 5, and Harrison Lambert, 2, are eager for the arrival of their baby brother Hank. Their baby brother's crib has been set up in their bedroom. (Curtis Compton / Curtis.Compton@ajc.com)

Credit: Curtis Compton / Curtis.Compton@ajc.com

Credit: Curtis Compton / Curtis.Compton@ajc.com

The Brookings Institution, a nonprofit public policy organization, forecasts there will be 300,000 fewer children born in the U.S. in 2021.

Ovia, a fertility and family health app-based program, conducted a survey of 451 women in Georgia who were either planning to have or considering having children. Slightly more than a third (37%) said they had decided to not get pregnant during the pandemic.

The reasons included concerns about losing jobs, the desire to avoid health care facilities and worries about the impact of COVID-19 on pregnant women and unborn babies.

CDC FINDINGS ON PREGNANCY AND COVID-19

A CDC report released late year found that:

• Pregnant women are almost three times more likely to be admitted into intensive care units or to be put on ventilators than women who are not pregnant.

• Pregnant women with COVID-19 might have an increased risk of adverse pregnancy outcomes, such as preterm birth.

• The overall risk to pregnant women remains small because they tend to be young and healthy.

“I think it’s a scary time, and there’s a lot of uncertainty, and that uncertainty influences people’s decisions in different ways,” said Adam Wolfberg, Ovia’s physician-in-chief and a specialist in high-risk obstetrics. “The way young parents have to navigate this time seems completely impossible.”

But, while some couples can wait out the pandemic, others don’t have the luxury of time. Wolfberg noted that, last year, many fertility treatments were paused, sometimes in the middle of the process.

“Can you imagine how devastating that is and having no idea how long it would last and when [the treatments] could resume?” he asked.

“Adding the stress of advanced maternal age is one more stress to an extremely stressful time,” he said.

COVID-19 VACCINE PREGNANCY REGISTRY

The CDC has established the v-safe COVID-19 Vaccine Pregnancy Registry to analyze data to better understand how COVID-19 vaccination impacts pregnant women. V-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after receiving a COVID-19 vaccine. Participation is voluntary, and women can opt out at any time.

You can find the v-safe app-based tool by going to www.cdc.gov and searching for v-safe pregnancy registry.

Some aspects of pregnancy have improved significantly since the early days of the pandemic. Doctors have a better understanding of the virus, and hospitals have used their experiences during the spring surge to learn how to prevent the spread in that setting.

Wolfberg added that many hospital staff members have been vaccinated, which can make patients feel more comfortable.

‘Vaccine now or wait?’

Pregnancy puts women in a COVID-19 “high risk” category that now makes them eligible in Georgia for vaccines but that doesn’t make vaccination an easy decision.

The vaccines currently available under emergency use authorization have not been tested in pregnant women.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said recently that more than 20,000 pregnant women have received coronavirus vaccines, and, so far, there have been no “red flags.”

ExploreComplete coverage of COVID-19 in Georgia

The Centers for Disease Control and Prevention, too, says there are no known safety concerns, but that more data will be available in the weeks and months ahead.

That certainly lacks the clarity pregnant women would like.

But, even with that lack of clarity, experts say the known risks of catching COVID-19 far outweigh the theoretical risk of any harm from the vaccine.

Melanie and Kris Lambert, with their sons, Connor, 5, and Harrison, 2, prepare the boys' room for the birth of their third son, Hank. (Curtis Compton / Curtis.Compton@ajc.com)
Melanie and Kris Lambert, with their sons, Connor, 5, and Harrison, 2, prepare the boys' room for the birth of their third son, Hank. (Curtis Compton / Curtis.Compton@ajc.com)

Credit: Curtis Compton / Curtis.Compton@ajc.com

Credit: Curtis Compton / Curtis.Compton@ajc.com

Pregnant women who are sickened with the coronavirus are more likely to be hospitalized and to require a high level of care, possibly including being placed on a ventilator, according to the CDC. An October study published in Obstetrics & Gynecology also found that as many as one in four pregnant women diagnosed with COVID-19 can have lingering symptoms that can last more than two months, far longer than the average patient.

Research also suggests that contracting the virus might increase the risk for premature birth, particularly for those with a severe case of COVID-19. Six pregnant women in Georgia have died from the illness, according to an analysis of data from the Georgia Department of Public Health.

ExploreThe latest news on the coronavirus vaccines

“I understand people are agonizing over this because the information is not clear,” said Courtney Yarbrough, pregnant with her first child, due this summer, about getting a coronavirus vaccine. “It’s an individual decision for each person and, because we have such limited information, it makes it difficult to make this decision in this environment.”

Yarbrough, an assistant professor at the Emory School of Public Health, said she has decided, after many hours of research and consideration, to get the vaccine.

Dr. Gretchen Koontz, perinatologist and medical director at Maternal-Fetal Specialists, an Atlanta practice specializing in high-risk pregnancies, recommends the COVID vaccine to all her patients. She especially stresses the need for inoculation to those with illnesses that put them at higher risks, such as diabetes or hypertension.

A boy!

When Melanie Lambert of Cartersville first learned she was pregnant late last year, she was both surprised and delighted.

“I really didn’t think it was going to happen, so, initially, I wasn’t thinking about COVID-19,” she said. But that lasted only about a day.

“I’m a worrywart, so that’s now been part of the process,” she said. “I am a mask wearer and use hand sanitizer and we do things we need to do, but I just went into hyperdrive.”

Along with her husband and two sons, she stays mostly at home, and they’ve taken a break from in-person church services.

Maggie Buchanan felt huge relief after giving birth to her baby boy Beau in February. "When I first held him in my arms and he was healthy, I felt like the weight of the world was off my shoulders,” she said. (Contributed)
Maggie Buchanan felt huge relief after giving birth to her baby boy Beau in February. "When I first held him in my arms and he was healthy, I felt like the weight of the world was off my shoulders,” she said. (Contributed)

The Buchanans welcomed a baby boy in late February.

Maggie Buchanan’s father, who lives in Virginia, quarantined, then came to their Buford home to watch the couple’s three other children while she gave birth.

She could not have been more relieved to get through her pregnancy healthy.

“I felt like each study about COVID-19 and pregnancy was worse and worse,” she said. “I just needed to not get COVID and the baby to be healthy. When I first held him in my arms and he was healthy, I felt like the weight of the world was off my shoulders.”

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