Deciding to conceive in a pandemic

Editor’s note: As what we know about COVID-19 evolves, so could the information contained in this story. Find our most recent COVID-19 blog posts here, and learn the latest in COVID-19 prevention at the Centers for Disease Control and Prevention.

COVID-19 has affected nearly every corner of our lives, including family planning. Here’s what to keep in mind when it comes to planning a pregnancy:

New pregnancy considerations

Of course, there are several things to think about when planning a pregnancy even in normal times. Those include:

• Maternal health conditions (past and current, including mental health)
• Current medications (prescribed and over-the-counter)
• Family history of genetic conditions in either partner
• Financial considerations

COVID-19 presents new factors. And it’s not the only disease to consider, depending on your circumstances—Zika, for example, remains a threat to unborn babies, so the latest research supports delaying trying for a baby if you’ve recently been to a Zika “hot spot” location.

That’s why preconception counseling considering fertility is a great reason to set up an appointment with your Ob/Gyn—they can help you consider everything in your medical history and other important circumstances.

As for COVID-19, we’re still learning how it could affect pregnant people or their babies.

Our most current information suggests that a pregnant person isn’t more susceptible to COVID-19, nor are they at high risk for severe illness from the virus that causes COVID-19, unless there are other health risk factors at play. Current data also doesn’t suggest “vertical transmission” (disease transmission from mother to fetus in utero).

However, the long-term implications of COVID-19 in the first trimester of pregnancy have yet to be studied. And a larger database of pregnant people and their babies needs to be studied before we can be certain of the effects of COVID-19.

Since the coronavirus that causes COVID-19 is a novel virus first detected in December 2019, it’s difficult to know if COVID-19 patients who conceived around the time that they were infected have long-term pregnancy effects. After all, many of them have yet to deliver their babies.

What to consider about a second wave of COVID-19

There’s been much talk about the possibility of a second surge of COVID-19 cases that would begin in fall 2020. We may have more research and guidance for patients by then, but for now, what we do know doesn’t suggest that there’s any increased severity for pregnant people.

Although the risk of infection in newborns is rare, the disease is more severe in newborns, so those with newborns should continue social distancing, working remotely (if possible), washing hands frequently and wearing face coverings when out and about. Those steps will continue to be important in mitigating the virus.

So, should you wait to start trying to conceive?

As antibody testing is implemented, researchers will be able to study previous COVID-19 infection more closely. That means that in the next 12 months, we may be able to provide more guidance about pregnancy during the COVID-19 pandemic. You could talk with your partner and doctor about whether it makes sense for you to wait for information to surface.

For those with other medical conditions that would normally make them high-risk for severe infection with COVID-19 (cardiac disease, renal disease, chronic lung disease, morbid obesity, diabetes, liver disease or otherwise being immunocompromised), they should ensure that their conditions are well-managed before conceiving, or consider delaying if it’s feasible for them.

The bottom line

As always, determining when to conceive is family-oriented and very personal. It may be appropriate for some couples to wait, especially if waiting wouldn’t increase their risk of fertility concerns.

Those who struggle with depression, anxiety or other mental health challenges should factor this into their decision and consider whether social distancing would make pregnancy and newborn-parenting much more difficult.

It’s also important to know that, for many couples, pregnancy doesn’t just happen. And if you want to wait until the pandemic has passed, we don’t know how long you’ll be waiting.

It’s hard to make these decisions without considering every factor that’s unique to you and your family.

For help making sense of the latest research and what it means for you and your health, check in with your Ob/Gyn or primary care provider.

Melissa Goist is a physician in obstetrics and gynecology at The Ohio State University Wexner Medical Center and an assistant professor in the Ohio State College of Medicine.