With COVID-19 vaccinations now being distributed, pregnant women have lots of questions.
Two main concerns: What are the risks? What are the benefits?
It’s a topic Sanford Health providers and health experts around the world are addressing as the vaccination roll-out continues to expand.
At present, major health organizations agree pregnant and breastfeeding women should not be excluded from COVID-19 vaccination. In the meantime, providers will continue to keep their patients informed with the latest information.
The World Health Organization, U.S. Centers for Disease Control and Prevention, the Society for Maternal-Fetal Medicine and the American College of Obstetricians and Gynecologists all advise that COVID-19 vaccines should be offered to those eligible to be vaccinated.
“It’s a very challenging topic because so much is fluid and changing,” said Sanford Health OB/GYN Nicole Grossenburg, M.D.
There are multiple factors in support of the vaccines being safe for those who are pregnant and those who are breastfeeding.
“Based on how the vaccine works, the mechanism of action, we theorize it should be very safe for pregnant women,” Dr. Grossenburg said. “We wouldn’t anticipate that it should increase complications for their pregnancy or for themselves any more than what it would for the general public.”
As Dr. Jeremy Cauwels, Sanford Health chief physician explained: “There is no physiologic reason and no observed reason after we started dosing, that anybody should consider themselves unsafe, whether they’re pregnant, hoping to become pregnant, or looking at their pregnancy options in the future.”
Consult with your provider
Jon Dangerfield, M.D. is the department chair for Sanford Women’s in the Fargo, North Dakota region. He stresses that each pregnant woman’s vaccination depends on their comfort. They should consult with their primary care provider before making any decisions.
“It’s always their choice,” he said. “My job is to go through the pros and cons, the knowledge that we currently have, assign what our concerns are about their potential risk, and come to a consensus. I tell my patients: I’m going to support you whether you do or don’t do it. Try to make the best decision for your particular situation.”
Giving birth comes with challenges under any conditions. The presence of the pandemic has the potential to add to the stress and anxiety. All the more reason, as Dr. Dangerfield suggests, to have conversations with your provider to help alleviate your concerns.
When you’re a provider – and having a baby
Sometimes providers themselves are dealing with pregnancy during the pandemic. Dr. Jessica Sedevie is an OB/GYN at Sanford Obstetrics and Gynecology in Bismarck, North Dakota, whose pregnancy coincided with the presence of COVID-19.
At the same time, she was caring for others who were having babies.
As front-line provider, she was included in one of the first groups who were eligible to receive the vaccine. Her pregnancy added complexity to the decision-making process, but did not keep her from getting vaccinated.
She now shares how she arrived at that decision with her pregnant patients.
“I talk to my patients about this a lot now, especially since I came forward and went public about my vaccination,” Dr. Sedevie said. “It’s a starting point for conversation. I think everyone needs to make their own decision based on their risk factors, but for me, being on the front lines, I’m glad I had a choice between getting the vaccine and getting the virus.”
Their health and health of their patients
Jenna Meldahl, a family nurse practitioner at Sanford East Mandan Clinic, is one of Dr. Sedevie’s patients who had to make the same decision. She listened to her doctor, reviewed the science, and then came to the same conclusion.
“Dr. Sedevie helped me make my final decision,” Meldahl said. “I read the recommendations, and she provided the reassurance that I needed. She was also getting the vaccination herself. That helped me out with my decision quite a bit.”
In the end they had their own health to think about, their own pregnancies and the health of their patients. They were grateful to have a decision to make. It meant a vaccine was available.
Prior to the emergence of vaccines, providers like Dr. Sedevie and Meldahl had other dilemmas to deal with involving their careers and their pregnancies.
“It’s been particularly hard being pregnant because I have had patients who were COVID-positive,” Dr. Sedevie said. “In order to reduce the risk to myself and my baby I’d not been able to involve myself in their deliveries or their care. That was difficult to do.”
In addition to sharing roles as caregivers, Dr. Sedevie and Meldahl shared the belief that, without a vaccination, it was likely they’d have to deal with the virus personally.
“I really believe it was only going to be a matter of time before I got the disease if I wasn’t vaccinated,” Meldahl said. “That was not a chance I was willing to take.”
Pregnancy and COVID-19 recommendations
The decision to get vaccinated came accompanied by the reality that the alternative — being an unvaccinated caregiver — was not going to work very well for them or for patients.
“We know there are potential long-term effects from COVID-19 that involve the cardiovascular system that are tangible – things none of us would want to deal with,” Dr. Sedevie said. “We also know pregnant women are at increased risk of hospitalization with COVID, as well as ICU admission and death.”
The technology behind the available COVID-19 vaccines are quickly integrated into the body, Dr. Sedevie will explain to patients. In addition, no existing research or clinical trials suggest the risk of outcomes to be worse in terms of reproduction or pregnancy than risks associated with the virus itself.
“I encourage patients to have discussions with their health care providers,” Dr. Sedevie said. “I’ve tried to let my patients know why I made my decision while also giving them information to make theirs. I welcome them come back to discuss any additional questions after doing their own research.”
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