Obstetrician and Gynecologist, ChristianaCare, Newark, Delaware
“We are five months into this global pandemic, and we still know relatively very little about COVID-19 infection in the general population, let alone the obstetric one. There is insufficient data on vertical transmission of SARS CoV-2; an early study out of China is somewhat reassuring while a new one from Italy hints at transmission. We don’t know if maternal infection has any immunologic benefit to the neonate. We are gathering more information every day here in the United States, but this does little to assuage the fears of pregnant moms. … The patients I see are overwhelmingly concerned about the impact coronavirus will have on their family’s health, if there is an increased risk of miscarriage or other complications. They are very anxious about delivery if they are positive at that point in time. They fear having to immediately isolate from their new baby and family. They are concerned about the impact it will have on breastfeeding. Worry is a constant companion during pregnancy; it is heartbreaking to witness this kind of anguish. … Perhaps more disconcerting are the health inequities that have been magnified by the pandemic. While I take labor and delivery call and do Ob triage [ER shifts], my role for my department with respect to the COVID-19 epidemic has primarily been in the outpatient world. I manage our hospital’s COVID-19 Pregnancy Center, treating positive patients or those suspected of having the virus. We are able to provide lab services, maternal fetal medicine ultrasound services, prenatal care and basic urgent women’s healthcare needs to women who would otherwise not be able to be seen safely in their usual office setting. I see patient referrals from private practices as well as state-funded clinics. … Many of the patients I see live in crowded conditions, multiple adults and children under one roof—a greater potential for viral spread. Many rely on public transportation to get to their prenatal care appointments. Some work service jobs that put them in dangerous proximity to others. They lack access to health care and health insurance outside of pregnancy. Many struggle to afford even their prenatal vitamins. There are so many barriers. Too many barriers. … Recently, I made my first impromptu house call to a COVID-19 positive patient whose situation rendered her unable to come to the center for her weekly progesterone injection that helped prevent a recurrent preterm birth. Without it, there could be a COVID-19 positive mom going into preterm labor because of a very simple injection. When I arrived, I thought showing up on her doorstep in all my PPE was going to be intimidating, but instead I saw a bit of relief on my patient’s face in the midst of this pandemic.”
As told to Jennifer Schaffer Leone
May 15, 2020
Digest, the magazine for alumni and friends of Philadelphia College of Osteopathic Medicine, is published by the Office of Marketing and Communications. The magazine reports on osteopathic and other professional trends of interest to alumni of the College’s Doctor of Osteopathic Medicine (DO) and graduate programs at PCOM, PCOM Georgia and PCOM South Georgia.