COVID19 Vaccine Considerations for Pregnant or Breastfeeding Women

Many of our patients have been asking about the safety and effectiveness of the COVID19 vaccine in pregnancy and breastfeeding.  Vaccination is the best way to reduce the risks of COVID-19 infection and COVID-related complications for both you and your baby.  Now that the vaccine has been out since December 2020, we have a lot more information about the vaccine for pregnant and breastfeeding women.  We encourage all of our pregnant and breastfeeding patients to stay up to date on their COVID-19 vaccinations including the newly released omicron booster.

Both the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) recommend that pregnant and breastfeeding people be vaccinated against COVID19.

Although pregnant or lactating women were not included in the COVID19 vaccine clinical trials, hundreds of thousands of pregnant people have been vaccinated and no unexpected pregnancy or fetal problems have occurred.  There have been no reports of any increased risk of pregnancy loss, growth problems, or birth defects.

We know that about 1 to 3 in 1,000 pregnant women with COVID19 will develop severe illness.  Compared to those who aren’t pregnant, pregnant women infected by COVID19 with symptoms are 3 times more likely to need ICU care, 2 to 3 times more likely to need advanced life support, and have a 70% increased risk of death.  According to a September 29, 2021 urgent health advisory from the Centers for Disease Control (CDC), there have been more than 125,000 confirmed cases of COVID19 in pregnant people including more than 22,000 hospitalizations and 161 deaths.  To reduce these risk, the COVID19 vaccine is recommended.  See the full CDC health advisory here.  

The best way to prevent complications from COVID-19 is vaccination and continue to be up to date on your vaccination series.  We strongly recommend that our pregnant and breastfeeding patients get the COVID19 vaccinationPregnancy is not an indication for a COVID19 vaccine waiver.  

If you have questions about the vaccine, please talk to your provider at your next visit.

Dr. Colleen Barber and Dr. Adili Shay joining Bedford Commons OBGYN!

We are pleased to announce that Dr. Colleen Barber and Dr. Adili Shay will be joining Bedford Commons OBGYN!  Both physicians will be seeing patients in our Bedford location starting in late September.  To make an appointment, click here to schedule an appointment online or call 603-668-4646 to speak with one of our scheduling specialists.

Directions to our new Manchester locations – Elliot & Cypress

We have two new temporary locations, both on the Elliot Hospital campus!

Bedford Commons – Elliot –  located at 4 Elliot Way, Bedford Commons Elliot is located in the Medical Office Building on the Elliot campus.  Enter the Elliot campus at the main entrance and continue on Elliot Way to the free parking garage.  Access to the Medical Office Building is on Level 2.  Bedford Commons Elliot is on the first floor of the building in Suite 101.

Bedford Commons – Cypress – Located off Auburn Street, Bedford Commons Cypress in the 445 Cypress Street building, is the second gray building on the right if you are traveling West on Auburn Street.  It is next to Briarwood Family practice and across from Dartmouth Hitchcock ENT.  Parking is limited so please arrive 15 minutes prior to your appointment to find parking.  There is parking near our main entrance and in the back of the building.  Additional parking is available on the side street.

 

Derry Location Temporarily CLOSED

Due to a fire at the end of July, our Derry location at 6 Tsienneto Road will be closed temporarily until at least February 2023 as the building is being repaired.  If you had an appointment in our Derry office, one of our team members will reach out to you to reschedule your appointment in one of our other locations including:

Bedford – 201 Riverway Place, Bedford, NH
Windham – 49 Range Road, Windham, NH
Elliot – 4 Elliot Way, Suite 101, Manchester, NH
Cypress – 445 Cypress Street, Manchester, NH

Click here for directions to Elliot and Cypress locations

Welcome Dr. Lena and Corinne Forgue, APRN

We are excited to announce that Dr. Ryan Lena and Corinne Forgue, APRN have joined Bedford Commons OBGYN. They are now open to schedule with. Schedule now!

 

Regarding Supreme Court Decision

We understand that recent events regarding access to women’s healthcare may be causing concern.

We want to reassure you that we at Bedford Commons highly value and will continue to support patient autonomy, reproductive health, and the patient-clinician relationship.

We also want you to be reassured that at this time there are no changes or new limitations to access to reproductive health care in the state of New Hampshire.

COVID-19 Visitor Policy Update

We are pleased to share that due to low community transmission rates in our area, we are no longer restricting visitors to our office.  Like always, children accompanying you to your visits need to be supervised at all times.  In addition, for ultrasound visits, we have space only to accommodate one adult visitor in addition to the patient.  We look forward to seeing you!

We continue to follow CDC and NH state guidance regarding COVID-19 precautions.  Bedford Commons OBGYN continues to require masks for all patients and team members.  If you have any questions or concerns, please reach out to our office.

I just tested positive for COVID-19 and I’m pregnant! Now WHAT?!?!

With rising COVID19 cases in New Hampshire, we are getting calls daily from our patients reporting a positive COVID-19 test.  We are here to support you with the latest information about pregnancy and COVID19.  We know that you are worried and have lot’s of questions.  We are updating this information as new guidance becomes available.

If you think you may have symptoms of COVID19, you should be tested.  Symptoms include: cough, fever, shortness of breath, headache, cold-like symptoms, sore throat, or loss or change to your sense of smell or taste.  There are many options for testing including at-home test kits (only should be done if you are symptomatic), state test sites, and pharmacies.  For a full list of testing sites, click here.  New Hampshire is also offering free COVID19 test kits.  To get your test kit, follow this link.

If you test positive for COVID-19, please call us during office hours at 603-668-8400 to let us know.  For the safety of our patients and team members, your next visit will be scheduled at least 10 days from the date of your positive test.  We are also happy to convert your scheduled visit to a telehealth visit to check-in with you.  You should isolate from others and stay at home for 10 days.  If you live with unvaccinated family members, try to isolate yourself from them.  If you are unable to isolate yourself, those family members also need to quarantine – they will need to quarantine for 20 days.  If you do need to leave your house for medical care, please be sure to wear a mask and call your healthcare provider before you arrive to notify them of your positive COVID-19 test result.

Most cases of COVID-19 are mild and can be managed at home with getting plenty of fluids and rest, as well as using medication to reduce a fever.  It is safe to treat a fever in pregnancy with Tylenol (Acetaminophen) 1000mg every eight hours.  In addition, make sure you’re staying hydrated by drinking a lot of water.  If you are fully vaccinated for COVID-19, your risk of severe illness is significantly less than those who are not vaccinated.

Primary care providers are well versed in the symptoms of COVID-19 and recommendations for treatment.  We would encourage you to reach out to your primary care provider for additional recommendations.  Because pregnancy is considered to be a high risk condition for COVID-19, your primary care provider may recommend that you receive monoclonal antibodies.  Monoclonal antibody treatments are recommended by the Centers for Disease Control (CDC) and the American College of Obstetricians and Gynecologists (ACOG) for treatment of pregnant people with mild to moderate COVID-19 who are at risk for complications from COVID-19.  There is a limited supply of monoclonal antibodies so we are relying on insight from your primary care provider as to whether you should receive monoclonal antibodies based on your symptoms.  Although monoclonal antibodies have not been specifically evaluated in pregnancy, preliminary data suggests that monoclonal antibody treatment is safe in pregnancy.  Orders for monoclonal antibodies need to come from your primary care provider.

If you feel like your symptoms are worsening, please reach out to your primary care provider for additional recommendations.  Watch for emergency warning signs for COVID-19 which may indicate more severe illness including difficulty breathing, confusion, persistent pain or pressure in the chest, or pale, gray, or blue-colored skin, lips or nail beds.  If you have any of these signs, seek emergency medical care immediately.

According to the data available from the CDC and ACOG, people with COVID-19 during pregnancy are more likely to experience preterm birth (delivering the baby earlier than 37 weeks) and stillbirth and might be more likely to have other pregnancy complications compared to people without COVID-19 during pregnancy.  Unfortunately, there are not any specific ways to prevent these risks once someone tests positive for COVID-19 other than monitoring for symptoms.  Due to a risk of pre-eclampsia (high blood pressures in pregnancy), if you are less than 28 weeks pregnant, you should begin taking low dose aspirin (81mg) daily starting at 12 weeks of pregnancy, if you have not already been instructed to take aspirin.  If you’re more than 28 weeks pregnant, you do not need to start aspirin.  If you’ve already been on it, continue taking your aspirin until you deliver.

If you were hospitalized with COVID-19, we will schedule non-stress tests to monitor your baby’s well-being twice weekly starting at 32 weeks (and at least 14 days after you were diagnosed with COVID-19) and an ultrasound to check your baby’s growth.  Please reach out to our office with any symptoms of preterm labor which include: Regular, frequent contractions or tightening of your belly, leaking fluid like your water might have broke, worsening lower back pain, and a sensation of significant lower pelvic pressure.

If you have not already received your COVID-19 vaccine or booster, once you are feeling better and it’s been at least 14 days since you were diagnosed with COVID-19, please get vaccinated.  Even if you have already had COVID-19, vaccination is still the best way to protect you and your baby.  

We hope you feel better soon.  Again, please be sure to seek emergency medical help if you are having any severe symptoms of COVID-19.

For more information, please visit: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnant-people.html