Navigating High-Risk Pregnancy During COVID-19

Adding a child to your life with lupus is a big responsibility. And facing a high-risk pregnancy can be very intimidating. But COVID-19 has put even more weight on these decisions and led to more questions.

How will you manage a pregnancy during the pandemic? How will your medical care be impacted? Or future childcare? Parents and parents-to-be have faced a myriad of difficulties over the past year.

During my first pregnancy, I spent months trying to overcome my anxiety about how lupus increases my risk for all sorts of poor pregnancy outcomes – from preeclampsia to intra-uterine growth restriction to premature delivery.1 Now, during my second pregnancy, my thoughts are consumed with avoiding COVID-19 and how to best manage my life during a pandemic while going through the ups and downs of pregnancy.

Are these symptoms COVID-19, lupus, or pregnancy?

Standing in front of the list of COVID-19 symptoms at my son’s therapy office, I realized that I was experiencing several. At 6 weeks pregnant I was incredibly nauseous and short of breath – and it was obvious to the staff member checking me in. I found myself sharing my very personal news so that I could reassure the medical staff that my symptoms were from pregnancy and not COVID-19.

Of course, how could I prove it? Thankfully, I didn’t have a fever and everyone has been understanding about the pregnancy symptoms, but it was a tricky situation that I hadn’t contemplated beforehand.

I’m also one of the lucky women who suffer from pregnancy rhinitis – long term nasal congestion. In early pregnancy, your blood volume increases significantly.2 This leads to more blood flow to mucous membranes, like the ones in your nose, which can cause stuffiness and drainage.

The continual congestion is unpleasant, but it’s also stressful to be sniffling in public during a pandemic. I felt like I needed to wear a shirt saying, “My pregnancy is causing a runny nose – I am not deliberately going out while sick!”

Other COVID-19 symptoms that overlap with pregnancy symptoms include fatigue, headache, vomiting, and diarrhea. Pregnancy, COVID-19, and lupus can cause aching muscles and joints. There have been several days where I wondered if I was coming down with COVID-19, entering a lupus flare, or just going through a burst of pregnancy growth that made me feel extra run-down and nauseous.

Complexities of medical care during a pandemic

Many pregnant women are facing fewer appointments or more e-visits than they expected. This can be stressful since there are so many things that do need to be checked in-person during pregnancy, especially for those with lupus.

Many OB/GYN offices are not allowing visitors in order to protect their pregnant patients. But this means that moms can’t bring their significant others along for those special ultrasound viewings or bring their other children if they can’t find childcare. My OB doesn’t allow visitors, but I have ultrasounds at a maternal-fetal medicine practice that does allow for my husband to wait in the hallway until it’s time for him to come back.

Pregnancy with lupus means you need more specialized care, and it may not be as easy to access during a pandemic when some offices have strict protection measures in place. Or, in my case, having to go to extra appointments for monitoring can lead to stress about more potential exposure from so many doctors’ offices.

The struggles of staying safe

I worry a lot about what could happen if I catch the virus during pregnancy, as pregnant women have a higher risk of severe illness and death.3 And, no one knows for sure yet how it might affect a developing baby.

I am tired of having to stay home and evaluate risk levels for every scenario, but even more concerned about making sure I stay safe. My heart goes out to all moms, but particularly the first-time moms, that should be celebrating a joyous time but aren’t able to because of the virus. This impact may be even greater within the lupus community for those that have struggled to get pregnant or have a high-risk pregnancy.

One positive of a pandemic pregnancy is that it’s easier to stay home on those days when you feel totally wiped out. Most of my first trimester was spent in bed or on the couch, but at least I never really felt like I was missing out on anything.

I’m wishing every mom, especially those moms balancing lupus, a safe and healthy pregnancy.

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