By Effie Koustas, MSPT
Being pregnant comes with certain expected precautions that most of us are well aware of and will adapt to. Not drinking wine or eating soft cheeses, not lying on your back after 4 months or sleeping on your stomach are some of the more obvious recommendations. But there are others as well. For example, during pregnancy, your body will transform, not only physically, but emotionally and systemically. Your heart rate and blood pressure will increase, and you may develop gestational diabetes or become anemic. There are many other concerns during pregnancy with Covid-19 now being added to the list.
This virus is illustrating that there is still a world of unknowns. Although, we are daily learning more about its presentation and how it compares to other viruses, there is still a high level of uncertainty.
As I sit here and type, the newest recommendation is that we should all be wearing masks in the United States. As for pregnancy specifically, the CDC states, “COVID-19 is a new disease and we are still learning how it spreads, the severity of illness it causes, and to what extent it may spread in the United States.” The agency lists the people at risk are older adults, people with asthma and HIV, and those at risk for severe illness. Pregnancy and breastfeeding, as well as homelessness, fall under the “Others at Risk” category. What we do know is that women are at a higher risk of catching respiratory illnesses during pregnancy due to an immunocompromised body.
The CDC adds, “We do not currently know if pregnant women have a greater chance of getting sick from COVID-19 than the general public nor whether they are more likely to have serious illness as a result.” (https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html) The recommendation is the same during pregnancy, as it is for everyone else: cover your mouth when you cough/sneeze, avoid sick people and wash your hands with soap and water. The agency is also unsure if there will be any complications during pregnancy or after birth; or if the infant could contract COVID-19 from the affected mother during birth. However, in the past couple days there have been infants born with COVID-19. Again, it is unknown if the baby contracted the virus from the mother before/during delivery or hours/days later. In the U.K., women are now considered high risk and advised to self-isolate x 12 weeks. https://www.whattoexpect.com/news/pregnancy/coronavirus-during-pregnancy/
Every day, new data is being released for all ages, healthy or not. For more information on pregnancy and guidelines, the WHO has developed a 6-page infographic at https://www.who.int/reproductivehealth/publications/emergencies/COVID-19-pregnancy-ipc-breastfeeding-infographics/en/ as well as other pertinent information on its website related to pregnancy and COVID-19. Lastly, there is no data to suggest that a Cesarean section is required if you are COVID-19 positive.
From a physical therapy point of view, musculoskeletal changes will continue to be experienced. Some of the usual diagnoses we tend to see during pregnancy are sciatica, general low back pain and sacroiliac joint dysfunction. We are currently offering telemedicine appointments for evaluation and treatment of most orthopedic diagnoses. For example, an important part of treatment during pregnancy is education