Anna Brown sat on her bed and cried after her doctor’s appointment.
That was years ago, when the Volcano, Hawaii, resident was told she would likely never have biological children without egg freezing and surrogacy — neither of which she and her husband could afford.
But she didn’t give up hope. In November, she took a pregnancy test. It was positive.
“To have that hope be rewarded has been one of the greatest joys of my entire life,” she says.
The pandemic has certainly complicated Brown’s pregnancy experience. She and her husband lost their jobs early on and are now forging new paths.
Meanwhile, her landlord is taking advantage of a booming real estate market and selling their home. They have about a month left to find a new place to live.
But by far, the greatest impact has been the loss of Brown’s mother-in-law, who died from COVID-19 last September.
“She was unvaccinated, and after spending over a month on a ventilator, she died just four days after her 55th birthday,” Brown says. “It hurts to think about all the moments that she won't be there for.”
All of the storms Brown has weathered have made her even more determined to protect her health and that of her growing family.
She is among the 42% of pregnant adults who are fully vaccinated in the U.S., but she is not boosted yet. It’s not clear exactly how many women are in her position, as the Centers for Disease Control and Prevention has not released what it knows so far about how many pregnant people have received boosters.
Dozens of Here & Now listeners like Brown have been writing in with questions about being pregnant during this pandemic.
To help get some answers, we asked Dr. Linda Eckert, who is the American College of Obstetricians and Gynecologists' liaison on the CDC's Advisory Committee on Immunization Practices. She’s also a professor specializing in infectious diseases and immunization at the University of Washington School of Medicine.
Questions about pregnancy and COVID-19, answered
On theories as to why a significant percentage of pregnant adults are not fully vaccinated against COVID-19
“Well, I think pregnant women in general are very hesitant to take any medications, whether it be vaccines or pills through their mouth, etc. And we've seen this traditionally with vaccines in pregnancy, where even with flu vaccine, you typically only get about 50% of women vaccinated. I think with COVID, [the] challenge was that pregnant women were not included in the original trials that the manufacturers did. And I think that we've been playing catch up since we started immunizing pregnant women and getting data about how safe this vaccine was in pregnancy, how well it was working and how well it's protecting mothers and their babies.”
On what is known about the impacts of COVID-19 on an unborn child and whether getting infected while pregnant offers any immunity to a baby after birth
“Well, those are great questions that have been a little bit difficult to research, but we're starting to get more and more data. We do know that if a pregnant individual acquires COVID in pregnancy, it can be much more dangerous than a similar peer who's not pregnant. The risk of being on a ventilator is about 15 times greater. And there's a four times increased risk of stillbirth that we saw with the delta wave and the risk of death, depending on the study, is about 15 to 22 times greater. So I think the best way to protect your baby isn't to acquire COVID but is to get the vaccine and pass the protection through your umbilical cord and your breast milk to the baby.”
Listener Anna Brown: When is the best time in pregnancy to get a booster to give the most benefit to the mother and the baby?
“Well, we're starting to get more data about that. And there was just a recent study out that looked at 1,300 pregnant individuals who had been vaccinated against COVID. And indeed, if you get the booster closer to when you deliver, you do have a higher level of antibody protection. But I would say that the antibody protection, even if you receive the vaccine early in pregnancy, is still high. And so what we are recommending, frankly, is the best thing to do is to think about protecting the pregnant mother. Get your booster when it's suggested to happen ... five months after your Pfizer [or Moderna], and that once you are protected, that protection will pass to your baby, whether it happens in the second trimester, first trimester or third trimester.”
Listener Christine Tran of Los Angeles: What data is there about the outcomes of people who are fully vaccinated but infected with COVID-19 and possibly giving birth while infected?
“We are seeing in this new wave individuals who've been vaccinated, acquiring COVID, and when you do have COVID, when you deliver, of course, you may not get the delivery experience you want. You may not be able to have as many people present with you in the room. You may not be able to visit the nursery where your child might be kept. And so it definitely does have implications for the delivery that are not desirable for sure. But also getting vaccinated still offers protection against the most dangerous implications of getting COVID in pregnancy.”
On whether vaccinated pregnant people are just as vulnerable to COVID-19 as unvaccinated pregnant people
“Absolutely not. They are protected in a way that decreases the serious complications, such as needing a ventilator, needing a prolonged hospitalization, even death. And so becoming vaccinated is the best way that you can protect you and your unborn baby against COVID.”
Listener Hilary Oliver of Missoula, Montana: Should vaccinated pregnant people exercise more caution amid omicron?
“I personally am recommending all of my pregnant patients, of course, to be vaccinated and boosted, but to wear N95 masks, if they can get them, or KN95. And I am recommending them to try to limit contact. We do know that masks have worked well traditionally, but the omicron seems to be highly infectious and I would recommend trying to go beyond a cloth mask. … We're seeing that people who are vaccinated and boosted are acquiring omicron, whether they're pregnant or not. And so I do think it merits special caution.”
On how getting COVID-19 while pregnant impacts a baby’s development
“That is something that we're studying. And I think if you can recover from COVID and have the baby at term, we have seen that women with COVID do have an increased risk of getting hypertension in pregnancy, but we haven't really seen some other complications, such as low birth weight if the baby can be born at term. We are, of course, following those babies and following their antibodies and following how they do. And, you know, since we've only got a year's worth of pregnancies now, having had the vaccine and having delivered since the vaccine came out, it's really hard to give you a long-term answer about that.”
Online resources for those looking for more information about COVID-19 and pregnancy:
- One Vax, Two Lives: Doctors and scientists at the University of Washington School of Medicine have launched a campaign to show how one vaccine benefits the life of someone who is pregnant and their baby. They are also active on Instagram and Twitter.
- The American College of Obstetricians and Gynecologists’ Patient FAQ: ACOG regularly updates this reference page as it learns new information for pregnant and breastfeeding adults, but recommends if people need medical advice to talk to their doctor.
- Dr. Jen Gunter, OB/GYN: Dr. Gunter’s goal is to “build a better medical internet” and she often answers pregnancy questions on social media platforms such as Instagram, Twitter and Facebook.
Final thought from Dr. Eckert: If a pregnant patient is searching for answers on Google, she recommends including the words “fact check” in the search line to help get accurate information. For example, “COVID vaccine in pregnancy fact check.”
Moms, we want to hear from you. How has your career, your pocketbook and your sense of economic security been affected by the pandemic? Click here to let us know.
Editor's note: The audio for this story reflects outdated guidance that people vaccinated with Moderna should wait 6 months to get a booster. The guidance has been revised to 5 months.
This segment aired on January 12, 2022.