General Considerations
Delivery Considerations
Stress & Anxiety
Prenatal Care
Abortion & Family Planning
General Considerations
As of 5/2021
Should I get the COVID-19 Vaccine?
- The guidelines will rapidly evolve as more data is collected about the vaccines.
- A new study in the New England Journal of Medicine came out from the “v-safe after vaccination health checker” following 35,691 individuals who identified as pregnant after getting their COVID-19 vaccine (a combination of Moderna and Pfizer). Injection-site pain was reported more frequently among pregnant individuals than nonpregnant, whereas headache, myalgia, chills, and fever were reported less frequently. Of those participants only 827 were able to be reached after their pregnancy in order to inquire about pregnancy outcomes. They found that “although not directly comparable [because of smaller sample size], the proportions of adverse pregnancy and neonatal outcomes (e.g. fetal loss, preterm birth, small size for gestational age, congenital anomalies, and neonatal death) among participants with completed pregnancies from the v-safe pregnancy registry appear to be similar to the published incidences in pregnant populations studied before the Covid-19 pandemic.” Read the article here.
- A study was published in the American Journal of Obstetrics & Gynecology (AJOG) on 03/25/2021 that studied 84 pregnant, 31 lactating, and 16 non-pregnant individuals receiving the COVID-19 mRNA vaccine, and they found that there was a robust immune response (IgG, IgA, and IgM antibodies) in pregnant and lactating individuals 2-6 weeks after the second dose, just as in non-pregnant, and the adverse effects were similar across groups. They also found even higher immune responses in individuals who had been infected with COVID-19 during their pregnancy. In addition, they found an immune response (antibodies) in umbilical cord blood, which may indicate that protective antibodies can be passed through the placenta to the fetus, as well as in breastmilk samples, which may indicate that protective antibodies can be passed by breastfeeding. The study can be found here.
- The current vaccines being used include the Pfizer-BioNtech mRNA vaccine, the Moderna COVID-19 mRNA, and the Johnson & Johnson (Janssen) vaccine. See more detailed information in our vaccines section.
- As of 12/21/2020 (and updated on 2/2/20), The American College of Obstetricians and Gynecologists (ACOG) recommended that COVID-19 vaccines should not be withheld from pregnant individuals, and they should be given to lactating individuals who meet criteria. They, and the CDC discuss that since the risks of a severe COVID-19 infection are higher in pregnant individuals than the general population, the benefits of the vaccine may outweigh those possible risks. However, the CDC emphasizes that getting the vaccine while pregnant is a personal choice. Pregnant and lactating patients will be supported regardless of their decision to become vaccinated.
- To decide if a vaccine is right for you, a conversation with your healthcare worker about the level of activity of the virus in your community, potential efficacy, side effects, and safety for the pregnant individual and the fetus can be helpful. However, although it may be helpful, a conversation with a clinician is not required to get the vaccine, as this may cause unnecessary barriers to vaccine access. For more information about FDA approved COVID-19 vaccines, please see the FDA COVID-19 Vaccine website.
- Please reference our vaccine section for more vaccine specific information.
Am I at increased risk of getting the virus as a pregnant person?
- Although information at this time regarding COVID-19 is limited in pregnant patients, data suggest that pregnant women are at the same risk of contracting the virus as non-pregnant people.
- However, according to the CDC, pregnant people are at an increased risk for severe illness and death from COVID-19 compared to non-pregnant people. A recent study from the CDC shows that pregnant women may be more likely to have severe illness and be hospitalized from COVID-19 than non-pregnant women, and may be at an increased risk of adverse pregnancy outcomes such as preterm birth. The study also shows that non-hispanic black pregnant women have been affected more than other pregnant women.
- The CDC recommends that pregnant women and individuals who live with them take the necessary precautions to prevent contracting the virus including washing hands or using hand sanitizer with at least 60% alcohol, wearing masks, avoiding touching your face, and practicing social distancing.
- It is known that pregnant women are more likely to contract the seasonal influenza and other respiratory viruses compared to non-pregnant individuals. It is important to keep this in mind and to be cautious by practicing social distancing and maintaining good personal hygiene.
Should I wear a mask?
- The American College of OBGYNs (ACOG) recommends that pregnant women follow the same guidelines as non-pregnant individuals regarding masks, which is the same as the CDC’s recommendation, to wear non-surgical masks or cloth face coverings when near other individuals that you do not live with. This holds true regardless of if you have been vaccinated or not.
- In healthcare facilities:
- All persons entering a health care facility should wear a cloth face covering or facemask.
- Patients with suspected or confirmed COVID-19 should wear a facemask or cloth face covering when interacting with healthcare providers or when leaving their room.
- Be sure to adhere to respiratory hygiene, cough etiquette, and hand hygiene and follow triage procedures throughout the duration of the visit.
- Outside of the healthcare setting:
- Wear a mask if you are experiencing symptoms of COVID-19 or if you have confirmed COVID-19 when you are in public or around others.
- If you are healthy and asymptomatic, especially in areas with many cases, the CDC recommends wearing a cloth mask if you are out in the community, especially in a public place where it is difficult to maintain social distancing such as in the grocery store or pharmacy.
- Please follow all local mandates and regulations regarding wearing masks and social distancing while in public.
- Cloth masks are acceptable face coverings. You do not need to wear an N95 or surgical mask.
- The CDC does not recommend you place face coverings, masks, or face shields on babies and children under the age of 2 due to suffocation risks. In addition, there is no data showing that face shields for newborns or infants are protective.
If I get COVID-19, will I pass it on to my unborn baby?
- There is limited data available at this time regarding transmission of COVID to babies. While there have been a few reports of transmission between a mother and baby either immediately before or after birth (also called vertical transmission), ACOG reports that this is uncommon. The CDC reports that babies infected with COVID-19 generally have mild or no symptoms and recover well.
- The CDC recommends that individuals who are pregnant or who are contemplating getting pregnant continue to follow best practices (hand washing, mask wearing, social distancing) to avoid potential exposure to COVID-19.
Can my baby get COVID-19 in general?
- Studies have shown that newborn infants can contract COVID-19. Unfortunately, there has not been a definitive mode of transmission identified, but it can be attributed to the mother and/or to the environment.
- For mothers with suspected or confirmed COVID-19: available CDC data shows that there is low risk of newborns getting COVID-19 when they stay in a separate room compared to the mother’s room as long as safety measures to minimize the risk of transmission are used (mask wearing, hand washing, physical barriers, etc). If you are diagnosed with COVID-19, you should discuss the benefits and risks of rooming with your newborn with your healthcare provider in order to make an informed decision about what is best for you and your baby.
Can I still breastfeed if I am COVID-19 positive?
- It is not known if mothers with COVID-19 can spread the virus to their babies through their breast milk, but the limited data available suggests it is unlikely. Per ACOG and CDC recommendations, breastfeeding and pumping are still recommended even if you test positive. Talk to your healthcare provider regarding your decision about whether and how to start breastfeeding.
- If you are planning to breastfeed:
- Wear a mask during breastfeeding and wash your hands before and after.
- If you decide to pump, be sure to wash your hands before and after, wear a mask while pumping, and clean the pump regularly (instructions here).
For general breastfeeding tips, click here!
Should I still go to my prenatal appointments?
Should I still go to my prenatal appointments?
- Yes! Do not skip your prenatal or postpartum care appointments. It is important to check in with your healthcare provider as scheduled. If you are concerned about attending your appointment, talk to your healthcare provider.
- Some offices are offering telehealth appointments in addition to in-person appointments; if you are interested in participating in a telehealth visit and if you are eligible, you should ask your doctor’s office.
- Also, do not delay getting emergency care because of COVID-19.
- It is important to still get your recommended immunizations such as the vaccine against influenza, whooping cough (Tdap), and any others that are recommended by your provider. The influenza virus can be dangerous for you while you are pregnant, and both influenza and whooping cough are dangerous for your baby, and the symptoms can mimic those of COVID-19, so it is important to get both of those vaccines while you are pregnant! Both of those vaccines and many others are safe for you and the baby while you are pregnant.
What if I need to self-quarantine and have no way to obtain food or essential items?
Be sure to let your healthcare provider know! They will be a good resource for any questions you may have.
Eligible DC residents who have been directed to self-quarantine by a medical provider and have no way to obtain food or other essential items can call 1-888-349-8323 or visit gethelp.dc.gov for delivery of food or essential items.
Delivery Considerations
As of 5/2021
I am scheduled to be induced soon. Will this still happen as planned?
Although this varies by hospital, at this time the ACOG recommends that inductions occur as indicated.
Please ask your healthcare provider about your hospital’s policies regarding inductions.
I have hired a doula for my delivery. Can my doula still be a part of my delivery experience?
For the safety of the doulas and patients, ACOG recommends that doulas follow the individual hospital policies regarding visitors and your doula’s role in the laboring process.
Please check in with your hospital regarding this matter; while some hospitals consider doulas part of the healthcare personnel, others consider doulas to be visitors. If your doula cannot be part of your experience physically, some doulas are offering virtual services.
Can my spouse, parent, or friend be in my delivery room with me while I deliver?
Please check with your hospital to determine how many visitors will be able to stay with you during your birth. Most hospitals are allowing only one visitor who must stay there the whole time without leaving/returning, however, in recent months many hospitals are allowing two visitors. Again, it is different in every hospital, so check with your hospital or your provider.
I’ve been hearing about home births in the news. Should I prepare for a home birth?
The American College of OB/GYN has not changed its recommendations about home births during the COVID-19 pandemic.
Hospitals and accredited birthing centers under the supervision of trained healthcare providers are the safest places for delivery. However, every woman has the right to make an informed decision about her delivery, so it is important to research all of your options and discuss with your healthcare provider.
Be sure to discuss your birth plan and any concerns with your OB/GYN or nurse midwife.
Stress & Anxiety
As of 5/2021
- Particularly during a pandemic, it is important to stay both physically and mentally healthy. If you are feeling stress, anxiety, or depression, talk to your healthcare provider and refer to the CDC’s recommendations about coping strategies for anxiety and depression during and after pregnancy. There are many resources available to you, for example, The Doula DC has many pregnancy and postpartum resources in the DMV area.
- Giving birth as a Woman of Color and/or Black woman comes with a unique set of stresses, especially since this virus is striking these communities disproportionately across the country. The Black Women’s Health Initiative is a helpful resource if you are struggling during this time and would like more guidance. This website can help with healthcare coverage, self-advocacy, self-care, and general pandemic lifestyle tips. There is also a blog post specifically about delivery in times of COVID-19.
- As a Woman of Color, or Black woman specifically, it is imperative to advocate for yourself. This is challenging and sometimes impossible in general, let alone while pregnant and during a pandemic. This website is a resource guide that has been put together by Doulas of Capitol Hill to help all pregnant women, but specifically Black pregnant women, navigate this difficult time. It includes books, birthing centers, advocacy, mental health support, support groups, and much more. They offer many services, and you can contact them at 202-854-9899.
- Additionally, postpartum (and peripartum) depression and anxiety are very common, and no one should go through it alone. Tell your support system, and most importantly, a trusted provider, if you need help. Click here to find community resources for perinatal mental health support groups, counseling, and more in the DMV area.
Prenatal Care
As of 5/2021
There are helpful resources for individuals with barriers to healthcare access in other sections of this website (testing under “Health Info”, and many under “Communities”) that can also apply to mothers-to-be. Note that Bread for the City (free COVID-19 testing and free primary care) does not offer prenatal care.
- Most low-income women in D.C., Maryland, and Virginia are eligible for Medicaid when they become pregnant, opening access to all clinics in the DMV area that accept Medicaid patients.
- For more information about medicaid eligibility in your area or to apply, please call or see the appropriate website:
- DC: (202) 724-5506 or www.DCHealthLink.com
- Virginia: 1-855-242-8282 or www.commonhelp.virginia.gov
- Maryland: 1-855-642-8572 or www.MarylandHealthConnection.gov
In addition, there are many clinics and healthcare centers in the area that take insurance but do not require it. They offer free, discounted, or sliding fee scale payments. This is helpful if for some reason you are not eligible for Medicaid, or while waiting for your application to be processed. Because of COVID-19 many of these health centers are not accepting walk-ins, so it is important to call beforehand. There is more information on the DC Department of Health Website and on each of these healthcare centers’ individual websites:
- Capitol Hill Pregnancy Center – (202) 546-1018 – Free pregnancy testing, mentoring, childbirth and parenting classes.
- La Clinica del Pueblo – (202) 462-4788 – Sliding Fee Scale based on income and family size. Limited prenatal appointments are still being offered.
- Community of Hope – (202)-398-5520 – Sliding Fee Scale based on income. Prenatal visits, care for newborns in clinic. Pregnancy support groups over zoom.
- Forestville Pregnancy Center – (301) 423-0063 – Free pregnancy testing, prenatal vitamins, ultrasounds, pregnancy education classes.
- Mary’s Center – (202) 483-8196 – Discounted fees and they will help you apply for public benefits. Sonography clinic, prenatal appointments.
- The Northwest Center – (202) 483-7008 – Free pregnancy testing, options counseling, referrals to community resources.
- Unity Health Care – (202) 469-4699 – Sliding Fee Scale based on income. Some providers are doing telemedicine prenatal visits, some are doing in person prenatal visits.
- The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is still going on but NOT in person. Call for information and go to this website to see if you qualify.
Abortion & Family Planning
As of 5/2021
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What are my options in DC and the DMV?
- Laws about abortion differ in DC, Maryland, and Virginia.
- If you need to talk to someone, All Options runs a free hotline and provides nonjudgmental options counseling on unintended pregnancy, parenting, abortion, and adoption. Call (888) 493-0092 to access their toll-free talkline.
- National Abortion Federation (NAF) provides information on options and how to evaluate if you think you may be pregnant. They also can help you determine if you require financial assistance. They also have a hotline, and can help you evaluate options as well as what to expect if you do get an abortion.
Where can I get services and do I have to go to a clinic? What about contraception?
- The need for an abortion does not stop during a crisis or pandemic! Currently reproductive health clinics in the DMV are OPEN and considered essential businesses. Many clinics are adjusting hours and numbers of patients they are able to see at a given time, so make sure to call ahead of time if you can. All clinics are requiring or requesting that patients wear a mask, and most are requiring you to make an appointment ahead of time.
- Many of the clinics listed under our “Accessing Prenatal Care” section offer options counseling (medication vs. surgical abortion, adoption, etc.) and contraception care. They may also be able to give you a recommendation for an abortion clinic near you. Some, including Capitol Hill Pregnancy Center and Forestville Pregnancy Center, also offer post-abortion support and recovery.
- Carafem continues to provide birth control, abortion care, and STI testing. If you have a D.C. or Maryland address, you may be eligible for medication abortion via telehealth.
- Learn more information about TelAbortion and see if you qualify in Maryland and D.C. here, and Virginia here.
- Planned Parenthood of Metro DC is open for in-person visits and offers telehealth appointments on applicable services 7 days a week.
- Falls Church Healthcare Center in Virginia offers many different options for abortion care.
- This is not an exhaustive list, but there are several other clinics providing abortion in the DMV.
To discuss with your doctor:
- Self-managed medical abortion (“No-Touch Medication Abortion”) is an option at this time under the care and supervision of a medical provider. For more information please contact your doctor or one of the providers listed above.
- The M+A Hotline is a resource to for people who are completing a medication abortion at home, or who think they may be miscarrying. You may text or call (833) 246-2632 and speak with a physician. The number is staffed from 10AM-10PM and they will respond within an hour.
Resources for providers:
- The World Health Organization publishes guidelines on the medical management of abortion. NAF and the Reproductive Health Access Project have recently published new protocols for No-Touch Medication Abortion to support providers during COVID-19.
- The Repro Legal Helpline offers guidance and information about people’s rights regarding self-managed abortion. The laws and legal precedent of this topic are complex; it is important to know what your rights are. Call their hotline at (844) 868-2812 or refer to their website to submit questions via their secure webform.
Where can I get financial assistance or practical support for an abortion?
- DC Abortion Fund (DCAF): DCAF provides financial support for individuals of any age who lack resources to access abortion care. They run a free, confidential helpline in English and Spanish at (202) 452-7464. A case manager will return your voicemail. Residents of DC, MD, and VA, or those traveling to the area for abortion care are eligible for funding.
- National Network of Abortion Funds (NNAF): This is a network of abortion funds throughout the country. They can help connect you to other resources.
- NAF Hotline: NAF also operates a free, anonymous, multi-lingual hotline for abortion referrals and financial assistance. Call (800) 772-9100 to reach them (there may be very long wait times).
- DC Abortion Practical Support Network (DAPSN) currently offers practical support, ie. clinic escorts and rides with COVID precautions (wearing masks, having hand sanitizer available etc). They can be contacted via email: dmvpracticalabortioncare@gmail.com and have coordinators monitoring the email around the clock. At this time they cannot offer housing to those traveling into the DMV for an abortion.
- Capitol Hill Pregnancy Center offers medical, legal, adoption, and housing referrals to those who need it.
- The Richmond Reproductive Freedom Project supports the full spectrum of pregnancy options, and they may be able to help you with resources for the abortion. Please call 888-847-1593 on the 1st and the 15th of the month (when their funding cycles begin) and leave a detailed message. For Spanish Language Accessible Funding dial that same number with extension 105, and for Inmate Rights Funding use extension 106.
- The Blue Ridge Abortion Fund has been serving individuals who need help paying for abortion care since 1989.
- First trimester: Funding support is available for those who live in central and western parts of Virginia (for northern Virginia, Richmond, or Tidewater areas they recommend The DC Abortion Fund or Richmond Reproductive Freedom Project).
- Second trimester: funding support is available to callers throughout Virginia. Please call 434-963-0669.
- The Baltimore Abortion Fund is an all-volunteer, nonprofit organization that provides financial assistance to people who live in Maryland for abortion care. Please call 443-297-9893 and leave a voicemail with your name, phone number, how many weeks pregnant you are, the date of your doctor’s appointment (if you have already made an appointment), and whether or not it is OK for them to leave you a voicemail.
- If you are on Medicaid/Maryland Medical Assistance, you may be able to get your abortion covered, click here for more information.
