DENVER, Colo. — Sarah Sefranek, a Catholic wife and mother living in Parker, Colorado, is 37 weeks pregnant with her fourth child.

While she normally homeschools her other children even when there’s not a global pandemic on, coronavirus restrictions have changed what normal life looks like for everyone.

“It’s not regular homeschooling” right now, she said. “Regular homeschooling means you go out, you see your friends, you do exciting things.”

Sefranek and her family have been doing their best to stay home and maintain social distancing in order to avoid getting the coronavirus, especially so close to her due date. They’ve stopped going to the library, they’ve stopped playdates and book club meetings. Sefranek told CNA her husband leaves the house only to get groceries or other essentials.

But, like most pregnant women, even if Sefranek remains healthy, labor, delivery and postpartum recovery will likely look very different for her than they would have without pandemic restrictions.

“I know the things that were helpful to me when my (other babies) came, like having a meal train and having my mom come over. Now I can't have playdates for my big kids while I'm recovering. I don't even know where people are going to get the meat to make me meal for a meal train. So it is strange,” Sefranek said.

Things “suddenly felt a lot more serious” for Sefranek when her doctor offered to do a telemedicine visit for her 38 week appointment instead of an in-clinic appointment. Normally, at this point in pregnancy, Sefranek would be going in for weekly visits until she delivers. But her doctor told her this time, unless she had serious concerns that something was wrong, it would be best to do the visit over a video call.

Looming large among Sefranek’s worries - what happens if she, or her baby, get coronavirus?

“Recommendations are changing all the time, but right now, if I tested positive, they would want to separate the baby from me at birth, which is pretty scary to me,” she said.

There is also a shortage of coronavirus tests in most places in the U.S. Sefranek wonders what would happen if she showed up to the hospital to deliver, and had a cough or a fever, but could not get tested.

“I feel a little bit like I have to hide in even more of a bubble, because I feel I can't catch anything at all. In a way, I feel I'm more scared of being separated from baby than I am of the virus itself,” Sefranek added, which she admits is “maybe not rational.”

A Dearth of Research on Coronavirus and Pregnancy

Information about pregnancy and coronavirus is scant, as the disease is so new and there has not been enough time for extensive research. 

While pregnant women are not considered immunocompromised in the classic sense of the term, their immune systems are considered “suppressed,” meaning they are more susceptible to illnesses like the flu or coronavirus, and may suffer more severe symptoms and complications than they normally would have, were they not pregnant.

“With viruses from the same family as COVID-19, and other viral respiratory infections, such as influenza, women have had a higher risk of developing severe illness. It is always important for pregnant women to protect themselves from illnesses,” the CDC website states.

The CDC notes that it is still unknown whether mothers infected with coronavirus could pass the illness on to their babies, though it says that so far, no infants born to COVID-19 positive mothers have also tested positive for COVID-19. The virus has also thus far not been found in the amniotic fluid or breast milk of mothers who have tested positive.

There have been a small number of reported complications in pregnancy or delivery in mothers who are COVID-19 positive, though the CDC notes that it is unclear if the complications were related to the infection. Women of childbearing age are also in age categories where coronavirus death rates are not as high as older populations.

Jennifer Murphy is the medical director of the Pregnancy Support Center of Carroll County in Maryland. The pregnancy center helps women in crisis pregnancies or with low incomes with material assistance such as diapers, with medical care such as pregnancy tests or sonograms, and by connecting them with additional resources.

Murphy told CNA that so far, her center has not had any of their clients test positive for coronavirus. As a precaution, they have moved most of their operations to the parking lot, and only bring women into their facility if necessary, and once they have been screened for symptoms.

“You always worry that pregnant women are more susceptible to things than other people. So far, the data doesn't seem to show that,” Murphy said.

“I'm not making light of it, but there's so much in the news that's horrifying, but most people will actually come through this just fine, and there's not so far any evidence that pregnant women do worse than anyone else,” she added.

Murphy said she has been telling her clients to remain calm, to practice good hygiene and quarantine protocols, and to be in close contact with their doctors if they do suspect symptoms of coronavirus.

“It's a lot of quelling of anxiety, a lot of folks who are just very afraid, and understandably,” Murphy said. “But anxiety isn't good for you when you're pregnant either, so we're trying to emphasize positive things they can do quarantine-wise, and keeping their environment clean and calm as much as possible, and trying not to think too far ahead about bad things.”

“Pregnancy is a time of anxiety anyway, especially first time moms,” Murphy added. “And it's hard not to have this add a great burden, but just to try to stay focused on a few good things and taking care of your baby. So just (focus on) keeping yourself safe, and probably not even overexposing yourself to media, because I think that just makes it worse,” she said.

“Be informed, but don't make yourself crazy.”

Disrupting Birth Plans

The lack of information on pregnancy and coronavirus worries Anna H., a Catholic in Long Island, New York, where the pandemic has hit the hardest in the U.S. thus far. She is 22 weeks pregnant with her first child.

“It's just the unknown,” Anna told CNA.

“There isn't enough research on how it affects pregnant women, how it affects babies. I know there's a lot of research that says that it probably isn't too bad for the babies, but I also have asthma,” she adds, an underlying condition that could worsen the effects of coronavirus, a respiratory disease.

Anna, who teaches high school theology, said her school has been closed since March 12. She’s been teaching online, which is easier on her body, and she’s less worried about exposure now that she and her husband are working from home. She said she’s also grateful for the stay-at-home order in her state, and hopes the aggressive approach will slow the spread of the virus and relieve some of the pressure on hospitals and doctors.

Already in New York, some overwhelmed hospitals are not allowing pregnant women to bring any support people with them - no spouses, parents, children, friends or doulas.

“I'm pretty nervous about that,” Anna said. She and her husband joke that they would schedule a home birth with a midwife if it came down to him not being allowed at the birth - and Anna knows a Catholic mom in the area who has delivered all five of her children at home.

But she’s hoping it doesn’t have to come to that, and that things will calm down by the time she needs to deliver.

“Right now I feel like we don't need to worry about that too much. We can put it in God's hands for now,” she said.

Baylyn Wagner, who is 28 weeks along and due on June 19th with her third child, has already decided to change her labor and delivery plans in light of the coronavirus pandemic.

“Initially I thought, ‘Oh, it'll for sure be over and done with by June and we won't have to worry about delivery,’” Wagner, who lives in Minnesota, told CNA.

But then she started hearing reports of hospitals restricting support people for pregnant women to one person, or to no one. Her own hospital emailed her and told her that they would only allow one support person, even though Wagner had been planning on her husband, doula, and birth photographer attending her labor and delivery.

Wagner said her doctor tried to reassure her. Wagner had a late loss in her second pregnancy - she miscarried a little after 21 weeks - and in light of that, Wagner’s doctor said she would do her best to advocate for the hospital to make an exception for Wagner’s husband to be present for the birth of their third child.

“But she said if it gets to ‘full crisis mode,’ those were her words, they absolutely could limit it down because their priority is keeping their staff healthy. I know hospitals are doing what they can, but for us...with the anxiety we already had with this pregnancy, we chose to look into midwives to do a home birth option,” she said.

After talking with four different midwives, Wagner said it sounded to her like a lot of couples were making the same changes.

Wagner said they’ve also changed their contract with their birth photographer to a more tentative plan, that accounts for whether the photographer is sick and cannot come to the birth.

Wagner lives with her grandparents, so she said they will watch her son while she gives birth at home. Her grandfather is also a Catholic deacon, and she said she is considering asking him to baptize her child soon after the birth, in the event that churches are not yet open.

“There's really no way to know right now what things will look like by June, if things will be better, if we'll able to have Masses again by that point, or what the world will look like,” Wagner said.

Keeping Calm, Trusting God

Claire Le, who lives in Littleton, Colorado, is expecting her first child with her husband Huy. The Le’s said they stocked up on food as they saw the pandemic worsening, and since then they have been staying home as much as possible to avoid any exposure.

“My main fear is if I contract the virus, then I would have been in ICU and then my husband can't be there during the delivery,” Claire said. “And then also, if hospital protocols get even worse, there may even be a chance he may not be there. So, right now we're trying to control what we can, and trying to both stay healthy.”

“I think we just constantly remind ourselves that this is not in our control,” Huy added. “I mean, we can pray for a good May 1st due date where everything's just back to normal, but things like that are not really under our control.”

Thinking about postpartum recovery is what makes Claire a little sad, she said. Her family is out in California, and they were planning to come see the baby and help out after the birth. But now, they’re not sure when a visit will be possible.

Huy and Claire are also wondering about the baptism, and if it will be performed privately.

Claire said she has found peace in prayer and offering up the situation to God.

“I know God's been with us from the very beginning, from conception, and he's been with us the whole way. I know we'll be okay,” she said.

Huy said staying connected with loved ones, watching daily Mass on YouTube, and praying together as a couple has been helping them stay calm at this time.

“We went to a chapel which was relatively quiet, that gives us a little bit of a release where we can just go there and with God for a while,” he said.

Anna said she has been trying to balance her worries and anxieties by also counting her blessings.

“I always try to think about what blessings I have at this time: more time with my husband, more time prepare for the baby, more time to rest,” she said. “The fact that I'm not on my feet all the time is really helpful...teaching is physically demanding because you're on your feet so much.”

The time at home has also afforded her more time to pray, Anna said.

“I did a novena to St. Gerard (a patron saint of pregnancy) when we first got pregnant and I just started the other day to do another novena to St. Gerard,” Anna said. “(I’m also) able to live stream daily mass, where normally when I'm a teaching I don't have time for that.”

Wagner said she and her husband have been trying to say a daily rosary in order to stay calm at this time.

“(We’re) especially meditating on what Mary and Joseph went through and their pregnancy and their birth with Jesus, and uniting our own uncertainty to what they experienced,” she said.

She’s also been using Hallow, a Catholic prayer app that leads users through guided meditations similar to the popular Calm app, but based on Scripture readings.

“They've had a whole series of little guided meditations on different ways to cope with isolation and stress through all of this, so that's been a nice tool and prayer as well,” she said.

Sefranek said the pandemic has made her identify more closely with women experiencing unplanned pregnancies, and helped her realize how much of life is out of her control.

“I planned this pregnancy nine months ago,” Sefranek said. “I didn't plan to have a baby in the middle of pandemic...maybe every pregnancy, every birth, in a way, is unplanned.”

“I don't want to diminish the pain and the difficulty of a real crisis pregnancy,” she added. “It just is reminding me of that…(because) so much of this outside of my control.”

Sefranek said she’s been saying a lot of “midnight rosaries” when she wakes up from pregnancy discomfort, and that’s been helping her to feel at peace, though she deeply misses the sacraments. She said she’s also been connecting with loved ones virtually to help ease her anxieties.

She is also paying attention to the small blessings in her life. For example, she said, the other day she found out that she had two extra boxes of sticks for her fertility monitor that she will need to track her cycle once the baby is born. She had previously been worried - panic buying has caused the sticks to be scarce online.

“(It was) a small thing, but maybe God had a plan for me and he used my absent mindedness to give me this small thing right now that could increase my peace,” she said.

“So that was a nice reminder that God can work through the things that feel really frustrating in the moment.”