COVID vaccine and Pregnancy FAQ
From Dr. Kathleen Watt
26 September 2022:
The following is an update to the blog written on COVID-19 vaccination in pregnancy for Ob/Gyn Affiliates and its division, Women’s Health Care Associates. This update is being issued because new data and recommendations continue to emerge and because the pandemic and the SARS-COV-2 virus continue to change.
What should I expect during my first appointment?We typically see patients during their 7th week of pregnancy (about 3 weeks after a missed period). At this time, we perform an ultrasound of the early pregnancy. An office visit with one of our providers follows this ultrasound. We discuss the findings on the ultrasound, and welcome and orient you to our obstetric practice. An exam and labwork, with the option of genetic screening, is performed during the 10th week of pregnancy. If you have a history of miscarriage or ectopic pregnancy, we may want to see you earlier for some bloodwork to give us early information about how the pregnancy is progressing.
What can I do to ease morning sickness?Morning sickness is common in the first trimester. Try eating some toast or crackers before you get out of bed in the morning. Drink plenty of fluids and try to eat small, frequent meals. Try to eat bland foods that appeal to you and are easy to digest, and keep crackers or other bland snacks with you to eat throughout the day. You can also try food that contain peppermint or real ginger. If these suggestions do not help, please call our nurse line to discuss starting medication for nausea.
What type of exercise is safe?After the first trimester, you will want to avoid any exercise or activity that poses a risk of falling on your belly ( eg. horseback riding, road biking, skiing). However, you can continue most exercise throughout the pregnancy. Walking, swimming and prenatal yoga are all good options. Use common sense and listen to your body.
What type of fish can I eat? What about sushi?We recommend eating plenty of fish that is high in omega-3 fatty acids (eg. salmon, shrimp). Two servings per week is ideal. We recommend limiting fish that contains higher mercury levels. It is best to limit white (albacore) tuna to six ounces per week. We do not recommend eating shark, swordfish, king mackerel, marin, orange roughy, or tilefish while pregnant. Sushi and any food containing raw eggs, seafood, or meat can pose a risk of food-borne illness. It is safest to avoid these foods in pregnancy to decrease the chance of food poisoning.
Is it safe to get a massage? What about getting my hair or nails done?Massage is safe in pregnancy, just be sure to notify the practitioner that you are pregnant. Some places do not offer massage in the first trimester, so be sure to check ahead of time. Hair dyes and nail services are generally considered safe in pregnancy.
Is it safe to take a hot bath? What about hot tubs or hot yoga?Hot showers and baths are safe in pregnancy. We generally recommend avoiding hot yoga and hot tubs in the first trimester. After that, we recommend avoiding hot tubs or hot yoga that are >100 degrees. As always, please listen to your body and stop if you get dizzy or light-headed.
Should I be worried about the Zika virus? What are my travel restrictions?The Zika epidemic is relatively new, and information and guidelines are changing quickly. We recommend visiting https://www.cdc.gov/zika/index.html for the most up to date info. In general, we do not recommend travel to countries with endemic cases of Zika when you are trying to conceive or while you are pregnant. Travel within the continental US & Hawaii is considered safe.
Is caffeine safe in pregnancy?It is safe to drink one 12-ounce caffeinated beverage per day.
What are kick counts? Do I need to be doing them?In the third trimester, we recommend paying attention to fetal movements and learning what is normal for your baby. If you feel that fetal movements have decreased, you should perform a kick count. To do this, drink some cold water or juice and lie on your left side with a hand on your belly. Keep track of the number of movements, and you should feel ten movements within one hour. You can stop counting once you get to ten movements. If you do not get ten movements within an hour, please call our office.
When do I need to stop traveling by plane? What about long car trips?In an uncomplicated pregnancy, it is safe to continue airline and car travel up to 34-36 weeks. You can use your judgement about how important the trip is to you. It is always a good idea to travel with a copy of your medical records.
Do I need a birth plan?A birth plan is optional. We are always happy to review birth plans, so feel free to bring yours to your visit anytime. We will make a copy and distribute to all the physicians.
What phone number should I use to call the practice?For routine questions during business hours, please call 303-795-0890. For emergent questions during business hours, please call our emergency OB line (303) 730-9286. After office hours, you may call our main number (303) 795-0890, which will direct you to our answering service and page the doctor on call.
When should I call the office if I think I am in labor?We recommend following the 5-1-1 guidelines. Wait until contractions are five minutes apart, lasting a minute, for one hour. This refers to painful contractions that you are needing to breathe through. We also recommend calling if you have a gush of fluid suggesting your water broke, or if you are bleeding like a period.
Finally, please remember:
If you choose to vaccinate:
This is your choice.
You may be able to have more freedom to do the things you had to stop doing because of the pandemic.
Your baby may benefit from your antibodies.
If you choose NOT to vaccinate:
This is your choice.
You should continue to observe other safety measures to protect yourself and others, such as wearing a mask, social distancing, and avoiding crowds.
You can still get the vaccine after you deliver/when you are breastfeeding.
The American College of Obstetricians and Gynecologists Website: Practice Advisory: “COVID-19 Vaccination Considerations for Obstetric Gynecologic Care”. December 2020 (updated July 30, 2021).
The American College of Obstetricians and Gynecologists Website: “ACOG and SMFM Recommend COVID-19 Vaccination for Pregnant Individuals”. July 30, 2021.
Arizona Healthcare, Emergency Response, and Other Essential Workers Surveillance Study (AZ HEROES) in JAMA. 2021;326(6):473. doi:10.1001/jama.2021.12619.
Centers for Disease Control and Prevention Website: “Joint Statement from HHS Public Health and Medical Experts on COVID-19 Booster Shots”. August 18, 2021.
Centers for Disease Control and Prevention Website: “When You’ve Been Fully Vaccinated”. Updated July 27, 2021.
Centers for Disease Control and Prevention Website: “Reduced Risk of Reinfection with SARS-CoV-2 after COVID-19 Vaccination — Kentucky, May-June 2021. MMWR Early Release. August 13, 2021 / 70(32);1081-1083.
Centers for Disease Control and Prevention Website: “SARS-CoV-2 Variant Classifications and Definitions”. Updated August 17, 2021.
FDA.gov website “Pfizer-BioNTech COVID-19 Vaccine Frequently Asked Questions “. Updated August 12, 2021.
“Myocarditis and Pericarditis After Vaccination for COVID-19” in JAMA. August 4, 2021. doi:10.1001/jama.2021.13443.
“Sperm Parameters Before and After COVID-19 mRNA Vaccination” in JAMA. 2021;326(3):273-274. doi:10.1001/jama.2021.9976.