Pregnancy is life-changing enough on its own, so it’s understandable that expecting mothers have many more questions and concerns about prenatal care during the 2019 coronavirus disease (COVID-19) pandemic.
At NYU Langone, we’re changing and innovating how we deliver prenatal care to ensure our patients stay safe and healthy throughout their pregnancies. This includes using video doctor visits and at-home monitoring to limit the number of times they come into the doctor’s office. For those times when they do need an in-person visit, we have safety measures designed to keep our patients and staff healthy.
“Whether it’s coming into our offices or into the hospital to give birth, our goal is to keep our patients as safe as possible,” says Ashley S. Roman, MD, director of the Division of Maternal–Fetal Medicine at NYU Langone.
Our maternal–fetal medicine experts, who specialize in caring for women with high-risk pregnancies, answer questions about their approach to prenatal care and patient safety during COVID-19.
How Has COVID-19 Changed Prenatal Care?
Women are making fewer trips to the doctor’s office and are using video visits for most appointments. This is done to support women’s efforts to stay home or limit the need to be on public transportation or in other places where social distancing might be a challenge.
In-office care is now limited to the essential visits, says Dr. Roman. For a routine or low-risk pregnancy, that can be as few as four in-person appointments. Visits considered essential include the following:
- the first appointment to confirm the pregnancy and perform necessary lab tests
- 20 weeks for an ultrasound exam to evaluate fetal anatomy
- 28 weeks for a diabetes screening and whooping cough vaccination
- 36 to 38 weeks for group B strep testing and to check baby’s positioning to confirm he or she is not in a breech position
Women experiencing high-risk pregnancies come in more frequently for ultrasounds to monitor fetal growth and other factors that point to the overall health of the pregnancy. The number of times you need to come in, and when, is determined by your doctor and your needs during pregnancy.
How Do Video Doctor Visits Work During Pregnancy?
Video visits provide women with the same personalized care they’d receive in the doctor’s office. During these visits, your doctor talks with you to assess your health and encourages you to ask any questions you have about the pregnancy.
“The flow of these video visits is very similar to what happens in the doctor’s office,” says Dr. Roman. “I ask if anything new has happened since the last visit. Do you have any questions? Are you feeling the baby move? We develop a plan for the upcoming weeks. All of our care is individualized, so that each woman receives the care and attention she needs for a healthy pregnancy.”
Video visits take place through your NYU Langone Health MyChart account. We recommend that you download the NYU Langone Health app to access your MyChart account from your mobile device. These visits are secure and allow you to have all of your questions answered from a place that is convenient and comfortable for you.
What Is Done to Ensure a Safe In-Office Visit?
When a woman does come to the doctor’s office, we have a number of patient safety protocols in place, including symptom screening before their visit and temperature checks and asking again about symptoms when you arrive.
“We are doing all we can to implement social distancing during your visit,” says Shilpi S. Mehta-Lee, MD, site director of maternal–fetal medicine at NYU Langone Hospital—Brooklyn. “There are only 4 chairs in our waiting room, and they are 6 feet apart. We’ve extended our daily hours so we can space out patients more safely through the day.”
Can a Support Person Join the In-Office Appointments?
To support our efforts to make the in-office environment as safe as possible, women are asked to come alone to all in-person visits. We understand that this is not optimal for soon-to-be-parents, but safety is our priority.
We are doing all we can to limit the amount of person-to-person contact for our patients and staff. “For their safety, I’m limiting my interaction with patients as much as I can,” says Nadia B. Kunzier, DO, maternal–fetal medicine specialist at NYU Langone Huntington Medical Group. “I can view the ultrasound results from my office and follow up with the patient during a video visit.”
How Does In-Home Monitoring Work?
Because the majority of prenatal appointments are video visits, women are participating in monitoring their own health. This includes tracking their blood pressure for signs of pre-eclampsia, a potentially dangerous condition that can develop after the 20th week of pregnancy.
“In all of our practices, we arrange for each woman to have her own blood pressure cuff,” says Dr. Roman. “We want them checking their blood pressure regularly, starting early in the pregnancy. If we see consistently high blood pressure, we will ask that she come into the office for further evaluation.”
Blood pressure logs can be emailed or uploaded to your MyChart account, where they can be reviewed by your doctor. Women who have diabetes or have received a diagnosis of or are at risk for gestational diabetes are also asked to record and submit their blood glucose readings.
NYU Langone is also starting to roll out technology that allows for automated monitoring, such as Bluetooth-enabled blood pressure cuffs that automatically upload your numbers to your MyChart account. “Even before COVID-19, we were talking about moving more to telehealth, home blood pressure monitoring, and logging blood sugar into MyChart where they can be reviewed regularly,” says Dr. Roman. “All of these innovations are now here to stay.”