New and Expecting Moms: Don’t Skip These Health Visits During the Pandemic

Originally published on UTSWMed.org/medblog, authored by Robyn Horsager-Boehrer, M.D.

The COVID-19 pandemic has changed prenatal care. Patients are asked to come to the clinic only when a physical exam is needed, including lab work and ultrasounds. When you do come in, medical practices are taking extra precautions to keep you and your baby safe.

The message during the COVID-19 pandemic has been clear: Practice physical distancing, wear a mask, and stay home as much as possible. OB/GYN offices around the U.S. transitioned to telehealth for many services, asking patients to come to the clinic only when necessary.

Unfortunately, some patients stopped visiting their doctor’s offices altogether – even the emergency room. A May 2020 poll found that nearly half of Americans skipped or delayed medical care because of the pandemic, and 11% said their condition got worse as a result.

Emergency departments around the world, including at UT Southwestern, have reported major drops in heart attack and stroke-related visits. So, it’s no surprise that patients getting prenatal or postpartum care might also be concerned about coming to the clinic.

The Centers for Disease Control and Prevention guidelines state that pregnant women should not skip prenatal or postpartum appointments – and no one should delay care for health emergencies.

Quick adaption to telehealth has allowed many of our patients to continue their care from the comfort of home. In the OB/GYN department at UT Southwestern, they’ve been planning for the switch to telemedicine since 2018.

pregnant couple

Now, patients are asked to come to the clinic only when a physical exam is needed, including lab work and ultrasounds. When you do come in, they’re taking extra precautions to keep you and your baby safe.

Let’s discuss why it’s important not to skip certain types of visits and what to consider if you’re questioning coming to the clinic.

Prenatal care

Since 2016, the World Health Organization has recommended that eight total appointments is sufficient for positive outcomes in patients with low-risk pregnancies. Here in the U.S., women may be used to having many more visits because of how we’ve traditionally provided prenatal care.

But prenatal care looks a little different during this pandemic, and likely will for a long time after. With low-risk pregnancy care, we may change approximately four in-person appointments to telehealth visits. For example, we may combine a new OB/GYN visit with the pregnancy confirmation ultrasound appointment rather than scheduling them separately.

Patients have reported that they enjoy the option of telehealth to see and visit with their providers between exams. However, there are symptoms that can occur between prenatal appointments that might require more immediate, in-person care.

If you notice any of these symptoms, or if something doesn’t feel right, call your prenatal care provider right away to determine next steps, or go to the emergency room:

  • Blurred vision
  • Decreased fetal movement
  • Elevated blood pressure
  • Increased swelling in the arms, legs, or face
  • Severe abdominal pain
  • Severe headache
  • Vaginal bleeding
  • COVID-19 symptoms, such as a fever, cough, shortness of breath, chills, severe fatigue, loss of taste or smell, and sore throat.

newborn

Postpartum care

Postpartum care is important for women’s long-term health. In fact, you can think of the weeks after your baby arrives as the “fourth trimester of pregnancy.”

In these visits, the doctor will assess your physical health and discuss your emotional wellness. They will also talk through future health considerations, such as:

  • Care for ongoing conditions, such as high blood pressure or diabetes
  • Connecting with a primary care doctor
  • Family planning, such as birth control and how long to wait between pregnancies
  • Infant care, including feeding and how the patient is adjusting to motherhood
  • Mental health in the weeks and months after delivery
  • Sexuality and relationships at home
  • Vaccinations for you and the baby

They might conduct some postpartum appointments as virtual visits during the pandemic. However, at UT Southwestern, they will ask you to come in for lab work and certain physical exams such as checking cesarean section incisions or healing after vaginal delivery. If you’ve had preeclampsia during or after pregnancy, they’ll likely recommend an in-person visit to check your kidney function.

While it may be safe for you to delay your postpartum visit by a week or so, don’t skip it altogether. Talk with your provider about your concerns before changing your appointment. You should also check how long your insurance policy covers pregnancy-related services. You’ll want to complete your postpartum visit in that time frame to be fully covered.

woman smiling

Well-woman care

Your annual well-woman exam is essential to maintaining good health throughout your lifetime. This appointment can be delayed a few weeks but plan to reschedule.

Usually, a well-woman visit includes a pelvic exam, a breast health checkup, and a comprehensive conversation with your provider. This is a good time to discuss your general physical and emotional health, ask about age-related changes, and get personalized recommendations for your health through the next year.

Checking in at least annually with your provider helps you stay well with the most recent women’s health recommendations. For example, they used to recommend an annual Pap smear to screen for cervical cancer once a woman becomes sexually active. Today’s guidelines recommend that women ages 21 to 29 with low-risk and no previous abnormal Pap tests should be screened every three years. Women ages 30 to 65 can space them out every five years.

In recent years, recommendations and technology have also been updated for women’s heart health, colonoscopy, and breast health screenings. Talk with your doctor about when you should schedule your next well-woman visit and whether it should be an in-person or telehealth visit.

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