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Everything we know (so far) about giving birth during the COVID-19 pandemic

So far, it does not appear that COVID-19 can be transmitted from a pregnant woman to her fetus.

coronavirus_birth

The impact of coronavirus is unprecedented.

Everyone in the world is worried right now—we are worried about our collective wellbeing, and of course, we are worried about ourselves and our own unique circumstances. If you are pregnant during this wild time, you likely have even more on your mind. Mama, I am so sorry this is happening.

Your mind is likely reeling with all of the stories on the news and social media. Perhaps one of the hardest parts of this is that we are still learning. Few questions have solid answers. Still, every day we know more, and I want to assure you that although it feels scary, there is still a good chance everything will be okay, especially if you take the proper precautions.

Let's take a look at some of the questions you may have about giving birth during the COVID-19 pandemic.



Can babies born to mothers with COVID-19 contract the virus?

coronavirus_baby

So far, it does not appear that COVID-19 can be transmitted from a pregnant woman to her fetus. A small study was done in Wuhan, China, looked at four pregnant women who were known to have COVID-19. After their infants' were born, three consented to infant-testing, and all were found negative. None of the four babies had symptoms of coronavirus.

Previously, a study of nine women had similar findings. On March 24th, 2020, a report by David A. Schwartz, M.D., from the Medical College of Georgia at Augusta University in Atlanta, that reviewed the cases of 38 pregnant women with COVID-19, found that "there were no confirmed cases of intrauterine transmission of SARS-CoV-2 from mothers with COVID-19 to their fetuses."

Of note, most of the women in these studies had Cesarean sections in an attempt to reduce transmission—it is important to note that no changes in practice have been recommended yet, though. In other words, we are not currently suggesting that all pregnant people with COVID-19 have Cesarean sections. We simply need to learn more.

The American College of Obstetricians and Gynecologists (ACOG) writes that "adverse infant outcomes (e.g., preterm birth) have been reported among infants born to mothers positive for COVID-19 during pregnancy. However, this information is based on limited data and it is not clear that these outcomes were related to maternal infection. Currently, it is unclear if COVID-19 can cross through the transplacental route to the fetus."

A report released on March 26th, 2020 did state that we still cannot rule out in-utero transmission—this, in response to 3 babies who tested positive for COVID-19 on day 2 of life.

The current data does not show concern, though certainly, scientists are monitoring the situation very closely.

Here is what Sarah Bjorkman, MD, Motherly's Medical Advisor, has to say about it:

"There is no hard evidence (yet) of a mom passing the virus to baby during the pregnancy/birth, but a new case report published today suggests it may be possible....The handful of positive cases of COVID-19 in babies seem to be from exposure AFTER birth."

She also reassures that there is no evidence of birth defects due to COVID-19.⠀

Are there any cases of newborns with COVID-19?

babies_coronavirus

Since March multiple newborn babies have tested positive for COVID-19 shortly after being born.

According to the CDC, "a very small number of babies have tested positive for the virus shortly after birth" and that while it is unknown if these babies got the virus before or after birth, "mother-to-child transmission of coronavirus during pregnancy is unlikely."

Basically, newborns are susceptible to person-to-person spread after birth, and research suggests the youngest children are more severely impacted by COVID-19 than older kids are.

This is why the CDC's Interim Considerations for Infection Prevention and Control of Coronavirus Disease 2019 (COVID-19) in Inpatient Obstetric Healthcare Settings states that to "reduce the risk of transmission of the virus that causes COVID-19 from the mother to the newborn, facilities should consider temporarily separating (e.g., separate rooms) the mother who has confirmed COVID-19 or is a PUI [person under investigation] from her baby until the mother's transmission-based precautions are discontinued."

If a mother has COVID-19 while giving birth her baby may be cared for away from her temporarily, but the World Health Organization states that mothers with COVID-19 should be supported in sharing a room with their baby.

Mothers can choose to keep their infants with them while taking precautions to prevent the spread of the illness, including wearing a mask while breastfeeding or having someone who is well feed expressed milk to the baby.

During the coronavirus pandemic, what precautions should I take if I am pregnant?

pregnant_coronavirus

Recommendations are evolving as we learn more about this, so the best thing to do is to keep in close communication with your provider, who will be able to provide you with the most up to date and personalized information. Some hospitals are limiting visitors, including partners.

Here are the current guidelines from ACOG:

  • Regarding recent travel, people should adhere to the Centers for Disease Control recommendations for specific areas, in addition to consulting with their providers. Providers will likely ask a lot of questions about your recent travel.
  • Providers will be following a detailed algorithm when deciding when to test pregnant people for COVID-19. The primary criteria involve assessing the presence of Coronavirus symptoms.
  • Pregnant people should report concerning symptoms immediately: these include fever, cough, and chest tightness or difficulty breathing.

Talk to your provider about their current policy regarding birth partners—many hospitals are restricting entrance, and only allowing one person to attend a birth. This might mean that your doula can't come. If this happens to you, ask your doula about virtual support services, which can be highly effective.

I'm scared to go into a hospital right now. Are there any other options?

Due to concern surrounding the business and transmission risk in hospitals right now, some women are choosing to explore alternate options for their births, such as home birth or birth centers.

It's important to know that these options may not be available to everyone—home birth and birth centers are considered safe for low-risk pregnancies. It's also key to investigate whether your insurance covers out-of-hospital birth. And certainly, you'll need to see if the midwives have availability.

If an out of hospital birth without an epidural sounds appealing to you, this might be a great option to consider. Reach out to a local birthing center or home birth midwife—if they are already full, they can refer you to other local professionals who might have space.

What will my birth be like if I have COVID-19?

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If a pregnant woman has COVID-19 at the time of birth, they will be isolated from other patients, and providers who care for them will be wearing masks.

If you have a partner, they may or may not restrict their access to being with you. Here is what the CDC says about "visitors" of COVID-19 patients:

"Limit visitors to patients with known or suspected COVID-19. Encourage use of alternative mechanisms for patient and visitor interactions such as video-call applications on cell phones or tablets." In the event of necessary visitors, they recommend that facilities "evaluate the risk to the health of the visitor" (for example, if your partner has a compromised immune-system).

Your partner will also be instructed to perform good handwashing, to limit touching surfaces, and to use masks following hospital policy. They will only be allowed to go to your room, (they cannot be in multiple patient rooms), and will be asked to leave the room when you are having specimen collection procedures.

When making the incredibly difficult decision about whether or not to have your partner with you, one factor is of course, the newborn. If your partner is able to stay infection-free, they might be able to care for the newborn while you recover from birth and your infection. This is, of course, a very personal decision, and I'd urge you to talk to your provider about what they recommend.

It may be recommended that the newborn be separated until their infection status can be confirmed—this is in an attempt to prevent transmission if it hasn't happened—if this happens, you can ask to provide pumped breastmilk for your baby, as it does not currently appear that the virus is transmitted in breastmilk. If you have COVID-19 and your baby does not, you'll likely be separated from them until your infection is over. If you already both have it, providers may be okay with you staying together—ask them what their current policy is here.

You'll be allowed to leave the hospital when your symptoms have stabilized, and you've had two negative swabs tests, with 24 or more hours between them.

I am so stressed right now. What can I do?

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Oh, mama. Now more than ever, I wish I could wrap you in my arms—but for a lot of reasons that's not a possibility, so this will have to do:

  1. Talk to your provider. They are home base right now. Tell them what you are worried about and let them calm your fears with information.
  2. Take a birth class. Almost every person I know that teaches birth classes is offering them virtually right now. Find a class and gain valuable information and connection. You can find out about our online birth class here.
  3. Protect your energy. Spend some time honestly assessing the sources of strength and stress in your life, and make choices accordingly. Does going for a walk make you feel better? Lace-up and head outside (away from people). Does your well-intentioned family member stress you out every time they call? Let the phone ring out. It's okay to protect yourself and your wellbeing right now, mama.
  4. Speak with a therapist. Whether you have been diagnosed with a mental health concern or not, this is an incredibly trying time. Therapists are amazing and can provide you with tools to help you cope. And, there are many services that offer virtual therapy appointments. Reach out for help immediately if you feel like hurting yourself or others.
  5. Take it one day at a time. I know, I know. This is so cliche, but goodness, it is true. Thinking too far ahead can be really detrimental, especially when we just don't have a ton of information. Do the best with the information you do have, and try to stay as present as you can.
  6. Remember the helpers. Isolation is needed right now to #flattenthecurve. The hard aspect of isolating yourself, though, is that it's hard to remember all the people out there who are helping—mama, there are so many. Researchers and scientists are working around the clock to learn more. Medical providers who are updating policies and ready to take care of you the moment you need it. Delivery drivers who can bring you chocolate and canned food. You are not alone in this.

[A version of this post was originally published March 27, 2020. This is a developing story, and we'll continue to update it as new information comes in.]

14 outdoor toys your kids will want to play with beyond summer

They transition seamlessly for indoor play.

With Labor day weekend in the rearview and back-to-school in full swing, most parents are fresh out of boxes to check on their "Fun Concierge" hit list. It's also the point of diminishing returns on investing in summer-only toys. So with that in mind, we've rounded up some of our favorite toys that are not only built to last but will easily make the transition from outdoor to indoor play. Even better, they're Montessori-friendly and largely open-ended so your kids can get a ton of use out of them.

From sunny backyard afternoons to rainy mornings stuck inside, these toys are sure to keep little ones engaged and entertained.

Meadow ring toss game

Plan Toys meadow ring toss game

Besides offering a fantastic opportunity to hone focus, coordination, determination and taking turns, lawn games are just plain fun. Set them up close together for the littles and spread them out when Mom and Dad get in on the action. With their low profile and rope rings, they're great for indoors as well.

$30

Balance board

Plan Toys balance board

Balance boards are a fabulous way to get the wiggles out. This one comes with a rope attachment, making it suitable for even the youngest wigglers. From practicing their balance and building core strength to working on skills that translate to skateboarding and snowboarding, it's a year-round physical activity that's easy to bring inside and use between Zoom classes, too!

$75

Detective set

Plan Toys detective setDetective Set

This set has everything your little detective needs to solve whatever mystery they might encounter: an eye glasses, walkie-talkie, camera, a red lens, a periscope and a bag. Neighborhood watch? Watch out.

$40

Wooden doll stroller

Janod wooden doll strollerWooden Doll Stroller

Take their charges on a stroll around the block with this classic doll stroller. With the same versatility they're used to in their own ride, this heirloom quality carriage allows their doll or stuffy to face them or face the world.

$120

Sand play set

Plan Toys sand set

Whether you're hitting the beach or the backyard sandbox, this adorable wooden sand set is ready for action. Each scoop has an embossed pattern that's perfect for sand stamping. They're also totally suitable for water play in the wild or the bathtub.

$30

Water play set

Plan Toys water play set

Filled with sand or water, this tabletop sized activity set keeps little ones busy, quiet and happy. (A mama's ideal trifecta 😉). It's big enough to satisfy their play needs but not so big it's going to flood your floors if you bring the fun inside on a rainy day.

$100

Mini golf set

Plan Toys mini golf set

Fore! This mini golf set is lawn and living room ready. Set up a backyard competition or incorporate into homeschooling brain breaks that shift focus and build concentration.

$40

Vintage scooter balance bike

Janod retro scooter balance bike

Pedals are so 2010. Balance bikes are the way to go for learning to ride a bike while skipping the training wheels stage altogether. This impossibly cool retro scooter-style is built to cruise the neighborhood or open indoor space as they're learning.

$121

Wooden rocking pegasus

plan toys wooden rocking pegasus

Your little will be ready to take flight on this fun pegasus. It gently rocks back and forth, but doesn't skimp on safety—its winged saddle, footrests and backrest ensure kids won't fall off whether they're rocking inside or outside.

$100

Croquet set

Plan Toys croquet set

The cutest croquet set we've ever seen! With adorable animal face wooden balls and a canvas bag for easy clean up, it's also crafted to stick around awhile. Round after round, it's great for teaching kiddos math and problem-solving skills as well.

$45

Wooden digital camera

fathers factory wooden digital camera

Kids get the chance to assemble the camera on their own then can adventure anywhere to capture the best moments. With two detachable magnetic lenses, four built-in filters and video recorder, your little photographer can tap into their creativity from summertime to the holidays.

$179

Wooden bulldozer toy

plan toys wooden bulldozer toy

Whether they're digging up sand in the backyad or picking up toys inside, kids can get as creative as they want picking up and moving things around. Even better? Its wooden structure means it's not an eye sore to look at wherever your digger drops it.

$100

Pull-along hippo

janod toys pull along hippo toy

There's just something so fun about a classic pull-along toy and we love that they seamlessly transition between indoor and outdoor play. Crafted from solid cherry and beechwood, it's tough enough to endure outdoor spaces your toddler takes it on.

$33

Baby forest fox ride-on

janod toys baby fox ride on

Toddlers will love zooming around on this fox ride-on, and it's a great transition toy into traditional balance bikes. If you take it for a driveway adventure, simply use a damp cloth to wipe down the wheels before bringing back inside.

$88

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Motherly editors’ 7 favorite hacks for organizing their diaper bags

Make frantically fishing around for a diaper a thing of the past!

As any parent knows, the term "diaper bag" only scratches the surface. In reality, this catchall holds so much more: a change of clothes, bottles, snacks, wipes and probably about a dozen more essential items.

Which makes finding the exact item you need, when you need it (read: A diaper when you're in public with a blowout on your hands) kind of tricky.

That's why organization is the name of the game when it comes to outings with your littles. We pooled the Motherly team of editors to learn some favorite hacks for organizing diaper bags. Here are our top tips.

1. Divide and conquer with small bags

Here's a tip we heard more than a few times: Use smaller storage bags to organize your stuff. Not only is this helpful for keeping related items together, but it can also help keep things from floating around in the expanse of the larger diaper bag. These bags don't have to be anything particularly fancy: an unused toiletry bag, pencil case or even plastic baggies will work.

2. Have an emergency changing kit

When you're dealing with a diaper blowout situation, it's not the time to go searching for a pack of wipes. Instead, assemble an emergency changing kit ahead of time by bundling a change of baby clothes, a fresh diaper, plenty of wipes and hand sanitizer in a bag you can quickly grab. We're partial to pop-top wipes that don't dry out or get dirty inside the diaper bag.

3. Simplify bottle prep

Organization isn't just being able to find what you need, but also having what you need. For formula-feeding on the go, keep an extra bottle with the formula you need measured out along with water to mix it up. You never know when your outing will take longer than expected—especially with a baby in the mix!

4. Get resealable snacks

When getting out with toddlers and older kids, snacks are the key to success. Still, it isn't fun to constantly dig crumbs out of the bottom of your diaper bag. Our editors love pouches with resealable caps and snacks that come in their own sealable containers. Travel-sized snacks like freeze-dried fruit crisps or meal-ready pouches can get an unfair reputation for being more expensive, but that isn't the case with the budget-friendly Comforts line.

5. Keep a carabiner on your keychain

You'll think a lot about what your child needs for an outing, but you can't forget this must-have: your keys. Add a carabiner to your keychain so you can hook them onto a loop inside your diaper bag. Trust us when we say it's a much better option than dumping out the bag's contents on your front step to find your house key!

6. Bundle your essentials

If your diaper bag doubles as your purse (and we bet it does) you're going to want easy access to your essentials, too. Dedicate a smaller storage bag of your diaper bag to items like your phone, wallet and lip balm. Then, when you're ready to transfer your items to a real purse, you don't have to look for them individually.

7. Keep wipes in an outer compartment

Baby wipes aren't just for diaper changes: They're also great for cleaning up messy faces, wiping off smudges, touching up your makeup and more. Since you'll be reaching for them time and time again, keep a container of sensitive baby wipes in an easily accessible outer compartment of your bag.

Another great tip? Shop the Comforts line on www.comfortsforbaby.com to find premium baby products for a fraction of competitors' prices. Or, follow @comfortsforbaby for more information!

This article was sponsored by The Kroger Co. Thank you for supporting the brands that supporting Motherly and mamas.

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It's science: Why your baby stops crying when you stand up

A fascinating study explains why.

When your baby is crying, it feels nearly instinctual to stand up to rock, sway and soothe them. That's because standing up to calm babies is instinctual—driven by centuries of positive feedback from calmed babies, researchers have found.

"Infants under 6 months of age carried by a walking mother immediately stopped voluntary movement and crying and exhibited a rapid heart rate decrease, compared with holding by a sitting mother," say authors of a 2013 study published in Current Biology.

Even more striking: This coordinated set of actions—the mother standing and the baby calming—is observed in other mammal species, too. Using pharmacologic and genetic interventions with mice, the authors say, "We identified strikingly similar responses in mouse pups as defined by immobility and diminished ultrasonic vocalizations and heart rate."

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