 And joining us now for our Your Health segment is Dr. Sarah Crimmins, Medical Director of Labor and Delivery at the University of Maryland Medical Center. Dr., thank you very much for joining us. Thank you for having me. It's my pleasure to be here. Let's start with how the pandemic is changing what you do. How it is affecting the experience for new mothers and what expectant parents need to know about that. So I think the biggest change that we're seeing is prenatal care has shifted its paradigm a little bit from a lot of in-person visits to more telehealth visits. So instead of coming to see the doctor 10 plus times during a pregnancy, a pregnant woman may end up having the doctor in doctor experience five to six times and then having a telehealth visit the other four to five times. And we tell parents, soon to be parents and expecting parents to be prepared for those kind of visits and have their questions ready, have weighed themselves before they come in and make sure that they have taken their blood pressure because that way they can really communicate well with their doctors and really have a meaningful conversation even if it's over a video conference. What's lost when you're doing visits that way? I mean obviously a well-equipped patient can do the things you're talking about but you can't listen to the heartbeat. That's there's probably the two things that people talk about is the one is the checking on the fetal heart rate. The other thing is when they do come in a lot of times their significant others are not invited so that them seeing the pregnancy or hearing the heartbeat is something that is a little bit lost and we try our best to do that over media and things like that. But that experience of experiencing the heart rate in person is something that the patients are talking about that their significant others are lacking. What about in the hospital the delivery experience itself how has that changed because of COVID-19? So the biggest change in the delivery experience is there's the less of a number of visitors. So we used to ask only two to three visitors come for delivery. We are strictly keeping it at one visitor for delivery. So it's usually only the significant other as the birth support person for delivery and all of the postpartum period. Usually we don't ask that visitors don't come and go. It means that grandparents aunts and uncles can't come to the hospital and see the baby right after it's born. They kind of have to wait for them to come home. And that's really just for the safety of the baby and the new mother to kind of limit that traffic and make sure that everybody's safe and healthy. Was there a notice some sort of advice from the CDC at some point that nobody should come that the new mother was going to be by herself? So that type of advice has never been strongly suggested. There have been points in the last four months where because of the hospital regulations and for safety and security of both the mom and the baby that some hospitals have chosen to exclude visitors. But for the most part we all know that a birth is a family experience and we try our best to make sure that at least the significant other or one birth coach can be part of the experience to make sure everybody's safe and healthy and have some sort of positive experience from this. What about testing for coronavirus? What's the experience been? So at the time of admission for delivery all of our moms are being tested for coronavirus. The reason is for the safety of the mom as well as the safety of the baby. This helps us guide the treatment for the baby after care and as well as follow-up appointments and knowing what's going on at that time. From what I've read it's not entirely clear whether the mother if the mother is infected if the baby can become infected before delivery or after. I guess it's largely respiratory. What do you do in that situation? So we know that there's a lot unknown in this situation as you alluded to. We have been testing babies of positive mothers at 24 and 48 hours of life to see if they become positive. So far none of our babies have been positive and have been very asymptomatic and well-appearing for their postpartum periods. Out of an abundance of caution moms who are symptomatically positive we've been kind of suggesting that they separate from their babies to make sure that there's the utmost safety between the baby and the mom. You know the numbers nationally, the numbers in Maryland have shown a disproportionate impact on members of minority communities from the coronavirus. Do you see that in your hospital setting? So we do. The majority of the patients who have come back in symptomatic actually have been either Latino or African American in descent and that it's disproportionately higher in those groups as for the other groups. There's a recent study that came out that said up to 70 percent of the pregnant women that have been diagnosed with COVID and hospitalized were either Hispanic or Black. Advice to expectant mothers. What do you do? I mean everybody knows the common advice about distancing and masks. If you're protecting or social distancing for two how do you think about that? So it's tricky. There's a balance between social distancing for two as you put it and getting the support that a new mom may need. So what I tell moms is you know social distance as much as you can. If you invite people to their house, invite one to two people at a time, don't invite any large gatherings, make sure that anybody that you invite over has no sick contacts, no ill-appearing symptoms, and keep those visits brief with hand hygiene and you know depending on the comfort level and the experience of the person that you're with, you may limit that to more than six feet away, things like that. Support family members, people who are coming to visit can always help with bringing food, offering to run errands, things like that, and making sure that moms really have that support as best we can give them in this time where there's so much unknown and just making sure everybody's safe. Yeah I guess you know everybody wants to see the new baby, hold the new baby, but also everybody's highly concerned about this situation. Even if the data would say that that young people aren't affected, what are the numbers like for newborns? The numbers for newborns are actually pretty rare that they get infected. We do know that children under the age of 12 months have an increased risk of severe disease in reference to older children, so if they do get sick they tend to be sicker, but they very rarely get sick. What about the psychological side of this? We know that a lot of new mothers have postpartum issues with depression, mood disorders, that sort of thing, and this is an especially stressful time. I mean you would just assume that it contributes to that, does it? Yeah so we know that about one in seven mothers get diagnosed with postpartum depression, so how will such an uncertain time change those numbers? Probably will disproportionately rise them. We know that anxiety disorders at this point are higher than they were six months ago, especially postpartum anxiety. I think that family members, friends of people who are having babies during this time need to really watch them and look out for them and make sure that you're checking, doing those mood checks for your loved ones and your friends and making sure that you can help in any way you can, even if you can't visit but a phone call or dropping some food off at the door and checking on them is really important during these times. Last thing I want to ask you, when the coronavirus started and everything was suddenly locked down, you saw a lot of speculation in the news that nine months later we're going to have a baby boom. Is there any way to forecast that? I think only time will tell obviously, but I think that we will probably, what will be interesting to see is how people will come in for prenatal care and present them for themselves for prenatal care. We've seen that early and frequent prenatal visits are the best way to prevent complications and prevent problems. If you happen to be have one of those post-COVID babies, make sure you come in and get prenatal care and come see us, even if we start your visits via telemedicine. But I think that probably the assumptions are right and the numbers of pregnant women will be higher come New Year's 2021. Sarah Crimmins, University of Maryland Medical Center. Doctor, thank you very much. Thank you for your time. Have a nice night. Your health segments are a co-production of Maryland Public Television and the University of Maryland Medical System.