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Kntrice Anadumaka has a powerful story of surviving COVID-19 while pregnant when she was not vaccinated early in the pandemic. In this episode, Kntrice shares about her experience with COVID-19 and vaccinations, as well as her fears and concerns of navigating the health system as a woman of color.
Becoming a parent is beautiful journey, but one that can also be full of uncertainty and stress. Add to that navigating a pandemic through pregnancy, birth and your little one’s first years, and the anxiety can be overwhelming. After all, it’s not just your health you have to be concerned about anymore.
That’s why Dr. Veronica Pimentel – a practicing OB-GYN, pandemic mom, and fierce vaccine proponent – is here to discuss the facts about COVID, vaccines, and motherhood. In Labor of Love, Dr. Pimentel works to alleviate the concerns of new parents who have questions about how COVID and the vaccines may impact pregnancy. In each episode, she’ll talk with real moms who share their stories about experiencing motherhood in the time of COVID, and follow up with maternal health experts who share accurate information so listeners are equipped to make the best choices for themselves and their families.
This podcast (“Resource”) is designed for patients and is for informational purposes only; it does not provide medical advice and it is not intended to replace the advice or counsel of a physician or health care professional. While ACOG makes every effort to present accurate and reliable information, this Resource is provided “as is” without any warranty of accuracy, reliability, or otherwise, either express or implied. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this Resource or reliance on the information presented. Please visit acog.org/laboroflove for more information, including the full disclaimer.
This Resource was supported by the American College of Obstetricians and Gynecologists (ACOG) and the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) as a part of a financial assistance award totaling $300,000 with 100 percent funded by ACOG and CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.
Dr Vero Pimentel (00:06):
As we watch COVID 19 cases unfold across the US, one thing became clear. COVID 19 presented a serious risk for pregnant women. It left a lot of new moms wondering, what kind of impact in COVID 19 infection have on my pregnancy and on the health of my baby? Personally, I found out I was pregnant in the beginning of the pandemic. And even as a high risk obstetrician, I too had similar questions and concerns. When the vaccine rolled out, it raised an even bigger question. How will the vaccine affect my pregnancy and baby? We're going to explore these questions today. This is Labor of Love.
Kntrice Coleman-Anadumaka was newly pregnant when she experienced severe COVID 19 and its effect on pregnancy. She was facing a tough decision, because while COVID 19 became a serious risk for her and for her baby, she wasn't sure how exactly the vaccine would impact her pregnancy. I got to sit down with Kntrice and hear her story. Hi, I'm excited to introduce our first guest for today's episode. Her name is Kntrice Anadumaka. She's a new mom who survived COVID 19. She's from Chicago, Illinois, and is joining us to share her story on how she was battling COVID 19 in the ICU when she was seven months pregnant, as well as the aftermath of this experience for her. Welcome Kntrice. Thank you for being here.
Kntrice Anadumaka (01:37):
Thank you for having me doctor. I'm really excited to chat with you today and talk about my experience.
Dr Vero Pimentel (01:43):
So tell us a little bit about yourself.
Kntrice Anadumaka (01:46):
Well, I am a jack of all trades, master of none as I like to call it. So during the day actually, I sell technology with a software company, but my passion is really around interior design. So I have my own interior design business and I'm also a life coach. And so, those are the things that I do for fun, because it's where my heart is. And then on top of that, I'm a mother, which is my number one, most exciting job that I have, that's a lifetime commitment.
Dr Vero Pimentel (02:16):
I can totally identify. So you got pregnant during the pandemic. I got pregnant just before the pandemic started and had a pandemic baby as well.
Kntrice Anadumaka (02:26):
Okay. Congratulations.
Dr Vero Pimentel (02:28):
Well, congratulations to you. I was fortunate that even though I'm an OBGYN, and taking care of patients, I did not catch COVID, but that's not your experience. I want to talk a little bit about that, but first I wanted to find out, how did you find out that you were pregnant?
Kntrice Anadumaka (02:47):
It's such an amazing story to that, because I'm a later in life mom, and my husband and I had been trying for years to conceive with no luck. We had unexplained infertility. And so, I had just given up, I was like, "It'll happen if it happens." If it doesn't, I was content just going through life as a really amazing aunt. And then, during a birthday trip, my husband took me hiking in the Sedona Mountains in Arizona. And when I left from that trip, I left with a little bundle of joy in my belly that I had no idea about. So I was almost two months pregnant when I found out I was even carrying. And from that moment, my life changed forever, but it was a surprise. So it wasn't planned, but it was well received and accepted.
Dr Vero Pimentel (03:30):
Definitely, sounds like you were excited.
Kntrice Anadumaka (03:33):
Yes.
Dr Vero Pimentel (03:34):
Were you also nervous, because you were pregnant during the pandemic?
Kntrice Anadumaka (03:38):
You know what? I would say, before it even hit me that I'd be pregnant during a pandemic. The first thing I thought about was, I wanted to make sure that my baby and I survived, because I did learn about just the mortality rate among African American women is three times higher than my white counterparts. And I had heard so many horror stories about African American women's experience in the healthcare system and not being believed or heard or their babies not being cared for properly. And so, even before COVID, that was my main concern. And then to add COVID on top of that, it's like, "Oh my God, let me make sure I don't get COVID let me make sure my baby stays safe." And so, being pregnant was an amazing experience, but it was also very stressful because of those two components, being an African American in the United States, pregnant and desiring to have a successful pregnancy and birth, and then doing that on top of COVID.
Dr Vero Pimentel (04:33):
And now you find yourself pregnant with, in some ways a double pandemic, right? There's the pandemic of COVID. There's also the pandemic of racial reckoning during this time. And you're trying to figure out how to keep yourself healthy. Did the vaccine come to be a part of that conversation about how to keep yourself and your baby healthy?
Kntrice Anadumaka (04:55):
It really did. So during my initial visits with my OB guy, she told me she wanted me to stay away from the vaccine until after I delivered. And this was early on when there just wasn't a lot of knowledge around pregnant women and the vaccination. So it just wasn't a lot of information available. So my OB guy and I elected to not get vaccinated, and then toward maybe the fourth or fifth month of my pregnancy, my OB guy told me, "I think you should get vaccinated." But by that time, I had already had my mind made up that I didn't want to impact fertility, because my husband and I wanted to have a baby soon after we gave birth to this one, we wanted to try again. I didn't know if there would be any birth defects involved. I didn't know how it would impact the fetus and the safety of my son.
So I elected not to do it. And again, it just wasn't enough information available at the time for me to make an informed decision. So I elected to not do anything. I was probably a little less than halfway through the pregnancy when my doctor said that she wanted me to and I elected not to. And I was very safe, in my opinion. I didn't have a lot of exposure. I had the same people that I was hanging around. So I felt like I was pretty safe. So I was comfortable with my decision.
Dr Vero Pimentel (06:05):
Where were you getting your information? I know you had some discussion with your doctor who at first, seemed to have said don't get vaccinated, but then perhaps because new information came, safety data came and also ACOG and SMFM and other organizations were recommending the vaccine, your doctor recommended the vaccine to you. Were you getting any information from other sources to help you make up your mind about the vaccine?
Kntrice Anadumaka (06:30):
Actually, no. And that's where I felt irresponsible, because the onus is really on me to also do that additional research, in addition to what my doctor recommended or told me. And I didn't do that because I was just settled and comfortable in my decision. And then also, another thing that made me reluctant was the history of African Americans and vaccinations in the United States. I really didn't know what this vaccine entailed, the history of African Americans and vaccinations in the United States was not a healthy relationship there. It's not that I wasn't going to do it. I just didn't want to do it while I was trying to conceive or while I was actively pregnant.
Dr Vero Pimentel (07:07):
I hear you. And then, at some point you end up getting COVID. When did this happen? And how was your experience at that time?
Kntrice Anadumaka (07:16):
So I actually contracted COVID at six months pregnant. I was six months pregnant and unfortunately, I contracted it from somebody in my pod. I was spending some time with my niece and nephews and unbeknownst to me, all three of them were COVID positive at the time. And they were spending time with auntie right before she gave birth. So they were spoiling me. They were all over me, hugs, kisses, you name it. And I didn't know they were all COVID positive. And so, I contracted it from them. And I initially had just some breathing issues, which I thought was related to just my asthma being flared up.
But my doctor told me to go to the hospital and just get it checked out, because being pregnant, having asthma, she just wanted to make sure everything was cool. I went to the doctor on that Sunday, April 11th. And they told me I was positive for COVID, but they gave me a breathing treatment, sent me home. Not even four days later, my condition had gotten so bad. I was rushed back to the emergency room, where they then found that I had double infiltrate in both my lungs. My oxygen level was critical. And from that point, I remained in the hospital until after I gave birth.
Dr Vero Pimentel (08:25):
Wow. So you never left the hospital until you delivered.
Kntrice Anadumaka (08:30):
The only time I left the hospital was when I was being transported from one hosp... My care was so critical in ICU, they had to transport me from one hospital to another hospital that could better care for my condition because up until that point, they really hadn't seen anybody with that level of damage or severity around the severity of damage with the lungs and the oxygen requirement at the time. So they transferred me to a hospital that could just better serve me in my condition.
Dr Vero Pimentel (08:56):
And what was your experience like in this new hospital?
Kntrice Anadumaka (09:00):
To be honest from the beginning, it was absolutely terrifying. And I say that because as I sat there struggling to breathe in the ER, the doctor, a resident doctor came in and said, "Your stats look fine." And she turns off my oxygen. And literally, I started hyperventilating and I texted my doctor and I said, "Oh my God, this doctor just came in and turned off my oxygen. I literally can't breathe." And so, there was a nurse that was there at the time working ER, he came in, he turned my oxygen back on and he literally said, "I'll protect from what you're experiencing with the doctor. My apologies that she didn't believe that your oxygen level was low. Clearly you're struggling to breathe, but your numbers do say otherwise." And so, the battle started there. So then when I was transported to the hospital where I remained for the next couple of months, there was constant issues and troubles around, it wasn't believed that I actually couldn't breathe.
Even though I was in ICU, I had a BiPAP mask on, my body was literally convulsing, physically, back and forth, trying to take in oxygen in the middle of the night. My nurses would look at my oxygen levels and take it upon themselves to make the decision to turn down my oxygen. And so, I would wake up gasping for air because my oxygen had been turned down and they kept telling me, "Our goal is to get you out of ICU. You need to get you out of ICU." But I literally, physically wasn't getting better. And even my mental health suffered, I had to get on antidepressants for a time while I was there, because the severity of the isolation and the depression that was brought on by this entire COVID experience.
Dr Vero Pimentel (10:41):
I am so sorry. That really does sound terrifying. And were you by yourself. Were you allowed to have any visitors at that point in time, any contact with the outside world?
Kntrice Anadumaka (10:51):
I wasn't allowed to have visitors, because I was essentially a COVID floor and there was a time where I couldn't eat, I couldn't speak so I could only write things out and I really couldn't make phone calls. So the nurses would come and help me use my phone to... Literally, the only thing I could do was video call my parents or my husband. And they would be able to just talk to me. I really couldn't talk back. It got to the point where I was literally hallucinating and counting breasts. It was times I even forgot that I was pregnant because my brain was so deprived of oxygen. I wasn't eating at the time. I lost a substantial amount of weight. And at one point I even talked to the doctors and asked them to intubate me. I said, "I'm done, I'm tired. I have no more fight left in me. I just pray that my body carries my son successfully into the world and that my husband and my mom can raise him in my honor." I was actually pretty much ready to give up.
Dr Vero Pimentel (11:43):
It almost sounds like you were trying to, if you don't mind me saying, sacrifice yourself for the benefit of your unborn baby, thinking that would help your baby.
Kntrice Anadumaka (11:54):
Yeah, that's exactly.
Dr Vero Pimentel (11:55):
We do know that a healthy... Moms have to be okay for babies to be okay. Right. As much as you want to make that sacrifice.
Kntrice Anadumaka (12:03):
That is so true. But I thought that if they could just keep my body alive long enough to bring my baby into the world, then I've done my job. And then they even had to have a conversation with my husband and my mom about, if we do have to intubate her, who do you want us to save? Who do you want us to focus our efforts on? So that's a really tough conversation to have with the soon to be grandmother and father. But those were the kind of conversations we were having during that time, because I was just at such a mission critical point in my pregnancy.
Dr Vero Pimentel (12:32):
How long were you in the ICU and when did you give birth?
Kntrice Anadumaka (12:35):
So I was in the ICU probably about at least three to four weeks. And then after that, they transferred me to the maternity ward and I was there for another four to five weeks where I in turn, gave birth while on oxygen. I had a vaginal birth, which was awesome. I had an epidural, but that was it. It was all about keeping me in a very calm state so that we didn't have to intubate me or put me under. I would say giving birth to my son was easier than being in the hospital. Giving birth, I was like, "This is easy. This is it? Wow." Compared to being in the hospital, fighting for my life for weeks at a time.
Dr Vero Pimentel (13:14):
Going through a tragedy like that, certainly put things into perspective. Once you gave birth, were you able to be discharged home with your son or did you have to stay hospitalized?
Kntrice Anadumaka (13:25):
So we did have to stay hospitalized. I had a slight infection. It was a slight infection that got into my placenta. Part of my placenta had even atrophied, which they think was the result of possibly having COVID or being on oxygen for so long. And then, my son had issues with his glucose levels. So he did have to go to NICU for a few days. And then, once that happened, we were released and I was supposed to actually be released with oxygen where I would have to stay on it at home for the next three months. But fingers crossed that wasn't the case. When I went home, I elected to not get on the oxygen and I have not been on it since.
Dr Vero Pimentel (14:00):
I'm so glad that you made it and that you hear sharing your story. I can imagine that things are still not easy, that there's still some things that you're dealing with. You feel comfortable sharing that with us?
Kntrice Anadumaka (14:12):
Oh yeah. The aftermath of not only dealing with COVID, being a person of color in the healthcare system, having a very negative experience with the healthcare system and not being believed or heard. There was a lot of PTSD that I left that experience with. And I've been in therapy. I've really been working on my mental health. I'm in a much better place. I also had a lot of PTSD just around people being in our space, because I was afraid that we would get COVID again. So the experience, every mother wants everybody to be able to dote over their baby, and they want all the grandparents around and aunts and uncles and cousins, that wasn't our experience because I had to be super cautious to make sure that our son was safe. And so, it has been a journey and it has not been easy.
Dr Vero Pimentel (14:57):
In trying to protect your son, you have been breastfeeding. What have you learned about passing antibodies onto your child to try to protect your child?
Kntrice Anadumaka (15:06):
Oh my gosh. Well first, you know what, let me backtrack and talk about how I got vaccinated. So I ended up electing to get vaccinated while I was about seven months pregnant in the hospital. They wheeled me down with my oxygen, in my wheelchair. I got vaccinated while in the hospital, because I literally ran across, during my stay at the hospital, probably 25 to 30 nurses that had been vaccinated and still got pregnant. And so, in seeing that real life example, I felt more comfortable making the decision to get vaccinated. And then I completed my second round of shots once my son was out of the hospital and we were released home. So with the breastfeeding, not only was I passing the antibodies to my son from having COVID, but also the vaccination was able to pass over the placenta. And because it was in my system, I could further protect him through the breast milk that I was providing.
So, I'm a huge proponent for breastfeeding. My son is very healthy. He's 23 pounds. He's almost 10 months old. And I overproduced milk. We had to buy a separate freezer just to store all of the milk that we had. I think my son has got his first cold just now. And that's because he was around another baby that happened to have a cold, but other than that, he's perfectly healthy, little chunky, my little chunky peanut.
Dr Vero Pimentel (16:27):
It sounds like he's beautiful.
Kntrice Anadumaka (16:29):
He's amazing.
Dr Vero Pimentel (16:31):
Vaccination rate is still low for pregnant women in the US, but there's a big racial disparity where black women have the lowest vaccination rate. What message do you have for expecting women specifically, those who are black or African American?
Kntrice Anadumaka (16:47):
Number one, I would like to say to all women who are carrying these beautiful babies, African American women and our sisters in other ethnic groups, it is your choice whether you want to or not. It's about protecting you. It's about protecting your baby. For me, I felt irresponsible by not getting the vaccine. I risked the life of myself and my baby by not protecting us. So I would say, do the research, understand the risks, understand the risks of choosing and electing to not get vaccinated, and getting vaccinated. I navigated moving the world with much more confidence, knowing that my baby and I are protected. And so I would say, if I had to do it all over again, I would've gotten vaccinated earlier.
Dr Vero Pimentel (17:30):
Well, thank you Kntrice. Thank you for sharing your story. I am so glad you survived, that you made it, that you hear with us sharing the story. I know that it brings back some bad memories, but at the same time, I want to congratulate you for having... First of all, for getting your masters, and for surviving, for being a mom for doing all the wonderful things that you're doing and for being here. Thank you again so much.
Kntrice Anadumaka (17:55):
Thank you doctor. I appreciate you having me on your show.
Dr Vero Pimentel (18:03):
When she survived a severe and traumatic COVID 19 infection, she received the vaccine after the worst of the infection was over and ended up giving birth to a healthy baby. We want to know exactly how COVID 19 infection and the vaccine can impact pregnancy. So I sat down with a provider to explore what we know so far. Our second guest for today's episode is Dr Laura Riley, Dr Riley is an obstetrician and gynecologist and chief at New York Presbyterian Weill Cornell Medical Center, and given foundation professor and chair of the Department of Obstetrics and Gynecology at Weill Cornell Medicine. Dr Riley is also maternal fetal medicine specialist and internationally recognized expert on obstetric infectious disease.
Dr Riley is here today as an expert to discuss evidence-based information around COVID 19 vaccination, pregnancy and breastfeeding. On a personal note, I've known Dr Riley for a long time, and both of us had a distinct honor of being an invited guest of the US Surgeon General during a virtual presentation last Fall, where we discussed the impact of COVID 19 in pregnancy and the benefits of vaccination in pregnancy. Thank you so much Dr Riley, for being here with us today.
Dr Laura Riley (19:18):
It's my pleasure.
Dr Vero Pimentel (19:19):
So Dr Riley, our first guest, Kntrice, had a very traumatic experience after getting COVID 19, where she became dangerously ill. Have you heard similar stories to Kntrice's where women get very sick?
Dr Laura Riley (19:32):
Yes, unfortunately I have. I think at least in the very beginning of the pandemic, we were seeing lots of women, lots of pregnant women who were getting ill with COVID, especially those before vaccination was even available. And what we were seeing was, women coming in with shortness of breath, fever, and rapidly actually, becoming even more short of breath and decompensated. Some of whom actually had to go to the intensive care unit so that they could receive mechanical ventilation. Personally, I never saw any maternal deaths, but there were several reported across the United States.
Dr Vero Pimentel (20:20):
Yes, that's very unfortunate. And I do have to say, as a physician, seeing somebody gasping for air because of COVID was definitely an experience that I don't wish to see ever again. We have heard many stories like this, where pregnant women have gotten very sick. Those who are particularly those who are not vaccinated ending up experiencing severe COVID 19. What are the potential risks of getting COVID 19 while pregnant for those who are not vaccinated?
Dr Laura Riley (20:49):
So unfortunately COVID 19, like many other respiratory infections is particularly serious, can be particularly serious for pregnant women. And what we saw, or what we've seen I should say, with COVID 19 is very similar to what was described actually with influenza, where women come in with what seems like a mild respiratory infection that rapidly progresses, some of whom need mechanical ventilation. Others need ECMO even, which is really severe infection and trying to preserve their lungs and allow it to recover. And then as I mentioned, death. I think the other issue is, obviously the maternal complications related to COVID 19, but there are also fetal complications that we need to consider. And some of these women who have such a severe respiratory infection will go on to have a pre-term birth. I think that also early on, mostly in the beginning of the pandemic, when we were just trying to figure out what was going on and how best to take care of women, we were actually delivering people early, because we were very concerned about keeping them pregnant.
I think now we have experience and we recognize that some of these women actually can stay pregnant, but pre-term delivery is definitely a concern. We also saw some interesting things. Initially, it seemed like possibly, preeclampsia was much more common in women who got COVID 19. There was also concern that those babies could be growth restricted, because we know that some of the placentas really get damaged from COVID 19 infection, others don't. So we don't have all the answers, but we can say from at least the epidemiologic data, that maternal illness can be quite, quite severe and the baby can also have complications related to that.
Dr Vero Pimentel (22:45):
Dr Riley, from your experience or based on the research thus far, do the potential risk of COVID 19 vary along the different stages of pregnancy, first trimester versus second, versus third trimester.
Dr Laura Riley (22:58):
I think that it's hard to say. I think at the beginning of the pandemic, most of the people obviously, who were getting sick were later in pregnancy and many people delayed their pregnancies even, delayed getting pregnant, because they were so scared about COVID, but it probably is worse in the third trimester as the uterus is bigger. Although we've definitely seen some severe illness and deaths, even in the first and second trimester of pregnancy, which is why we recommend to women that they get vaccinated, because until there's something that prevents disease altogether, at least the vaccination prevents women from having severe illness.
Dr Vero Pimentel (23:44):
Many women want to get vaccinated, but they're trying to find this ideal time to get vaccinated and some are thinking about their babies and how to best transfer that immunity. So they're trying to delay it just like Tdap delay until they're 28 weeks. What would you tell these women?
Dr Laura Riley (24:02):
Yeah, I totally understand, because we teach women that and we encourage women to wait and get their Tdap at 26 to 28 weeks gestation so that they can build antibody to pertussis. And then, those antibodies cross the placenta and protect the baby in the first two months of life before the baby can get its DTaP. And we also have data because we've done studies, which show that pregnant women who are vaccinated in the third trimester of pregnancy actually have very high antibody levels in cord blood, which then we assume is protecting their babies once the baby is delivered. The problem is... Well let me give the good news first and then I'll tell you the problem. The good news is that we also have data which suggests that women who are vaccinated in the first and second trimesters of pregnancy will also build a pretty robust antibody response to the vaccine and to COVID 19.
And then, those antibodies will cross the placenta. Now the news that is hard for people to understand is that, we don't actually know what's called, the correlate of protection for COVID 19. So I can't look at a lab value and say, "Oh, man you have enough antibody to protect your baby from COVID. But you know, Mrs Jones doesn't have enough." Because we don't know what that number is. We just can tell you that there's antibody there, that presumably will protect your baby. And so the other side of that is that, women obviously worry about their babies. And so, they want to get the vaccine at just the ideal time to give the baby the best protection.
The problem with that thinking is that, while you're waiting until that magic time, whenever that may be, 28 weeks, 32 weeks, you've now gone 32 weeks of pregnancy where you potentially could have been exposed to COVID 19 and gotten a really severe infection, in which case you're not protecting your baby at that point anyway, because as I said, these really sick women who land in the ICU, those babies aren't going to do well. So what I always advise my own patients is, get the vaccine as soon as it's available to you when you're pregnant, whether it's the first trimester, the second or third, depending on when you got it prior to pregnancy.
Dr Vero Pimentel (26:30):
Excellent advice, Dr Reilly and you talked about, unfortunately women have, or pregnant people have lost their lives because of COVID. And our guest, Kntrice, was especially concerned about the higher mortality rate among black pregnant people in the US, in comparison to other racial and ethnic groups. Can you explain how the COVID 19 pandemic has impacted black women, particularly pregnant black women, as well as other women of color, talking about the racial disparity gap that has existed or has actually become more pronounced since the pandemic started?
Dr Laura Riley (27:06):
Yeah, I think that it's quite scary and quite terrifying for black women I'm sure, all women of color. We have seen over the last 15 years now, that there is a huge racial and ethnic disparity in maternal morbidity, meaning maternal illness as well as maternal mortality. And the statistics show that black women are three to four times more likely to die surrounding childbirth than their white counterparts. And with this most recent data from the Centers for Disease Control, it showed that three to 4% is even higher this past year. And I think probably, a good amount of it is related to COVID if it's not COVID infection itself, it's all of the aspects related to COVID infection, which have worsened the maternal mortality rate in general.
It went up for everybody, but that disparity really widened. And I suspect that it's many things. It's, COVID infection, it's the lack of access to good obstetrical care. It's the isolation and mental health aspects that we know took a toll on all pregnant women during COVID, but probably disproportionately for women of color, with less access, less resources in general. So the statistics that came out just recently are really upsetting, really upsetting.
Dr Vero Pimentel (28:47):
Yes, because I think so many people, including myself doing my little bit, that I can try to combat the racial disparities in maternal health. And instead of going in the positive direction, we took a step backwards and hopefully we can learn from this and do better for the years to come. Our guest, Kntrice, was aware of health injustices experienced by black women and women of color. And she herself talked about her experiencing moments of not being believed when she was admitted with COVID. What would you want to tell women who face similar fears of not being believed or not being heard as a black pregnant person or a person of color in the healthcare system?
Dr Laura Riley (29:29):
Yeah. I think that this is the message that we really need to get out to women of color, which is, you deserve good healthcare. And the way to get that is to make yourself heard. And if it seems like you're in a situation where people aren't listening, you just need to speak up again. And also, to the extent that you can, having advocates go with you, I think is really important. Now, a lot of women don't have that resource, but I think it's part of what we know is likely to be helpful for women who have doulas during birth, who can advocate for them, who can support them in their ability to communicate with physicians. I think that, what we learned throughout this COVID pandemic is just how much of an impact the social determinants of health have on health.
I think that people think it's other people, but it's actually us. It's all of us. I think that we also learned how devastating the impact of racism is on health in general, and how that plays out in the space of a pandemic where resources are slim and almost non-existent. So I think that we've learned a lot during this pandemic. I think we've also, as OBGYNs, I'm sure you've had this experience. I've learned how important it is to communicate how important it is to communicate uncertainty, how important it is to communicate what we know and what we don't know. And that became incredibly crucial in the conversations that we had early on about the COVID vaccine, because there was so much hesitancy. And so, it was important to be honest with women.
And I think the way I presented it was, what we know is that COVID infection can be extremely dangerous for pregnancy. The vaccine will not necessarily prevent you from getting COVID, but it should prevent you from getting severe infection. And so, when we think about the risks and the benefits of the vaccine, the safety data that we have, although not as robust as it should have been, at least in the beginning, it was safe enough and it was far more safe to get the vaccine, than to not get it and get COVID.
Dr Vero Pimentel (32:02):
Very, very important point. So Dr Riley, when a pregnant person gets vaccinated, what are the potential long term effects of the vaccine on the person, herself or themselves and their babies, if any?
Dr Laura Riley (32:16):
Yeah, so we're not seeing any long term, effects, but full disclosure. Here's what I tell patients. We don't have that long term date on babies. There's no reason to expect a vaccine that is robust in your arm and under your arm, as many women will tell you, they get that soreness under their arm and you build antibodies and it protects you for some period of time. We don't have any data that suggests you have any long term implications from that. But you know what? We haven't seen children who are five years old, because the vaccine is just out, but there's been absolutely no reason to suspect that they'll be any long term implications.
Dr Vero Pimentel (33:00):
What advice do you give to black women to encourage them specifically, about getting vaccinated doing pregnancy?
Dr Laura Riley (33:06):
I think that to some extent, what I say now is dependent on when they tell me why they're not vaccinated. So you've seen what happens to people who get really sick with COVID 19, you're pregnant, your risk is even higher. And then, some of the women that I see anyway, some of the black women that I see also have hypertension and diabetes, and we know these are morbid conditions that make them at an even higher risk for severe COVID infection. So I talk to them about the risks of COVID infection. I talk to them about the benefits of vaccination, which we know will decrease the likelihood that you have severe infection. I think the next thing that we talk to women about is the safety of the vaccine, because now we have a good amount of safety data to be able to report.
And that's important. Women need to understand that there isn't an increased risk of miscarriage. There isn't an increased risk of preterm birth or low birth weight or birth defects, all things that women worry about. And then, the last thing is that I talk about the protection that can be obtained from being vaccinated during pregnancy, and the fact that we have good proof that shows that the antibodies that mom makes to COVID 19 while vaccinated, those antibodies cross the placenta and are found in the baby at birth. And those can protect the baby from its own infection. In fact, there's a paper that came out from the CDC data not that long ago, suggesting that babies less than six months of age, who became really sick with COVID 19 were less likely to be vaccinated. Their moms were less likely to be vaccinated than those babies who didn't become as ill, which is just a marker that suggests that those antibodies that mom produces were protective for those babies.
Dr Vero Pimentel (35:05):
That was certainly my hope is that, by getting vaccinated, that I was passing the vaccine in some ways to my baby. Of course, I'm not passing the vaccine, but I'm passing the antibodies, but that was my way of protecting my baby. And I do share that story with patients, because it's important for them to know. I've had patients, for example, who have said, "Nobody had told me about the potential benefits to my baby." And women respond very well when it tends to be about their babies, about protecting their children.
Dr Laura Riley (35:35):
That's very true. I do think also though, we have to recognize that we could only say many of these pieces of information over the course of the pandemic, because we learned things over the course of the pandemic, because as we were discussing early on, we didn't have specific pregnancy data. It actually took us a few months to realize that COVID 19 was actually worse in pregnancy than if you weren't pregnant. Once we figured that out, the next step was, okay, there's a vaccine. But remember there were no clinical trials that included pregnant women. So it took a while to get safety data. Once we got some safety data, then the data came out about, okay, women who are vaccinated, oh, gee, it crosses the placenta and can protect the baby. So part of the reason those stories didn't come out in that complete form is because we didn't have the data until most recently.
Dr Vero Pimentel (36:30):
Well, thank you so much, Dr Riley, it has been a pleasure. I have learned a lot from you as I have over the years. Thank you for being here today, sharing your knowledge, your expertise, your experience. I also thank you for addressing the challenges that too many women, in particular black women face while pregnant. And to help us continue to learn how to address the issue of COVID vaccination in pregnancy through a health equity lens. So I appreciate your presence and for taking the time out of your busy schedule today.
Dr Laura Riley (37:01):
Thank you very much. And thanks for the opportunity. I think this is going to be great for our patients.
Dr Vero Pimentel (37:11):
Thanks for listening to this episode of Labor of Love. In our next episode, we're going to focus on COVID 19 and infertility. We're going to hear from a mom who is particularly concerned about how both COVID 19 and the vaccine could impact her fertility.
Speaker 4 (37:28):
I've thought about that. And I think a lot of it has to do with being on that fertility journey. There is decision fatigue, there's shot fatigue, there's medicine fatigue. And then there was me thinking, "I already got COVID. So maybe I could just wait this out."
Dr Vero Pimentel (37:47):
Then we'll talk with a provider about how fertility is affected by COVID infection and receiving the vaccine.
Speaker 5 (37:53):
And I think it's really important to differentiate that from the COVID 19 vaccine, for which there are a lot of myths around fertility and the COVID 19 vaccine. And that we do know, there is absolutely no data whatsoever to support that the COVID 19 vaccine impacts your ability to get pregnant or impacts fertility.
Dr Vero Pimentel (38:12):
Until then, if you know of a pregnant woman, who's not sure about getting vaccinator or not, share this podcast with them and rate and review this podcast, wherever you are listening. To learn more about these recommendations and for additional resources, visit the websites of ACOG and the CDC. You can go to aco.org/covid19, or you can go to cdc.gov/covid19. This is Dr Vero Pimentel, your fellow mom, OBGYN physician, and host of Labor of Love. You can find me on Twitter @DrVeroPimentel, or on Instagram at Dr Vero for moms. Thank you.