Dr. Jessica Grayson is a professor of medicine at UAB who was pregnant this spring. Like many pregnant women in Alabama, she weighed heavily whether to get the COVID-19 vaccine, although there was little specific data on outcomes.
“It is not worth the risk of leaving your children. There are too many mothers who will never meet their children because of COVID, and there are too many babies that will not meet their moms,” she said at a UAB press conference on Wednesday.
There is now strong data showing the safety of COVID vaccines during pregnancy. Still, pregnant unvaccinated women are filling ICU beds in Alabama hospitals in numbers not yet seen during the pandemic as the delta variant spreads rapidly through younger people.
“Pregnancy alone is a high-risk condition to getting more severe COVID infection,” said Dr. Jennifer Thompson, associate professor of maternal fetal medicine at Vanderbilt University.
There were 51 pregnant women hospitalized in August at UAB hospital, 12 were in the ICU and two died. Most of those women were unvaccinated.
“There are more ICU admissions of pregnant women in July and August than there were at any time previously in the pandemic, so we’re seeing that there is a higher burden of severe illness in pregnant women now than before,” said Dr. Akila Subramaniam, a professor of medicine at UAB
Despite the heightened risks from COVID, just 23 percent of pregnant women have gotten vaccinated, according to the CDC, rates are lower among Hispanic women, at 11 percent, and Black women, at 6 percent.
Research is incomplete on why pregnant women are more susceptible to COVID, but their already shallow breathing and compromised respiratory system due to the pregnancy could be one reason, said Subramaniam.
In many cases of COVID, life and death decisions must be made that prioritize either the mother or the baby.
“It’s always a risk benefit of, what’s the benefit of continuing the pregnancy. Will delivering the baby help the mom? Will delivering help the baby and harm the mom? And so there’s always this push and pull.”
Pregnant women are more susceptible to the flu and other illnesses, possibly due to changes in the body that allow women to carry a genetically foreign fetus, said Thompson.
Recent studies show a 14-fold increase for ventilation for pregnant mothers and a 15-fold increase in deaths women who did not have COVID. The babies of COVID positive mothers are 60 percent more likely to be born preterm below 32 weeks, potentially causing lifelong health issues, cognitive delays and premature death.
“Pre-term birth is a very strong risk factor for actually infant mortality and for morbidity throughout that child’s life,” said Dr. Deborah Karasek, an assistant professor of obstetrics and gynecology at the University of California San Francisco
“The earlier that a baby is born, the more potential complications that that child might have.”
Karasek studied the outcomes of 240,000 births in California during the first COVID-19 wave.
Karasek’s study found pregnant women’s comorbidities of hypertension, diabetes or obesity have a two-and-a-half-fold increased risk of pre-term birth with COVID-19.
Recent studies show the vaccines are safe and a recommendation from the CDC advises expectant mothers to get the shot, but misinformation and fear of the vaccines has held some mothers back.
“I think you have a population that in general is a little bit wary of taking something because of what that potentially could mean to the intent, and then you compound that with misinformation, and here we are,” said Subramaniam.
Thompson said she speaks with pregnant women reconsidering whether to get the vaccine in her clinic at Vanderbilt.
“We know how severe the illness can be for pregnant patients and then we know the vaccine, based on the data we continue to get, is safe and effective for pregnancy,” said Thompson.
She shows them the data on the safety of the vaccine for pregnancy and on the dangers of COVID-19 for pregnancy.
“We try as best we can to put those concern at ease,” she said. “Sometimes that’s not enough for some patients”