Since this form of coronavirus (which causesCOVID-19) is new, research is underway tolearn as much about it as possible. Currently,the data suggests that pregnant women areNOT at an increased risk of severe illnesscompared to the general public. This is verygood news for pregnant women and theirbabies. We also know that pregnant women havechanges in their bodies that may increase theirrisk of infections. It is very important forpregnant women to follow guidance to stayhome as much as possible and take extrasteps to protect against COVID-19. COVID-19 has changed life dramatically foreveryone. Staying safe at home is critical tostop the spread of COVID-19, which meansmany in-person classes have been cancelled,including birth and breastfeeding classes. Tohelp prepare for your bundle of joy, virtualclasses may be an option. Reach out to yourOBGYN, midwife, doula, home visitor or otherpregnancy/breastfeeding support teammembers to learn about virtual classes as wellas other online support during pregnancy andafter your baby arrives.

A N S W E R I N G Y O U RQ U E S T I O N S O N

PREGNANCY &COVID-19

Resources For YourPregnancy & BeyondHelp is out there. Here are places youcan look.

COVID-19 Mental Health Resources Michigan.gov/StayWell Maternal and Infant HealthMichigan.gov/miheip Michigan Women, Infants & Children (WIC)Michigan.gov/WIC Michigan Home Visiting Program FinderMIHomeVisiting.com Find community assistanceMI211.org Apply for assistance with food, housing,insurance and childcareMichigan.gov/MiBridges

Michigan.gov/StayWell

Wash hands often with soap and water for 20 seconds,if water is not available, use an alcohol-based handsanitizer containing at least 60% alcohol.Avoid touching eyes, nose and mouth.Cover your mouth and nose with a bent elbow or atissue when you cough or sneeze. Throw away thetissue right away and wash your hands. Keep space between yourself and people you do notlive with (at least 6 feet) and avoid crowded places. Wear a cloth face covering if you must go out inpublic. Be sure it covers your nose and mouth.Don't forget to get the Tdap vaccine at 26-37 weeksgestation and the flu vaccine during the flu season.

800-799-SAFE (7233) or 800-787-3224(TTY)Text LOVEIS to 22522Live chat at thehotline.org

Stay Healthy!There are simple actions you can take to prevent illness.

Create a family plan in case you or someone in yourhousehold becomes ill. Identify a trusted adult who couldcare for your newborn if needed.  Start a household plan:michigan.gov/documents/coronavirus/Prevent_and_Prepare_Final_687282_7.pdf Feeling Under The Weather?If you have symptoms like shortness of breath, cough,fever, or are otherwise worried about your health,contact your doctor and follow their medical guidance. If you or someone you live with has been diagnosed withCOVID-19, tell your healthcare provider before visits sothey can appropriately treat you and/or your newbornand stop the spread of the illness. Feeling Unsafe?Abuse at home is known as intimate partner violence ordomestic violence. Abuse can get worse duringpregnancy and during times of crisis.National Domestic Violence Hotline (24/7)

Michigan resources for domestic and sexual violence:Michigan.gov/DomesticViolenceLearn about intimate partner violence:acog.org/patient-resources/faqs/womens-health/intimate-partner-violence

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Rest when you can.

Eat healthy meals –avoid excesscaffeine and sugarto regulate moodand get appropriatenutrients.

Avoid alcohol anddrugs.

Get regular exercise,and try to plan timeevery day to getoutside.

Mental well-being goeshand in hand withphysical well-being.Taking care of yourphysical health will helpyou feel betteremotionally, and helpyou be more patientand calm during timesof increased stress. Thisis always important,but especially duringpregnancy, deliveryand after baby arrives.

Physical HealthMatters

Will any visits be virtual? Phone call orvideo?Will your visit schedule change – spacedout differently than originally planned?Does the office provide any supplies?

Have there been any changes orrestrictions in their practices due toCOVID-19? Any changes to rooming in,skin-to-skin or breastfeeding supportpractices?What is the support person policy? Whomay join you during delivery? Are there restrictions on who may visit?Are there virtual support options? Doyou need to supply your own device?Who can be your back-up (like a doulaor other family member) in case yourchosen support person(s) cannot joinyou?

Before DeliveryTalk with your doctor about prenatal visits:

For in-hospital delivery, call your birthinghospital and ask:

FACTS The virus has not been found in amniotic fluid. There is no evidence that a pregnantmother who has COVID-19 passes thevirus to her baby during pregnancyor delivery – there is ongoingresearch about this. There is NO evidence that acaesarean (C-section) is necessary todeliver the baby of a woman whohas COVID-19.

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Create a birth plan:marchofdimes.org/materials/March-of-Dimes-Birth-Plan-2020.pdf

Prepare a safe place for baby tosleep - such as a crib, bassinet orpack n' play. For more information: Michigan.gov/SafeSleep

Talk with your family and doctorabout how you want to feed yourbaby.

Pack a bag for you and yourbaby for the hospital.

Make time for yourself: listen tomusic, read, rest, exercise andstay hydrated.

Prepare meals and freeze themfor quick re-heating.

Your local health departmentYour local MDHHS office2-1-1Your local home visiting program

If you need help planning for babyor obtaining a safe sleep space,resources include:

Find resources on page 1.

Select and install your newborncar seat appropriately in thevehicle your newborn will ridehome in. For more information:safekids.org/car-seat

Swelling in feet or legsHeadacheVomitingHeavy bleedingBlurred visionFeeling weak or faint

Hemorrhage AndHypertension Warning Signs

Bring a copy of your birth plan to thebirthing site, share with your deliveryteamShare health concerns with yourprovider - for example fever, cough,headache, etc.Capture special moments with yourphone and/or cameraOnly bring the items you really needfor a 1-5 day stayAsk about newborn screening:michigan.gov/newbornscreening

Delivery

have skin-to-skin time share a room with your baby, andbreastfeed safely.

Postpartum - AfterDeliveryHold and touch your baby after delivery.Close contact and early, exclusivebreastfeeding helps babies thrive. Youshould be supported to:

Know the early warning signs forpostpartum hemorrhage (bleeding) andhypertension (high blood pressure)emergencies. If you are experiencing anyof the symptoms below, are not feelingwell, or have any concerns about yourphysical health, alert your healthcareprovider immediately.

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Learn more about caring for yournewborn during COVID-19michigan.gov/documents/coronavirus/Newborn_Guide_691445_7.pdf Learn about breastfeeding your babyduring COVID-19michigan.gov/documents/coronavirus/Breastfeeding_During_COVID-19_691443_7.pdf Learn about postpartum depressionon page 5.

All women have the right to asafe and positive childbirthexperience. This is true evenduring a public health crisis likethe COVID-19 pandemic.

Postpartum DepressionPostpartum depression (also called PPD) is amedical condition that many women get afterhaving a baby. It is strong feelings of sadness,anxiety (worry), and tiredness that may last fora long time after giving birth. These feelings canmake it hard for you to take care of yourselfand your baby. PPD can happen any time afterchildbirth. It often starts within 1 to 3 weeks ofhaving a baby. This is not your fault and manywomen experience PPD - it is the most commonproblem for new mothers. There are many waysto manage and treat PPD.

Feeling depressed most of the day, every dayFeeling shame, guilt, or like a failureFeeling panicked or scared a lot of the timeHaving severe mood swings

Changes in your feelings

Signs & Symptoms ofPostpartum Depression

Loss of interest in things you normally likeFeeling tired all the timeEating a lot more or a lot less than normalGaining or losing weightHaving trouble sleeping or sleeping toomuchHaving trouble concentrating or makingdecisions

Changes in your every day life

Having trouble bonding with your babyThinking about hurting yourself or your babyThinking about suicide (killing yourself)

Changes in how you think about yourself or your baby

If you have signs or symptomsof PPD, don't assume it's justthe "Baby Blues" or that youcan tough it out. There arethings you and your providercan do to help you feel better.

English: 1-800-985-5950 ortext 503-894-9453Spanish: 971-420-0294Online support groups:

Leave a confidentialmessage 24/7 and avolunteer will return yourcall or text as soon aspossible.Postpartum SupportInternational Helpline

postpartum.net/get-help/psi-online-support-meetings

If you are worriedabout harmingyourself or yourbaby, taking yourown life, or are in astate of crisis call 911and seek immediatecare.

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Caring For Your MentalHealthThe stress of COVID-19 is something that all peopleare experiencing, however pregnancy, childbirth,breastfeeding and becoming a new parent can eachcreate unique worries and concerns. There are manyresources available to support you.Create a resilience plan on page 8. It is so important to seek healthy activities, findways to decrease and manage stress, and cope withworries and fears early on. Try several techniques –discover activities you enjoy and fit into your dailylife.Find mindfulness techniques on page 7. Monitor yourself for signs of increased stress (distressreactions) and risky health behaviors (high riskbehaviors). If you notice these reactions or behaviors,alert a family member or close friend. Reach out toyour healthcare provider to discuss your stress andseek additional support.

Insomnia or excessivesleepinessLoss of appetite or

AnxietyAngerScapegoating - placingblame on othersDecreased feeling ofsafetyLoss of self-worth andseeking others' approval

overeating

Inability to concentrateIncreased use of alcohol,tobacco, or drugsSocial isolationFamily conflictConnecting with thoseusing alcohol and drugsTaking "extra" medicationto ease stressTrading one addictivebehavior for anotherWorking extra or inabilityto focus on work

Distress Reactions High Risk Behaviors

888-733-7753 Daily 10 a.m.–

If you live with aserious mentalillness, talk to apeer with similarexperiences.Michigan PeerWarmline

2 a.m.

1-800-273-8255Text TALK to741741

Get immediatesupport 24/7 ifyou're havingthoughts ofsuicide.National SuicidePrevention Lifeline

1-800-985-5990

Text RESTORE to741741

Get immediatecrisis counseling24/7 if you'refeeling distress.National DisasterDistress Helpline

Michigan Crisis TextLine

You'reNeverAlone

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Sit outside in the sun.Feel the heat of the rayson you. Appreciate howfar the rays havetraveled just to reachyou.

Walk around. Feel asmuch as you can - noticethe grass, pebbles, or softcarpet under your feet.

Deep breathing. Takelong, slow breaths at thetop of the hour, or set areminder on your phonethroughout the day.

Look at the night sky.Appreciate how delicatethe stars and moonappear. Admire thetwinkling lights - maybenotice a satellite orshooting star.

Sit quietly. Feel thebreath coming and goingfrom your chest, throughyour nose. Feel how thebreath is cool as youinhale and warm as youexhale.

Grounding TechniqueA grounding technique can helpdecrease anxiety and anger whenyou are feeling overwhelmed. Think 5-4-3-2-1 as you notice:

Write in a journal. Writedown happy momentsyou can look back onwhen you're feelinganxious or stressed.Acknowledge theappreciation you feel forthe things around you.

Simple Mindfulness TechniquesMindfulness is one way to lessen the effects of stress – emotionallyand physically. These techniques promote being present, in themoment, and mindful.

Try the free app formeditation, sleep,and movementexercises.Headspace.com/mi

5 things you see4 things you feel3 things you hear2 things you smell1 thing you taste

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Think about how you overcamechallenges in the past.

How did you get started?

How did you stay motivated tocontinue your recovery?

Sleep: Get adequate rest daily.

Eat healthy: Vegetables, protein andwater while limiting sugar andcaffeine to regulate mood andenergy.

Who was supportive during difficulttimes in the past? Reach out to themfor support now.

Self-care: What do I do regularly forself-care? Can I add more activity tomy routine?

What useful advice did someone giveyou that can be shared withsomeone else in need of help?

Keep using your resources - people,skills, and groups.

Know your personal signs of stress -act to reduce stress before it spinsout of control.

Take care of your physicalhealth.

Exercise: Try an online class ortutorial for yoga. Take a walk or hiketo regulate stress and promotemindfulness.

Schedule check-ins with supporters.

Keep in touch with family andfriends. Reach out by text, calls, orvideo chats.

Limit media exposure: take timedaily to digitally unplug.

Take care of your mental health.

Create routine and structure.

Try humor to reduce stress - whenappropriate.

Give yourself permission to feelupset or scared. When is it easiest to get in touch with

others? Schedule calls and virtualmeetings.

Keep a daily routine as much aspossible. This helps curb stress.

What is the best time of day for youto exercise? Plan daily and weeklyexercise.

Maintain your sleep cycle -consistent times to wake up and goto sleep.

Plan time to get outside every day.

Stress Resilience Plan

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