Lindyn Kish began to worry as the reports about the coronavirus hitting the U.S. began. Ready to give birth to her second son, she started asking questions: Would the hospital restrict visitors? Would she be able to use a doula again? Would her husband be able to be with her? What would giving birth in the middle of a pandemic be like?


On March 24, she gave birth to Willem after deciding to be induced, perhaps a week earlier than she might have. The Thursday before, visitors such as a doula were allowed, but three days later, area hospitals went to a no-visitor policy in most cases. Exceptions were made for patients who were in labor or postpartum, pediatric, disabled or at the end of their life. Even then, it was one visitor per patient.


Kish’s husband, Rob, was allowed to accompany her, but this time she would have to give birth without a doula.


Even during her stay at Seton Medical Center, things continued to change. Two days in, visitors were not allowed to leave and come back. That meant no celebration Torchy’s Tacos, and Rob couldn’t go home to grab things they had forgotten or check in on son Walter, who was with his grandmother.


Kish stayed three days in the hospital to make sure her blood pressure was stabilized. Her doctors shared concerns about what would happen if they sent her home too early. She was told, "You don't want to have to come back; you'd be admitted through the emergency room, and we want to keep you out of the emergency room," she says.


The actual delivery and stay in the hospital did feel familiar, except for the lack of the doula. Hospitals are keeping their labor and delivery rooms reserved for only that purpose.


"It seemed like they were trying to keep everything as normal in labor and delivery," Kish says, but still, "I can't imagine what it would be like if this was the first baby. It would have been terrifying."


Pregnant women and those trying to get pregnant might be worrying about their babies, the danger of the coronavirus during pregnancy, whether there will be room in the hospital for their labor and delivery, and their safety during that birth.


We really don’t know what the risks for pregnant women and their babies are yet, says Dr. Jayme Evans, chief of obstetrics and gynecology at Austin Regional Clinic.


A study recently published in the medical journal Lancet of nine pregnant women in China with the virus seems to indicate that pregnant women do not have symptoms worse than nonpregnant women.


A study also in China found that it does not appear that COVID-19 is passed from the mother to the child through the placenta. The babies’ cord blood and placenta tested negative for the virus. One baby tested positive for the virus, but it’s believed the baby got it after birth. But in another case that wasn’t part of this study, a baby might have contracted the virus in utero.


Compared with other viruses like flu, SARS and swine flu, "this seems to be a whole different thing," Evans says, but the studies are really small. "What we’re telling our pregnant patients is as far as we know, without any data, obstetric patients are not at any increased risk," she says.


The American College of Obstetricians and Gynecologists’ statement on COVID-19 agrees with this, but because of the risk factors with other respiratory infections like SARS, it still considers pregnant women an at-risk population.


The studies are small and only on women in their third trimesters. The virus hasn’t been around long enough for any data on women in their first or second trimesters or their babies.


"This is going to be an ongoing study," Evans says. "We really don’t know."


Evans still tells her patients to be especially vigilant with social isolation and hand-washing to minimize their risks.


She is taking this opportunity to remind them that the way to prevent a graphic surge in the virus, which would tax the health care system, would be to follow the guidelines of staying at home, washing their hands and avoiding large crowds. She is asking patients to come to their doctor visits alone, and, if it is their postpartum visit, to not bring their newborn babies with them.


She tells her patients to concentrate on staying healthy. Continue prenatal care, get enough sleep, take prenatal vitamins, maintain good nutrition and exercise and practice the specific coronavirus guidelines of safe distancing and hand-washing.


"With anybody who has anxiety about this, we only have control over certain things, like doing our part to help society as far as the risks," she says.


What if someone is actively trying to get pregnant? Should they?


The American Society for Reproductive Medicine recommended on March 17 that doctors and patients not begin new treatment cycles including things like in vitro fertilization. It also suggested embryo transfers be canceled, as well as the suspension of nonurgent diagnostic procedures and elective surgeries.


Dr. Kaylen Silverberg, medical director of Texas Fertility Center, strongly disagrees with this recommendation, as does Evans.


Silverberg says this policy isn’t based on any data. "Are they going to advise the rest of the population not to have intercourse without contraception?"


It doesn’t make sense to impose this restriction on people using fertility treatments to get pregnant, he says.


So far, his patients at Texas Fertility Center have not been canceling treatments, but they are asking questions, and the center is creating policies such as telephone consultations to minimize risks.


When it comes to whether to start a treatment cycle or do a frozen embryo transfer, "some patients are going to want to proceed," he says, and others might want to hold off. It’s their decision. "We treat adults like adults," he says.