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Unvaccinated Pregnant Women Are Getting Seriously Ill From COVID-19

Dr. Ebony B. Carter is a high risk obstetrician who cares for patients at BJC HealthCare and Washington University.
Washington University in St. Louis
Dr. Ebony B. Carter is a high-risk obstetrician who cares for patients at BJC HealthCare and Washington University.

Many pregnant women have not gotten vaccinated against COVID-19 — across the U.S., only about 16% are fully vaccinated. And as the third wave of the coronavirus pandemic hits the St. Louis region, physicians say far too many are ending up in the ICU.

“In one of our hospitals, the rate of COVID positive on [the] labor and delivery [ward] was 20% last week. It's the highest that I've ever seen it the entire pandemic,” said Dr. Ebony B. Carter, an associate professor and chief of the Clinical Research Division in Obstetrics and Gynecology at Washington University. “It's déjà vu in the worst possible way.”

The scenes Carter is witnessing this summer remind her of the early days of the pandemic — a time she describes in a recent blog post as “the most traumatic professional period I’ve lived through in my 15 years as a physician.”

Prior to the pandemic, obstetricians didn’t typically have discussions about end-of-life decisions with their patients.

“But I'm having them now,” Carter said. “As a patient is struggling to breathe, and she's just trying to gasp for air, I'm saying, ‘OK, if the baby is in distress too, do you want me to do a C-section for the baby, if you can't make decisions for yourself? Who do you love and trust to make those decisions for you?’

“Young healthy people should not have to have those conversations when we should be talking about a gender reveal party and fun baby stuff, right? We shouldn't be talking about end-of-life care,” Carter said.

She joined St. Louis on the Air to discuss the increased number of unvaccinated pregnant women becoming seriously ill from COVID-19 and why it’s so important for pregnant people to get vaccinated as soon as possible.

“Pregnant people are prone to getting really sick with COVID. This is the way that I explain it to my patients: ‘You have this little foreign alien living inside of your body for nine months, and you do not want your body to attack that foreign being inside of you. So your immune system kind of tamps down a bit so that you don't attack the baby — which is great for the baby, [but] not good for you because that means if you get the flu, you're more likely to get sick or end up in the ICU,’” Carter said.

“Same thing is true for COVID. If you get a COVID infection, your risk of ending up in the intensive care unit [is] three times higher than the non-pregnant version of you. Your risk of needing a machine to breathe for you is three times higher. Your risk for death is twice as high than when you're not pregnant.”

Dr. Ebony Carter joins St. Louis on the Air

Carter also shared the results of a recent study that suggests a potential immune benefit to infants who drink breast milk from mothers who have been vaccinated within the past 80 days. She was both an investigator for and a patient in the study.

“I was breastfeeding, and I wanted to know if it was in my breast milk too,” Carter said. “So I was a volunteer for the study, and we saw that there were antibodies — those little soldiers against COVID — in the breast milk.”

While she acknowledged that the study sample was small and that it hasn’t been followed long enough to be certain, the findings suggest that vaccinated mothers are passing along antibody protection to their babies via breast milk.

“It's very unlikely that you're harming your baby through vaccination, and it's very likely that you're probably giving that kid some protection,” she said.

St. Louis on the Air” brings you the stories of St. Louis and the people who live, work and create in our region. The show is hosted by Sarah Fenske and produced by Alex Heuer, Emily Woodbury, Evie Hemphill and Lara Hamdan. The audio engineer is Aaron Doerr.

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Emily is the senior producer for "St. Louis on the Air" at St. Louis Public Radio.