ORLANDO, Fla. – Paola Gambini arrived at Orlando Health Winnie Palmer Hospital for Women & Babies by ambulance on July 29, with a nearly full-term pregnancy and a COVID-19 diagnosis, gasping for air.
“I remember the EMTs telling us, ‘you called at the right time,’ because they immediately put me on oxygen,” she said.
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From July 1 through September, about 260 COVID-19 positive pregnant patients were hospitalized at Winnie Palmer, said Dr. Lori Boardman, assistant vice president and chief quality officer.
AdventHealth’s South Central Florida division saw a spike in COVID-19 patients during the summer’s delta surge as well. It admitted 113 pregnant women with complications from COVID-19 from July 1 to Nov. 11, more than half the number hospitalized throughout the entire pandemic, said Dr. Kathryn Berryman, who specializes in maternal-fetal medicine.
Nationwide, from January 2020 to Nov. 15, 2021, over 145,000 pregnant Americans tested positive for COVID-19, and over 24,000 were hospitalized, according to the Centers for Disease Control and Prevention. As of Nov. 15, 229 pregnant people with COVID-19 have been reported dead.
Pregnant and recently pregnant people are at risk because they have weaker immune systems than the average person, Boardman said.
Growing, though limited, evidence finds the vaccine’s benefits outweigh its risks for mothers and their babies, according to studies shared by the CDC on its website. In contrast, COVID-19 increases the risk of severe outcomes and preterm birth compared to pregnant people without COVID-19, according to an analysis of 77 studies published September 2020 in the BMJ, a medical research journal. It is unlikely babies will catch COVID-19 from their parents, the CDC said.
Yet despite the evidence, less than four in 10 pregnant people aged 18-49 were fully vaccinated during or before pregnancy as of Nov. 13, according to CDC data.
“If I would have gone back in time and knew what I know now, I would have definitely gotten vaccinated,” Gambini said. “I don’t want other pregnant women thinking, ‘I’m a superhero, I’m taking these vitamins ... I’ll be OK, COVID won’t get me,’ because that’s exactly what I thought, and it’s not true.”
Fighting COVID-19
At first, it was just a fever. But about a week after Gambini’s diagnosis, she couldn’t catch her breath and her fiance, Michael Hazen, called 911. Her lungs were full of fluid.
Doctors performed an emergency C-section so they could better administer life-saving treatment to the 32-year-old. A girl was born preterm, before week 37 of pregnancy. They named her Lilliana.
Gambini held Lilliana for a brief moment before her fiancé took her, and Gambini was transferred to Orlando Health Orlando Regional Medical Center. There, a ventilator breathed for her; when that wasn’t enough, doctors used an extracorporeal membrane oxygenation (ECMO) machine to pump her blood outside her body and oxygenate it there before putting it back in. The staff told her fiance at multiple points that she might not make it.
“I feel blessed I left in one piece ... The nurses would tell me ... you’re one of the lucky ones,” she said.
She held her daughter once when she was born, and once when her medical team arranged a visit for her birthday. Other than that visit, they interacted only over FaceTime.
“I just counted down the days,” she said. “I remember them telling me, ‘You’ll be home by Thanksgiving,’ and I remember looking at Michael, and I’m like, ’I’m making it before Halloween, and I’m going to watch my baby dress up. And I did it.”
After 85 days, she came home. She dressed Lilliana up as a pumpkin.
Gambini has now spent about a month at home with her baby. She is on oxygen, and struggles physically after spending so long in bed; she lost about 80 pounds, and her muscles atrophied. Doctors had to give her a partial hysterectomy in the hospital to stop internal bleeding.
“I planned on having more babies. ... I’ve always wanted to be a mom. So for me to wake up and them tell me, ‘we have to take your uterus out,’ that was the hardest thing for me to hear,” she said. “She’s my rainbow baby, my one and only.”
She’s getting better, though, and her goal is to be off oxygen by Christmas. She said she wants other people who have spent time in the hospital to know that recovery is possible — but she also hopes that other moms and moms-to-be don’t end up there.
Fighting misinformation
One big barrier to preventing pregnant women from catching COVID-19 is misinformation about vaccines, said Boardman and Berryman. They urge doctors to continue talking to unvaccinated patients.
“We’re not seeing any increase in birth defects or things like that as a result of comparing vaccinated women to unvaccinated women,” Boardman said. “I still think some of those concerns just remain in place, despite talking about what we do know, as well as what we don’t know.”
A Kaiser Family Foundation survey published in November found that 17% of Americans believe pregnant women should not get the COVID-19 vaccine, and 22% are unsure.
State Rep. Angela “Angie” Nixon, D-Jacksonville, blames politicians for spreading falsehoods about COVID-19.
Nixon caught COVID-19 while pregnant herself. Pregnant Black and Hispanic people have the lowest rates of COVID-19 vaccination and are also at the highest risk for complications during pregnancy, according to the Kaiser Family Foundation.
“I know what it was like to fear for your life. Black women are four times more likely to have issues related to pregnancy, couple that with catching COVID, it only gets worse,” she said. “It’s just a shame that they are politicizing this.”
DeSantis signed legislation Thursday that allows employees at private companies to opt-out of vaccine mandates if they are pregnant or planning to become pregnant. The legislation also put several other restrictions on vaccine mandates.
Nixon said this legislation is “ridiculous” because it falsely implies vaccination harms pregnant people.
“It was a real slap in the face, particularly for pregnant people,” Nixon said. “They’re spreading untruth.”
In addition, a page on the Florida Department of Health’s website differs from the CDC on this issue.
It has a page on high-risk populations that states that pregnant people “are known to be at risk with severe viral illness,” but “to date data on COVID-19 has not shown increased risk.” However, it links to a CDC statement that states it as a “fact” that pregnant or recent pregnant people with COVID-19 are more likely to get severely ill than non-pregnant people.
The Florida Department of Health did not respond to a request for comment on why it phrases the risk differently than the CDC.
As for whether it’s OK for pregnant people to let their guard down now that the summer wave has subsided in Florida, Boardman reminded everyone the delta wave also started after a period of low positivity rates. She said COVID-19 vaccines and boosters will likely become vital during pregnancy like flu shots are now.
“(Do) not be lulled into a false sense of security, and realize that this is going to be part of the world we live in, to take those precautions to help prevent what happens to these moms,” Boardman said.
Berryman agreed that though COVID-19 cases are low right now, the pandemic will inevitably continue to follow a trend of a surge, then a valley, then a surge again, and pregnant women will be especially vulnerable without vaccination.
“I have yet to find a pregnant patient who regretted getting vaccinated,” Berryman said. “They universally said ... ‘I’m so glad I got it.’ I only have patients who regret not getting it.”