What happens when you get pregnant after years of living with long COVID? Is it safe? Will your symptoms get worse? And does anyone in the medical profession actually know?
In this episode of Bounded Energy, Katya shares some rather big news: she's pregnant! After three and a half years of long COVID, she's expecting her first baby, and while she's absolutely delighted, she's also got quite a few questions about what pregnancy might mean for her health and her baby's.
Katya talks Hannah through her decision to try for a baby, the anxieties that came with it, the emotional rollercoaster of trying to conceive, and the surprising changes she's experienced during pregnancy — including a dramatic improvement in her long COVID symptoms during the second trimester.
Meanwhile, Hannah has been doing what Hannah does best: reading an enormous number of scientific papers so Katya doesn't have to.
Together, they explore what the research tells us about long COVID and pregnancy, including possible risks, monitoring during pregnancy, labour and delivery, and why there are still so many unanswered questions.
It's an honest, occasionally funny and vulnerable conversation about pregnancy with chronic illness, the limits of medical knowledge and what happens when your body — which has spent years being spectacularly uncooperative — suddenly decides it can grow an entire human.
A note for listeners: This episode includes discussion of fertility, trying to conceive and pregnancy-related health risks. The research discussed reflects the evidence available at the time of recording and should not be taken as individual medical advice. Links to the studies discussed are included below.
Research discussed:
https://www.spandidos-publications.com/10.3892/br.2024.1893
https://pmc.ncbi.nlm.nih.gov/articles/PMC11059432/
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Katya: 00:03
Hello listeners, Katia here. Welcome back to another episode. This is an episode that I really wasn't sure about making. It feels really vulnerable, and I initially wasn't gonna speak about this, but I've changed my mind and I'll explain why. As I'm sure you've guessed from the title, I am currently in my first ever pregnancy and about three and a half years into my long COVID. While I'm absolutely thrilled to be pregnant, having long COVID has introduced quite a bit of health-related anxiety. In the first midwife appointment that you go to in the UK, they do a really long risk assessment where they take a full medical history and then assign you extra screening or interventions if you tick any of their risk factors. At my first appointment that I had at eight weeks, I did explain that I'd struggled with long COVID on and off since September 2021, and that I was really worried about how it would impact mine and my baby's health in pregnancy. But it just wasn't a risk factor that my midwife could tick off on her form, and no note of it was made on my file. I left that first appointment feeling really worried that the chronic illness that had had such a huge impact on my life wouldn't be considered by my midwives or doctors, and that harm would come to my baby or to me during the pregnancy or the birth. After that first appointment, I tried to do some research into the science on non-COVID and pregnancy because I wanted something to take to my midwife to convince her that I needed extra monitoring, but I just couldn't emotionally handle the reading materials, and I couldn't find anything in podcasts or on YouTube to neatly summarize the risks. So I asked Hannah to do the work for me. And fortunately, Hannah is a massive nerd about this kind of stuff, and so she did a really great and thorough job. The whole purpose behind making this podcast was to make something that I'd have wanted to listen to when I first got long COVID. And this episode is exactly what I would have wanted to listen to when I first found out that I was pregnant given my long COVID. So this episode is in two halves. In the first half, I talk about my experience of pregnancy, and then in the second half, Hannah shares what she's learned from her research on pregnancy and long COVID. I hope you find this episode as useful as I did. Thank you for listening. I'm having a good day. Apologies for the sound quality here. This is a voice note that I'm recording on holiday on my phone. I just needed to say that after we recorded this conversation, Hannah felt like she had quite a bit more useful information from her research that she didn't get to share. So we've decided to do a follow-up episode to this, which we'll release in a couple of weeks. Um, and then additionally, you can find links to all of the research that Hannah discusses in the show's description wherever you're listening to this. Okay, that's it. Enjoy part one of our conversation. How have you been, by the way?
Hannah: 03:18
Um, okay, yeah. Like my energy has definitely improved. Really? Um, yeah. So, like, since I've been taking this new supplement um called derribose, it's really boosted me. Yeah, I think just generally from just not doing all of like the stressful job I was doing before. I just I'm slowly, slowly feeling more like myself and just gradually doing a bit more and a bit more. But I'm not trying to like do that artificially. It's more just like I just kind of like instinctively do a little bit more and then look back on my day and I'm like, oh yeah, I did all that and I didn't think about it. Yeah. Um, which is very cool feeling.
Katya: 04:02
I agree. I remember someone saying to me something ages, like maybe a year ago or whatever, about like progressive, I can't even remember the name of it because it's been locked out of my head, but that idea of like progressively increasing your exercise. Yeah. Graded exercise therapy, is that it? Which is super, super dangerous for people with long COVID or fibro or whatever. But um I remember just thinking, like, I you you just don't need that because when you're better, you just do slightly more. I know, you just you just do it naturally. Like, no one wants to lie down all day.
Hannah: 04:32
I know, that's what I thought. I was like I totally felt the same. I was like, I'm not, it's not like I have the ability and I'm holding back. Yeah, yeah. Like I could go for a run, but I just yeah.
Katya: 04:45
Oh god. Um, you said this supplement to me ages ago, and I I don't know why I wrote it down. What is it that you've been taking, Hannah?
Hannah: 04:53
Um, deribose. So it's for mitochondrial function. I think it's got something called L-carnitine or something in it as well. I'll send you the brand um so that you can see what's in it, but I think it's it's really helped. But my nutritionist said that you know it's not gonna necessarily help everyone, and depending on kind of what it is that's really feeding your fatigue, and I guess for me, like my mitochondria just aren't functioning well. So as soon as I got that hit of deribose, I felt an instant improvement. Um and the other thing was she's only introduced it later in my journey because if she introduced it at the start, like my digestion was so terrible, my body wouldn't have known what to do with it.
Katya: 05:42
Um You're making me want to ask all the questions that I know we're gonna speak about next time. Yeah. Um, okay, yeah, I'll keep this in for the podcast then because I think it's still good. But yeah, next time we'll talk all about all about your um your work at the clinic. Cool. What's the clinic? What is it again? Optimum Health Clinic. Optimum Health, yeah, and how you're doing.
Hannah: 06:05
But yes, today is time for you to take the floor because I I hogged the limelight last time, so yeah.
Katya: 06:14
Um yeah, I was I've been really nervous for this. Really? Yeah, really nervous. And also like I have um I tried once to Google long COVID in pregnancy. I really did, and I just it was so stressful that I it was I just couldn't do it. So I'm really I feel like this is a good way for me to get some information, yeah, and also just let listeners know what's what's happening.
Hannah: 06:44
Yeah, yeah. Well, you've got me as like, you know, a lecturer, an ex-lecturer with nothing to do. So I was like, read studies, of course I will. Um so I was having a great time, and I've like got a nice little document of everything collated for you. So yeah, I know it was it was very fun. Um but yeah, so you haven't even like formally announced to the listeners what your news is, which they probably have guessed by now.
Katya: 07:08
Yeah. Um, okay, yeah, let me get my I've got all my notes. Okay, but I guess long story short is I am pregnant. I'm 21 weeks. Can I look at my butt? 21 weeks. Yes. Can you see it?
Hannah: 07:23
Wow, okay. It's definitely showing. Like a proper little thing. Wow. Before it was if you were wearing a baggy shirt, like you wouldn't have necessarily seen it. Whereas now it's like no baggy shirt's gonna cover that up.
Katya: 07:34
Yeah, and it's like none of my clothes fit me, and I can feel her moving around so much. That's like exciting. All the little kicks, I just yeah, I'm so in love. I just I can't wait for you to feel it because it's so it's so weird to feel it from I obviously don't know what it's like to feel her kicking from the outside because I feel it from the inside, but um it makes everybody smile so far.
Hannah: 08:01
Cool. Um, yeah, so kind of the talking points we had was you wanted to chat about, well, firstly, like what were your feelings and opinions about having a child, you know, before you made the decision, and then kind of what what kind of helped you get to that decision. Yeah. That would be great for you to chat about first before we move on.
Katya: 08:24
So I think I I always knew I wanted kids as an idea, and it was always an idea that I would pursue in like 10 years' time or something, but I I was sure that I wanted kids. It was just like part of my vision for life. Okay. Um, and then when I got COVID, I think I was 27, it was May 2021 infection that just became long COVID by September. Yeah. I feel like all of my ideas about what I would do with my life, so having children, traveling the world, climbing the career ladder, everything was just on pause. Like I just had no energy for any of that. And it was just getting through the worst of long COVID. Which, yeah, was about three years, I would say, of just like constantly battling it and having the cycle of um really sick in the summer, sorry, really sick in the winter, slowly making progress in the summer just to get COVID again. Yeah. And so I, you know, I definitely had the thought of like maybe I won't be able to do this. Maybe my COVID will never be good enough, or maybe COVID will wreck me such that I can't have kids. So I just put all the thoughts on hold. And then it was um it's har it's hard to explain how it happened, but I basically didn't get COVID last winter. I've been trying to think about what are the triggers for wanting to have children. And last winter I didn't get COVID. And so what that meant for me was like the slow improvement in health that I see every single spring just continued through autumn and winter. Yeah. And I just that trajectory wasn't then interrupted and you weren't brought back to square one. It was just allowed to play out. Yes, which has never happened which hasn't happened since September 2021 when I was first like, this is long COVID. Every year I would just get COVID again and just lose any progress I'd made in recovery. So I think that was one thing. I think it was having a long period of like better health. But I also I wrote it all down because I want to like, I wanted to get the timings right. But it was basically I think one of the big things as well was so last January was about three years into having long COVID, and I decided to quit work, to quit that current job I was doing. Yeah. Because I've been working for Goldman Sachs, the American Bank, and their policy had been you're in the office every single day. Yeah. It was very much like nine till six, you need to be present. Yeah. And I had actually moved to be next to the office so that I could work full-time.
Hannah: 11:17
Yeah.
Katya: 11:18
And it was, I think I just realized like, um, I will never get better if I keep doing this job. Like it just takes all my energy from me. Kind of like you.
Hannah: 11:28
Yeah, yeah, totally. It was too much. It was just draining you so much each day that you never had that bit left over. And like you need to to like get out of long COVID or to improve, you need to start building like energy reserves, like savings of energy.
Katya: 11:46
Um I had no, I had I just had no space. I had no money because I was paying a fortune to live in literally the city of London so that I could walk to the Goldman Sachs office every day. And I had no energy because I was doing that job.
Hannah: 12:00
Yeah.
Katya: 12:00
So I quit around May. I quit and I got a remote job that I still do, that I do from my brother's bedroom like four days a week, and go into the office if I want to once a week, but I don't have to. So I think I think the things that made me go back to thinking about that desire to have kids were quitting my job.
Hannah: 12:29
Yeah.
Katya: 12:30
Um, so that I just had more energy, and then that longer period of better health. I just felt like by last summer, I felt like I was starting to be myself again. And um I got married in August, which was great, which was wonderful, and it was literally like maybe a month before the wedding in August, and I just felt this urge to have children now descend on me almost overnight. It had gone from like one day in the future to like, oh no, I have to do this now. Like I'm I am the healthiest I've been in three years.
Hannah: 13:12
Yeah, it's like you saw the opportunity of like if if I don't take this opportunity now, what if the that this window of opportunity closes on me? Like I could, yeah.
Katya: 13:24
It was like that, and the desire came back, like it felt really biological, which I find really strange.
Hannah: 13:30
That's so interesting.
Katya: 13:32
I'm just thinking about you and people who choose to be child-free. Yeah. Because I feel like if you choose to have a child-free life, like people question it all the time. Like, are you sure about this decision? But like the decision to have children for me was literally overnight. It was like, not even I want to have I want to be pregnant, it was like, I want a baby right now. And I cannot, it feels like really just like biological.
Hannah: 13:59
Wow, that is such an alien concept to me, but I believe you. But it makes complete and utter sense that that would be coming from like deep within you, like biological, and then also it links in with just this feeling that you've always had that you know it's your kind of destiny to have children at some point.
Katya: 14:17
Yeah. Yeah, maybe it's that I I imagine it's a mix, it's like the I was raised with that societal image of what being an adult woman is, it's being a mum. So I think I wanted that, and my parents were so happy with us. And then I think it was like my body suddenly wasn't so sick it could go back to its like primal urges. Yes, yeah, and also getting married. I didn't want getting married to change anything, but I think subconsciously it gave me this sense of stability of like, oh no, he is legally tied down now. Yeah, it is safe to like it is safe to put your body on the line for nine months, and like yeah, yeah, not very romantic.
Hannah: 15:04
Yeah, he's now signed himself up for this.
Katya: 15:06
Yeah.
Hannah: 15:08
Yeah, totally.
Katya: 15:09
In front of everybody he knows. So, like and my husband really struggled to understand. Matty really didn't get how I could have gone from like one day we'll have children to like we must have children right now. And he was like, We have all these weddings this coming summer. So he was like, Catherine, it's a ter like in August. He was like, You can't get pregnant now because we're about to get married, but also you have all these weddings next year. Like, why don't we wait a year and then but for me it was like with the sudden urge to have children came this like uh massive anxiety and certainty that it wouldn't be easy for us. Like I was thinking about this the other day. I feel it's I feel like if you've experienced your body uh refusing to do something, you kind of lose this like childish uh delusion that you can do anything you put your mind to.
Hannah: 16:10
Yeah, yeah. You you stop taking your body for granted. You know it's not just gonna just bend everything you want it to do. Yeah.
Katya: 16:21
Yeah, it made me think of I can't remember why I read it, but I remember reading something that was like they did the survey and it was like most people thought they could write a bestseller if they just wanted to. Really? Whereas it's like you and I having this literature degrees, so we like we know for sure that that's not true. I feel like definitely not true. No. So it's kind of like having having a body that like you know, I say I I say I'm like the healthiest I've been, yes, but I also like still have long COVID. And I think when you've had a body that has just not gotten out of bed for you in the morning or not been able to do the walk you really wanted, why would you think that it could undertake the massive task of having a child? And I so I was really sure that we would need IVF and potentially a surrogate.
Hannah: 17:12
Were you? Okay.
Katya: 17:13
That's I was sure of it. And so what I had in my head in terms of the timeline was not, oh, we'll get pregnant in a year. It was we need to try for a year because that's how long you need to try before the NHS will consider you for IVF.
Hannah: 17:27
Got it. Okay.
Katya: 17:28
And then the waiting, then then you've got the waiting list of like two years.
Hannah: 17:32
Gosh, yeah, yeah.
Katya: 17:33
Like so in the case.
Hannah: 17:34
So you were thinking, you were thinking long-term, like we need to start now because this could be a really long road.
Katya: 17:40
Yeah. That's not true. So with with like the desire to have kids, just came this conviction that I wouldn't be able to. Um and so anyway, my husband is just really, really flexible. Like Matty's so funny. If you if you like push something with Matty, he will um dig his heels in and just say no, and then you're stuck. But if you like plant an idea, let it simmer for a bit and then go back, he'll like come around to it. Okay. And so I was talking him through like the timeline. And anyway, long story short, we started trying in September. Um, and trying for a baby is so weird. It like changes your whole sense of time. You know how normally it's like start of January, end of January, like the first and the 30th of January is your month.
Hannah: 18:33
Yes.
Katya: 18:34
When we were trying, it was like menstruation, then waiting like five days for the uterine lining to go back up, ovulation testing and ovulation, trying to have a baby, the agonizing two-week wait where you're like testing to try and see if you're pregnant, and then menstruation again. That was literally how I view my month. Wow. It was bizarre. Like how women do it for like a year, two years on end.
Hannah: 19:05
Oh, it just must drive you crazy. I could just imagine it just must be exhausting. And like, you know, when you've got like your career and everything else going on in your life, you then have this like background hum of like, yeah, where am I in the calendar? Um gosh, yeah.
Katya: 19:21
And then I would have all of the hope during waiting for ovulation. Um, you can get these like little ovulation tests these these days. It's so handy. Like you don't need to talk about those. Yeah, yeah. So you can literally find out when you're ovulating or when you're allowed to ovulate and just make sure you have sex then.
Hannah: 19:38
Yeah.
Katya: 19:39
And then you never have to have sex again. But you could you can you can like time it as opposed to, you know, just like fingers crossed.
Hannah: 19:47
Yeah.
Katya: 19:48
Um, what was I gonna say? But yeah, I get these like cycles of hope. And it was only four months of it, but it would really be like, well, fingers crossed, maybe I'm pregnant, walking around the world feeling like maybe I had this precious thing inside me.
Hannah: 20:01
Yeah.
Katya: 20:02
And then the negative test, I just always found it crushing.
Hannah: 20:07
Yeah, I do remember us talking and messaging a bit when you were going through that, and it felt like because like because your hope was like rising so much, it's like the the wanting the baby like really got strong and like stronger and stronger during that period, and it's just yeah, then you're crushed. It's yeah, yeah.
Katya: 20:30
And I started listening to a podcast called The Big Fat Negative, which is like an infertility podcast.
Hannah: 20:34
Oh, cool.
Katya: 20:35
And the parallels with long COVID struck me so much because one of the things that women with infertility do is they you try anything. So, like you stop drinking coffee, you start taking like green tea supplements, you literally do anything that you've heard of that might give you. And I I think it it's that desperate need to control something that actually is a biological mystery to you.
Hannah: 21:02
Yeah, yeah. And then I can imagine the like, I don't know, wanting to just like throw the towel in or getting really overwhelmed when you've just tried all these things and nothing's working.
Katya: 21:12
Um people tell you, just as people tell us with long COVID, like, I don't know, to exercise or just take it easy or don't be stressed. The common thing that people tell women who are trying is to relax. And it's just as triggering. It's like being relaxed is not gonna make me pregnant. Yeah. But anyway, um in December, that was the month it worked, and I remember on Christmas Day taking a pregnancy test, which was like the earliest I could have tested. And I had said to myself, you know, if it's negative, I'll enjoy Christmas Day, I'll get really drunk.
Hannah: 21:54
Yeah.
Katya: 21:54
And I took the test. I remember peeing on the stick, and I was like, by that point, I was physically shaking because I was just so. I don't know, Hannah. It it just like consumed my brain. Yeah, you were so desperate at that point, probably. I was, and I just yeah. And anyway, it was negative. And I remember I was just completely distraught. And it kind of like didn't ruin Christmas, but I just remember feeling so sad like all through Christmas. Um and I still didn't drink because I was like, maybe I feel like ever also, this is another thing that women are trying to get pregnant. You never believe your first pregnancy tests. You're like, oh no, I definitely tested too early. Anyway, I did because then on the 31st of December, I tested again in the morning and I got Matty to check because I just couldn't bring myself to like look at it and it was positive. And I just remember like bursting into tears and just being so because also like your body does like your body does it to you, like your breasts are really sore, you're feeling really sick, but like you get that every men, every period anyway.
Hannah: 23:01
Yeah, yeah.
Katya: 23:02
It's such a mind fuck.
Hannah: 23:04
But um, yeah, but I was pregnant and I was fucking over the moon. Amazing, amazing. From the reading that I have been doing, um, like I ended up looking at a few articles just about like um long COVID and like women's sort of sexual health fertility, that kind of thing. And it having long COVID definitely can um like interfere with some women's fertility. Um so yeah, you were completely right to be like to go in with those sorts of concerns, but it's just absolutely amazing that despite that, your body was like, no, I totally agree with Katia's brain, I'm gonna pop on out.
Katya: 23:44
I know. And then you have all the worry of like yeah, of like, what will this illness do to my baby? You know? But um I'll just talk through, I'll just talk through what it's been like up to now then.
Hannah: 23:59
Yeah, yeah.
Katya: 24:01
Um so just briefly, I'll try and be brief now because I feel like I've got through all the big stuff. But yeah, okay, so the first thing is the um the first trimester was rubbish. Like it, the morning sickness and the fatigue are bad, but they are nowhere near as bad as long COVID. Like if you've had long COVID, you can handle the first trimester. It's like kind of the same, except with long COVID, you have like crushing despair, and it it doesn't get better during the day. Whereas with morning sickness, it's kind of a reminder that you're pregnant and it does for me, it would go away during the day.
Hannah: 24:37
Yeah, and there's a there's an end in sight as well, isn't there? It's like I just need to grip my teeth through this and we'll get over the finish line. Yeah.
Katya: 24:45
Oh yeah. Like you would you get would you put up with 12 weeks of long COVID if at the end of it there was like a bundle of joy or like a million pounds? Yeah, you're not even gonna complain. So like I felt bad, but I didn't complain. And then um, in the second trimester, which is where I am now because I'm 21 weeks, I it was maybe around week 13, I just felt amazing. Like I noticed one day my morning sickness was gone, I wasn't vomiting, I wasn't feeling nauseous, but um I had so much energy. And I have been since since week 13, I have felt like I don't have COVID. Like I have been taking 8,000 steps a day.
Hannah: 25:30
Gosh, that's amazing.
Katya: 25:32
It's amazing, and I spoke to my midwife about it, and she just said it's really like it's really common that people with chronic illness feel better in the second trimester. Apparently, people with MS feel like they've gone into remission.
Hannah: 25:44
Really? That's so interesting. Actually, there's um something I came across in um my research that will be an interesting point, which I think can link back to that later on. Yeah. Okay. Um, I think what I feel like what's it been like carrying the extra weight of the baby?
Katya: 26:03
So that has been really good because one of my um so far, one of my long COVID side effects was I found it. It's hard because it's you know, three years of bad long COVID, but I from the beginning of long COVID, I found eating really difficult. Like I'd have very little appetite or I would get nauseous very quickly into eating. So while I know lots of people with long COVID gain weight because of exercise, because they can't exercise, sorry, I lost weight from like the start. Well, I say the start from like May 2021 until before I got pregnant. I think I must have lost like six kilos or something. I lost a lot of body weight. And I have gained it all back in pregnancy because my appetite has come back and I have been feeling so good and just really loving food and loving eating. Oh, that's great.
Hannah: 27:01
It's so honestly like glorious. Yeah. Being at the Optimum Health Clinic has like really instilled in me just how important feeding yourself enough is. Yes. To energy is like, and it's just such a um such a catch-22 when you're like too you feel too ill or your digestive symptoms are so bad that you can't eat enough what you should be eating. And when when you can, stomach it, like, it yeah, it's so good for you. It really boosts your energy.
Katya: 27:31
Yeah. So I've been feeling really good because I've been eating loads. Um, and I've been doing pregnancy yoga since week 13. My first lesson was weird because I feel like I went there at 13 weeks and everybody was so much stronger than me because they were just normal pregnant women. Yeah. And like at the end of the class, I actually lay down, you know, in Shavastana at the end and started crying because I was just I was just like, I can't do any of this stuff.
Hannah: 27:59
It must have been really confronting.
Katya: 28:01
Yeah, but then I also had the thought, I I had said to myself, I was like, okay, so you can't do like a squat or hold mount, hold downward-facing dog for like a minute, but like apparently you can grow a baby to 13 weeks.
Hannah: 28:14
Yes.
Katya: 28:16
So anyway, um, I think that's the important fact. Yeah, I think that was everything. So I'm pregnant with a little girl, 21 weeks, and I'm due in September. And I had asked Hannah to research some of the medical literature on pregnancy in people with long COVID because I am very concerned that my doctors know nothing about it and that I'm being treated like someone who is perfectly healthy. So, Hannah, what did you find from your research?
Hannah: 28:55
Well, it took me a little while to kind of tease through the studies that are out there. There's not a lot, um, but when you do start looking, you realize that um, you know, not everything out there that relates to long COVID and pregnancy is actually relevant to you, Katia, as a person, because a lot of the studies were done on um, say, pregnant women who got the COVID infection during their pregnancy, um, or it was done on women who um got COVID during pregnancy and then developed long COVID still during that pregnant period. And so pretty much all the research I could find was on those two groups of women. And I was trying to find stuff of like, well, what about women who've lived long term with long COVID and then get pregnant after the fact? And there's there's there's nothing out there yet, unfortunately. But um, what I have found is um a couple of articles that have sort of managed to glean some good information, like extrapolate from what we know about how long COVID interacts with pregnancy and have got some recommendations. So I think that's definitely something you could take to your midwife and doctor. So something that that I thought was an interesting point was that actually women who got pregnant, no, no, sorry, women with women with COVID who were pregnant, pregnancy was actually a protective factor against long COVID. They were less likely to develop long COVID if they were pregnant. And the researchers theorized that it's because of the altered immune and inflammatory environment in your body, because basically when you're pregnant, your immune, you have greater immune tolerance, like you don't want your body to like reject your baby. So, you know how with uh like long COVID, they think that you know we have really overactive immune systems.
Katya: 31:00
Yeah.
Hannah: 31:01
Your immune system right now might be really calmed down because it's like we don't want you to reject the baby from your body, but that might be one of the reasons why you're feeling better because your immune system's just chilled out now. Um but I just I thought that was an interesting point. Yeah. Um and so for the women who um contracted COVID-19 and then got long COVID during their pregnancy, there were some kind of there were some risks found in that population. Um, so there was found to be a higher incidence of liver function abnormalities um in the women or the babies. Um in the women. Yeah um but you know, again, we're talking about women who've literally just had the infection and are at the very beginnings of long COVID. Yeah. Um and the women who had really severe long COVID symptoms during their pregnancy were more likely to develop thromboembolic events and abnormal heart rhythms. But again, when you look at the study, it's like, well, this doesn't represent cattia. I was like, these populations don't is not you. So I that's why I was thinking I'm not gonna just like hide this stuff from you, I'm gonna tell you it's there, but also just reassure you at the same time that you know, it don't kind of jump to conclusions thinking, oh my god, I must now have an abnormal heart rhythm or something like that. Um but yeah, so women with who got COVID and developed long COVID during pregnancy were more likely to have hypertension or diabetes during the pregnancy, but which then resolves afterwards.
Katya: 32:48
Yes, and that's that's actually a really good thing to know, Hannah, just because, just as you said it, it I am already being monitored for hypertension and digestational diabetes because of my ethnic group.
Hannah: 33:06
Right, yes, yeah.
Katya: 33:07
Okay. Yeah, but if like a listener was thinking about getting pregnant or whatever with long COVID, that's something that like the midwives already know to check for. They just don't, I just think they don't know to check for it in long COVID populations.
Hannah: 33:22
Yeah, exactly, exactly. Um the one thing that they did find in um severe, in the more severe cases, was that um there were some women who whose um where the fetus um had like didn't grow so well. It's called like fetal entrauterine growth restriction. So growth restriction basically. And so um one of the recommendations that the researcher gave was that the baby should be like monitored through scans um during the pregnancy for any signs of growth restriction in in severe long COVID cases. Okay. Um, but you know, I I think even if you're not severe, that might be still something that you could kind of say to your midwife, like, are there any signs of that if you feel like you want to reassure yourself that everything's okay? Um yes.
Katya: 34:18
And that's I'm actually really glad you said that because um I had my 20-week anomaly scan uh last week, and they said, Oh good, baby's looking really normal. And then my husband said to me, Is that the last scan? And I said yes, because the NHS don't offer you scans beyond 20 weeks if everything's looking okay. But actually knowing this, I will get more because I have a friend who's lives in Germany and she has two more ultrasound stands after week 20. So I think I will ask for them on the NHS, and then if they don't do them on the NHS, I'll get them done privately. Okay, yeah, yeah. So I'm really glad that you told me that.
Hannah: 35:02
In like the really good article that I found, it's like there as a as a recommendation, so you can literally just bring the article in with you.
Katya: 35:09
Yeah, Hannah, can we make um the articles you looked at available in the footnotes for the show? Totally, yeah. You save the links. Yeah, save the links. Oh, I'm so glad. I feel really sorry. I feel I just feel really emotional. I feel really I have stuck my head in the sand about this, but it's good to know. Sorry, keep going.
Hannah: 35:30
Yeah, yeah, yeah. No, it's like information is power, right? So but I can totally relate. I could I could do this because I'm not myself pregnant. Yeah. I could imagine how this would just really stimulate all of your fight and flight and would stop you from like really kind of being able to read and process the information rationally. Yeah, I would like scan the article and read liver dysfunction. I'd like to do that. I did at the beginning. Yeah, I did. Yeah. Yeah. Um, and yeah, like another thing they found which is just like makes complete sense, is that um the women who were pregnant with who got COVID and had long COVID during their pregnancy had lower um health-related quality of life. Duh. Yeah. Um, uh, which is like, yeah, no shit. Um and well, actually, which is really sad, but this is like, you know, early in the pandemic, yeah, when women were pregnant getting COVID and then not getting better, they were more likely to have post-traumatic stress disorder from that experience, which I just think is yeah, yeah, horrible to think about, isn't it? But gosh, that must have been so horrible for those women. Um, it was it was it was like a really scary time for all of us. But like if you were a pregnant woman and you got COVID, I could imagine just how much anxiety that must have caused women.
Katya: 36:51
Well, totally, because because there's something about being the only place your baby has to live that makes any kind of health risk more stressful than when you're not pregnant.
Hannah: 37:02
Totally, totally. Um, so a really good study where I've kind of got some helpful recommendations from to start with is a systematic review from Greece uh from uh dated 2025. So it's a recent uh systematic review. And for any listeners who aren't aware, that's like a really structured, rigorous review of available research out there on a given topic. Um, so it's always a really good starting place. Usually when I'm like looking up research on a topic, I will just Google at the same time systematic reviews so that those reviews come up first, so I get like an overview before I dive deep in. Um but yeah, so the like I said, there's no research out there on women like you, Katia, at this point, but they have extrapolated some um helpful things. So they said like the care for women with long COVID who are pregnant should largely mirror non-pregnant individuals. Uh, there's nothing like dramatically different, but it suggested as self-management to do daily pulse oximetry. So just how do you have a pulse oximeter?
Katya: 38:14
Yeah.
Hannah: 38:15
Yeah. So just like checking in on your oxygen levels on a regular basis. And I suppose like as you get closer to delivering. Um, but I mean, I think I suppose you could speak to your midwife about like, well, what what is too low for a pregnant person? Um and it just has other more general recommendations which all pregnant women get, which is like sleep well, nutrition, stop smoking, don't drink, monitor your caffeine intake. It also recommends a gradual increase in exercise as tolerated. And I was thinking of your yoga and how you're already doing what you can within your envelope. So I don't think you need to stress about that at all. Um, it does say that for women with severe long COVID, it recommends that they seek preconception counselling to optimize their health before pregnancy, which I thought was a very sensible recommendation. It's it did say that symptoms such as fatigue and breathlessness might get worse during the third trimester. Um and it suggested tracking symptoms with a diary to help you identify like new or worsening symptoms. I think one of the things that it that a different article I'll move on to now seemed to indicate was that what you don't want is for a health professional to basically just put, if you say, Oh, I've got this new symptom, or I'm feeling way worse in this area, for them to just put it all down to long COVID without doing the proper checks. So sometimes when, like, especially when you're in a doctor's, I find it so hard to try and remember like what what what are my long COVID symptoms and what do I feel are my pregnancy symptoms, and what's about long COVID that's always been that way, and what's kind of got worse, and just those like tangle of symptoms that you have. Um, so yeah, they recommended like using a diary to keep track of things um so that it's you can kind of bring a clear picture to your health professional if you are worried about anything. Um, so the next article I looked at, which I found to be the most helpful one, was written by um a group of doctors from uh Switzerland, Canada, and Singapore. It was published in the Lancet Regional Health Europe journal. Um, and it's got like a nice graphic um of like points for um midwives and medical professionals to think about. Um, so I'll share that with you. And it it does mention that thing about monitoring for fetal growth restriction.
Katya: 41:06
Yeah.
Hannah: 41:06
Um and it also says that you know, if you have worsening, really worsening long COVID symptoms, that you should still be following those same sort of tests that you would do on a non-long COVID person. Say, like if there are signs that in a non-long COVID person you think, ooh, could that be a sign of pre-eclampsia, like after the birth, you should take the same precautions that you would a non-pregnant person. Well, that's how I've interpreted what the the um the advice they've given. The other thing which I thought would be helpful for you potentially is um it says that early um early epidural and sort of getting in early with IV um electrolytes can be helpful for when you are um starting labor because when you go into like extreme pain and stress, long COVID bodies are often like disautonomic, where like it kind of sets off our heart rate going a bit crazy. Whereas if you have that painkiller and you have those electrolytes sort of earlier in the labour, that will kind of help to keep your um, yeah, just help to keep your body kind of functioning well. Okay. So super interesting. Yeah, so that's something that you could mention, and like it's in it's there in the article for them to look at themselves. Let me see if there was anything else that I thought was useful. Yeah, elective cesarean section might be necessary in selective patients with severe functional impairment. That was something that was on my mind of like for people who have really severe long COVID, is it is there a situation where a doctor might say, actually, like vaginal birth isn't for you? And it sounds like that that might be the case in some people. Um another thing it says is to encourage breastfeeding because oxytocin has anti-diuretic effects. Um, so is helpful for people who have like POTS dysortonomia who help to keep you, like I guess, keep the hydration in, I suppose.
Katya: 43:13
That's really yeah. Sorry, I just my I feel like my brain is one 30 seconds behind you. I was just the cesarean thing was really interesting because it hit me like at week 13 that panic of like I'm gonna have to give birth. And the question that I had is like, what is worse for my long COVID body? Is it to go through 15, 20 hours of labor or to go through the extreme stress of a cesarean? It's such a hard, yeah, yeah.
Hannah: 43:43
And it kind of sounds like um caesarean would be offered if there were like obstetric indications like no, this is we we really should go down this route as opposed to vaginal. Um seems like vaginal is what is like the Preferred method, if at all possible.
Katya: 44:03
Yeah.
Hannah: 44:03
Um, but yeah.
Katya: 44:04
Yeah. But it is in general, isn't it? Like they say it's the mum recovers from it quicker, it's less stressful for the baby. Yeah. Yeah. Okay. Definitely not a home birth for me then. No.
Hannah: 44:18
No, no, I don't think so. You want to be somewhere where you can just be monitored really closely, and you know, also I just think if anything did like get complicated during the pregnancy, you just want to be right where you need to be. Like, you know how like exhausting travel is. Yes. You'd be like, right, now you're gonna have to haul yourself up and walk out to this like vehicle and get lugged somewhere and like, oh my god, you just want to be in exactly where you need to be from the beginning, I think. Yeah. Um, but yeah, so those are the key takeaways. But I'll I'll send you all the info. One thing that you know that I know I've said that there's really not a lot out there. Um, the systematic review that I looked at really highlighted that the current evidence base has a lot of limitations still. They said from trying to summarize all the research out there, there are so many different study designs, so many different sample sizes. A lot of the time the studies are really on quite a small number of women, and they all have different like follow-up durations and they all go by different definitions of what long COVID is.
Katya: 45:28
Yeah.
Hannah: 45:28
So basically, it just sounds like it's kind of messy trying to bring all the research together at the moment and come out with conclusive findings, uh, which I thought was interesting. Um, and another thing is that a lot of studies were conducted at single centers in specific regions and difficult to kind of generalize to more diverse populations. So, yeah, we need studies that are gonna like study the women for longer, study more women at a time, and just be more have more standardized like diagnostic criteria and assessment tools because it just sounds like it's a bit hodgepodge at the minute. But that I think that is quite normal, like over time the research will will grow and improve. But we're just in such early days. The article finishes by asking for medical teams to get involved in research on women with long COVID who are pregnant, and I was thinking, oh yeah, that could be a case study.
Katya: 46:31
Well, I mean, I will definitely take a look, but it's like it's a really it's a it's gonna become like a population-wide thing because like we're the generation of women who have long COVID and will be having babies now.
Hannah: 46:47
Yeah. There's gonna be more pressure on on doctors to be like, oh crap, we've got these women turning up and we need to know how to manage them. Yeah. Um, yeah.
Katya: 47:01
Um, thank you so much for doing that, Hannah. You're right, it was it's not as bad as I thought it was. And I feel like the question marks, like I'm definitely gonna insist on more scans now, even if I have to pay for them myself. I don't care. Um, although I will just say side note, it is extremely expensive. Yeah. Um, but I will definitely pay for that and I will take this information to my midwife. And um, yeah, one thing I'll just say as well is obviously when we get laid from pregnancy, the podcast will stop. I don't know if it'll recommence, I don't know what I'll be like. Um and then, but I think I will just do a short one to let people know how it goes.
Hannah: 47:46
Yeah.
Katya: 47:48
Just because some of our listeners have have been with us for a while, so I don't want it to like definitely they're gonna want to know the outcome of all of this. So yeah, that everything was fine and yeah, I'm sure it will be. Yeah. Um, thank you so much, Hannah. That's okay. Um you're okay, it's been really long.
Hannah: 48:07
Oh, I know. Yeah, no, I'm okay. I'm like, I'm super ready now to take a break. But also, I talked for ages because like I just I found it so interesting, and like I love doing this kind of thing for people. Like, I just yeah, I'm just it's what I did in my job as a teacher was like researching and like condensing things down to be like useful information on the ground for people. So I just love I love doing it as an activity, so yeah. Yeah, and you're really good at it. And also it's just something that I feel like, you know, I I felt really good like doing it for you as a friend because it's just like who else, who else is gonna read through long COVID pregnancy stuff for you and you need someone to do that for you.
Katya: 48:50
Yeah. Um, and also like who who else would I ask to take the because to take the amount of time? And so yeah, thank you so much for doing that, Hannah. That's okay.
Hannah: 49:01
Thank you so much for sharing all of your um like experiences, like in the lead up to getting pregnant and being pregnant. I think the listeners will really appreciate how like just honest and open you feel about the whole thing.
Katya: 49:13
Yeah.
Hannah: 49:13
And we'd love to hear from listeners if anyone has got some experiences to Katia thinking about having a baby or have gone through it. Um, yeah. Or or um kind of if anyone's kind of struggling with sort of fertility, like sexual health, that kind of thing as well, would be really interesting to hear from listeners about what what you're going through. Yeah, definitely.
Katya: 49:38
Thanks so much for listening. We hope you enjoyed this episode and that you join us next time.
Hannah: 49:43
If you enjoyed the podcast, please leave a review and recommend us to a friend. Send your questions and comments to boundenergy at gmail.com or find us on social media at bounded energy.
