CDC reports that COVID-19 presents increased risks during and after pregnancy
A new training initiative funded by the U.S. Centers for Disease Control and developed at UMass Chan Medical School aims to help health care providers counsel patients who are hesitant about accepting a COVID-19 vaccine while pregnant.
The training is one response to lower vaccination rates among pregnant women than among the general population; most women who are hospitalized during pregnancy and delivery with moderate and severe COVID-19 are unvaccinated. The CDC reports that pregnant women with COVID-19 are at increased risk for complications during pregnancy and delivery, and are at increased risk for severe illness and death compared to nonpregnant women.
“We focus on motivational interviewing, which is a collaborative counseling conversation style that has been proven to strengthen a person’s own motivation and commitment to change,” said Daniel Mullin, PsyD, MPH, associate professor of family medicine & community health and director of the UMass Chan Center for Integrated Primary Care. “We find that these kinds of conversations tend to help people make healthier choices than other ways of talking to them. When we focus on hearing from the individual and finding out what their own reasons might be to accept the vaccine, the likelihood they’ll choose the vaccine increases.”
Dr. Mullin developed the 90-minute webinar “Communication Skills Training for Clinicians Discussing COVID-19 Vaccination” with Stacy Potts, MD, associate professor of family medicine & community health.
Mullin is a clinical psychologist who often counsels pregnant women experiencing depression and anxiety at the fully integrated primary care practice at the Barre Family Health Center. A family physician at Barre and previous residency director of the UMass Chan Family Medicine & Community Health Worcester Family Medicine Residency, Dr. Potts has cared for pregnant women who have been sickened by COVID-19, many unvaccinated and some severely ill.
“It is normal for women to have many questions about exposures while pregnant,” she said. “A population that already has so much on their shoulders now has something else to be very concerned about. I start with understanding this level of stress and then I listen.”
In the online seminar, Mullin and Potts offer specifics on how to discuss in an empathetic and nonjudgmental manner the elevated risks of getting COVID-19 while pregnant and the benefits of the vaccines. They emphasize the need to adapt conversations with individuals from diverse backgrounds to each one’s medical history, values and preferences. Most important is emphasizing that the patient has autonomy because if people feel coerced, they are less open to change.
Tiffany Moore Simas, MD, MPH, MEd, chair and professor of obstetrics & gynecology, has been stunned by the rise in pregnant women who are being hospitalized for COVID-19 or who are experiencing complicated deliveries due to the virus.
“We offer vaccination because the scientific data supports it and our professional societies recommend it. However, we offer it and even seemingly urge it more so because we see pregnant persons who are in distress and admitted to our maternity center, some in the ICU, and some intubated,” said Dr. Moore Simas. “It is heart wrenching to deliver pregnant women who are incredibly ill, and often preterm, while sedated requiring intensive care, and not realizing they just became a mom. It is more heart wrenching to know it was potentially preventable with vaccination.”
The webinar is provided to Massachusetts doctors, nurses and counselors at no cost by the Center for Integrated Primary Care in partnership with the Massachusetts Department of Public Health as part of the Massachusetts Perinatal COVID-19 Vaccine Initiative and the Perinatal-Neonatal Quality Improvement Network of Massachusetts, which has received funding from the CDC to improve equitable delivery of COVID-19 vaccines to pregnant and lactating women.
Registration is open for online webinars taking place Friday, Jan. 14; Friday, Jan. 21; and Friday, Feb. 11. Continuing education credits are available.
More information on motivational interviewing trainings is available from the Center for Integrated Primary Care.