Coronavirus & Pregnancy: Tips and Facts

Pregnancy can sometimes be an uncertain and stressful period in the best of circumstances. But during a pandemic, that anxiety can quickly multiply. Researchers are working quickly to learn more about what the new coronavirus — as well as its impact on our daily lives — means right now for people who are pregnant. While there’s still a lot we don’t know about the virus or how exactly it affects pregnant women and their babies, we have collected expert information in this blog about the new coronavirus and pregnancy and answer some frequently asked questions. Please note that this is generic information only and country-specific advice exists which you should follow depending on your location.

Q. What effect does coronavirus have on pregnant women?

Generally, pregnant women do not appear to be more likely to be seriously unwell than other healthy adults if they develop the new coronavirus. More severe symptoms such as pneumonia appear to be more common in older people, those with weakened immune systems or long-term conditions. As yet, there is no evidence that pregnant women who get this infection are more at risk of serious complications than any other healthy individuals (source: Royal College of Obstetricians and Gynaecologists, https://www.rcog.org.uk)

Q. Why are pregnant women in a vulnerable group?

The immune system's efficacy dips during pregnancy, which places pregnant people at a higher risk for contracting many transmissible illnesses — whether foodborne or respiratory. Official recommendations about how best to avoid COVID-19 during pregnancy are currently about the same as for the general population, including avoiding public places and crowds, staying away from sick people, washing hands frequently and not touching the face. Based on the evidence so far, pregnant women are still no more likely to contract coronavirus than the general population (source: Royal College of Obstetricians and Gynaecologists, https://www.rcog.org.uk).

Q. How does COVID-19 affect babies and children?

So far, there is little information on COVID-19 coronavirus infections in children. Regarding children affected by COVID-19, Chinese authorities have described flu-like symptoms such as a head cold, coughs and fever; some also had stomach problems.

According to information published so far, laboratory-confirmed coronavirus infections involving children have all been milder. A pre-existing condition can make both children and adults more susceptible to a more severe disease, but so far little information has been gathered on this. The majority of serious cases have been diagnosed among the elderly. Most of them have also had other underlying conditions (source: Finnish Institute for Health and Welfare, https://thl.fi).

Q. Will labor and delivery policies change?

Yes, hospitals across different countries are actively revising their policies regarding birth and postnatal care. One big change that is already occurring in many labor and delivery wards is that they are limiting the number of visitors who can accompany anyone admitted for delivery — including through the postpartum stay. This can be upsetting as many families have expectations about sharing the occasion in person.

The general advice for women who might deliver during the pandemic is to ask their provider and the place where they intend to deliver about current rules on visitors. Typically, the limit has been to one other healthy adult for the duration of the hospital stay. Spouses or caregivers showing symptoms of illness are usually not allowed to visit the hospital but must self-isolate according to the existing rules.

Q. Do I need to prepare for a home birth?

At this point in the outbreak, women are not encouraged to change their delivery plans based on Covid-19. Hospitals in general are taking precautions to ensure that pregnant women are not exposed to ill patients and visitors. Women planning a hospital birth are generally encouraged to stick with their plan so that maternity hospitals can continue to deliver safe maternity care to all women having babies. It's rare but, if something goes seriously wrong during your labour at home, it could be worse for you or your baby than if you were in hospital with access to specialised care (source: National Health Service UK, https://www.nhs.uk).

Home births are only recommended for women who are low-risk, which includes:

• Women without pre-existing conditions
• Women with previous uncomplicated births
• Women having a single birth
• Women without pregnancy-related conditions, such as preeclampsia and gestational diabetes

Q. If I do get sick, how do I protect my newborn?

If you do get sick near your delivery date with confirmed or even suspected COVID-19, there are special precautions to be aware of. Though new mothers might not be at higher risk themselves, it is important to avoid passing the virus to a newborn. Different infection control measures may exist in different countries when it comes to neonatal care, so if you are showing symptoms of illness close to your due date, make sure to check the guidance with your maternity hospital directly.

Early research has not shown evidence that the virus can be transmitted in utero, during delivery or through breast milk. But transmission can occur after birth when infants are in close contact with someone who has the illness (source: Finnish Institute for Health and Welfare, https://thl.fi).

So far it seems that newborns who have contracted COVID-19 have in general been mildly affected by the virus.

Q. If a pregnant woman infected with Covid-19 gives birth will she be separated from her baby?

On the current information available, medics say there is no evidence to suggest that separating a baby from an infected mother will be helpful. Instead, this could cause significant distress for the mum and baby.

Professor Russell Viner, President of The Royal College of Paediatrics and Child Health, said: “The situation is now developing very quickly, and this guidance is based on a thorough review of the evidence – limited though that is. Based on current evidence, we don’t believe that babies born to women who test positive for coronavirus should be separated. The impact of this separation, even as a precaution, can be significant on both the baby and the mother. We will review this recommendation as we see more evidence in the weeks and months ahead.” (source: https://www.rcpch.ac.uk)

If you are pregnant and you start having symptoms like fever, dry cough or shortness of breath, call your ob-gyn. Do not show up unexpectedly at an emergency room or at your doctor’s office. If you don’t currently have an ob-gyn, call the hospital where you plan to deliver and ask to speak to a nurse about what to do.

Q. Can I breastfeed if I’m infected with coronavirus?

Though breastfeeding is ultimately a personal decision, the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO) and the Academy of Breastfeeding Medicine (ABM) all support giving mother’s breast milk to their babies even if they are infected with COVID-19. The W.H.O. and other organizations have said that an infected mother can breastfeed her baby and stay in the same room provided that she takes all necessary hygiene precautions.

Breast milk is packed with nutrients and provides protections against many illnesses. At present, there is no evidence that the virus can be carried in breast milk, so it is felt the benefits of breastfeeding outweigh any potential risks of transmission of coronavirus through breast milk.

Breastfeeding mothers who are infected should wash their hands before touching the baby and wear a face mask or a cloth over her nose and mouth. If the mother is symptomatic and too unwell to breastfeed her baby, she can consider having someone who is well feed expressed breast milk to the infant (source: Breastfeeding Peer Support, https://imetys.fi/in-english).

Q. Is it still safe to go outside with your baby?

The general advice is that infant travel should be limited to medical appointments that cannot be arranged online.

If you need groceries or medication and you’re able to leave your baby at home with a partner or caregiver, it’s best to do so. That said, you don’t need to stay cooped up indoors with your baby 24/7. It is generally acceptable for parents to be outside with their children in the vicinity of the home for fresh air – but always remember to follow the social distancing rules in your specific area.

Q. How can parents of babies prepare for coronavirus?

News about the coronavirus can make you feel helpless. But there are a few steps you can take to keep your family safe:

• Practice good hand hygiene. You've heard it time and time again but wash your hands often with soap and water for at least 20 seconds.
• Follow social distancing. It’s crucial to follow the advice of your local government and practice social distancing.
• Stock up. You don't need to go overboard, but it is a good idea to have supplies for your baby in your home to last for at least a few weeks.
• Order in. If there are delivery options in your area, order in rather than bring your baby to the grocery store or pharmacy.
• Cancel play dates and avoid all unnecessary interactions.
• Keep baby's gear clean, including baby´s bottles, plastic toys, bedding and clothes.