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Pregnancy during this pandemic (Covid-19) – FAQs

Oct 1, 2020

COVID-19 and Coronavirus are the most uttered words now a day across the globe. This Covid-19 pandemic has put a huge impact on mankind and currently, we are living a life characterised by strange and perturbed stillness. We all are invaded by fear, a dismal tocsin. In this difficult time, all of us especially expectant mothers and their family members are very much concerned about the health. Besides, parents-to-be are also worried thinking about several factors and potential risks which are associated with pregnancy such as prenatal and postnatal health check-up, pregnancy-related clinical examinations, hospitalisation, and new-born baby care, etc. amid of this Covid-19 outbreak.

If you are pregnant during this pandemic, you defiantly have numerous questions swirling in your head regarding this coronavirus.  The answers are not crystal clear yet, because epidemiologists and virologists are still researching to figure out the information regarding this. Here we have answered some common FAQS (frequently asked questions) that women who are navigating pregnancy want to know during this time of the pandemic. 

What is COVID-19?

COVID-19 is an infectious disease caused by the newly discovered Novel Coronavirus (nCoV) that affects the lungs and breathing system. Reported illness has ranged from mild symptoms to severe illness and sometimes death. 

Common symptoms include:

  1. Cough
  2. Fever
  3. Headache
  4. New loss of taste or smell
  5. Repeated shaking with chills
  6. Sore throat
  7. Shortness of breath
  8. Diarrheas
  9. Muscle pain

Symptoms generally appear between 2 to 14 days you are espoused to the virus. Some of the people with Covid-19 may not experience any of the symptoms at all who are called ‘Asymptomatic COVID patients’.

Is there any difference in symptoms of coronavirus disease for pregnant women?

There is no such difference between the clinical manifestations of Covid-19 positive pregnant and non-pregnant women. In either case, infected persons are likely to experience the common symptoms of Covid-19 (See above). 

So if you are pregnant and suspect that you may contract Covid-19, immediately consult medical experts because during this stage any kind of negligence could jeopardise the health condition including your baby.

What should I do if I am pregnant and diagnosed with Covid-19?

If you are tasted positive during pregnancy firstly you should not get panicked. Immediately get in touch with your ob-gyn and other health care experts for advice.

Please find the mentioned points listed below which are the common guidelines for the people with COVID-19:

  • Stay home except you need to visit the medical center. 
  • Avoid public transport and social gathering.
  • Separate yourself from others in your home.
  • Always use a face mask.
  • Always Get in touch with your health care experts. In this present situation, they are using telemedicine (remote clinical services) and tele-health (remote non-clinical services) via telecommunication technologies to assist the patients remotely.
  • In case if you feel worse or anything that implies an emergency please arrange medical care at the hospital immediately. 

Does COVID-19 cause birth defects?

This is a million-dollar question and very difficult to answer as there is not enough data to confirm anything in this regard. 

With every normal pregnancy, there is a small amount of possibilities (3.5%) of having a baby with birth defects. According to the doctors, a high fever during the first trimester can increase the chance of having a baby with birth defects. As of now, there are no published data that can analyze and indicate the relation of having a baby with a birth defect and COVID-19.

If you are sick with COVID-19 or other illness that develops a high fever, please get in touch with your health care professionals. 

Are pregnant women at higher risk of Coronavirus?

This is yet to know to get confirmed about the fact that where pregnant women are more susceptible to coronavirus or not.  Generally, like normal people, pregnant women are also likely to experience mild to moderate symptoms of Covid-19 if they are infected. However, women having a preexisting medical condition such as high diabetics, Asthma may experience severe symptoms of Covid-19. However, it is always recommended for pregnant women to take extra precautions during this time of the pandemic. 

What Precautions to be taken for pregnant women against Coronavirus?

Pregnant women are advised to take extra precautions against Coronavirus to protect herself and the expecting baby. Some of the statutory measures that can be practiced for ensuring safety during this pandemic have been listed below.

  • Wash your hands frequently with soap (at least twenty seconds) or sanitizer containing 70% of alcohol. Hand hygiene is really effective to get protected against the virus. 
  • Practice social distancing at least 6 feet from others. It is always recommended for pregnant women to reduce their social exposure to avoid contact with others.
  •  Go out of your home only when it is extremely necessary. 
  • Try to schedule a virtual consultation with your doctors when required. 
  • However, there will be some medical procedures which demand your physical presence such as Ultrasound or some other pregnancy-related tests. Additional precautionary measurement has to be maintained in such a situation. 
  • Don’t forget to use a face mask while going outside or in contact with people other than your family members.  
  • Use a tissue when you cough or sneeze and after using this throw it to the trash. 
  • Do not ignore any kind of symptoms that are related to COVID-19. If you experience any of the symptoms like cough, sneeze, fever, respiratory discomfort, loss of sense of taste and smell, do not hesitate to call your doctor. A medical expert can decide whether you need to be tested for COVID-19.
  • If you find anyone from your family circle having some symptoms of Coronavirus always try to refrain yourself from their close proximity.  
  • At this time you will definitely get support from your friends and other family members. So, get in touch with them via phone calls, Whats app and other social networking sites. 
  • Adopt habits that can keep your mind cheerful and stress-free. You can exercise yoga as per your doctor’s advice.
  •  If your due date is approaching, do not get anxious because the hospitals already have taken the mechanism to minimize the risk of exposure as far as this Coronavirus is concerned. 

Is COVID-19 communicable from a pregnant woman to the fetus?

Till now doctors and researchers don’t have any evidence that shows that the virus gets contracted during pregnancy. Apart from that study suggests that the virus is not found in mother’s breast milk as well as in amniotic fluids. 

However, every pregnant woman is advised to maintain proper restrictions and precautions to ensure the safety of the newborn.

What effects will Coronavirus have on your baby, if the mother tested positive?

As this virus is new to the doctors, all the characteristics are not understandable to them. There is no such data and reference that can imply the high chance of miscarriage if the mother is tested positive. On the other hand, there is no such evidence that shows vertical transmission. Vertical transmission is a medical terminology used to define the passage of a disease-causing agent (pathogen) from mother to baby during the period immediately before and after birth.

In an article published in China whether all the babies, whose mothers are tested COVID positive, are confirmed negative for the virus and are healthy and well. Contradictorily, an incident has been reported in UK where a COVID positive mother gives birth to a baby who is tested positive for the virus. However, it is not conspicuous whether the baby contracted this viral infection from the uterus or shortly after birth.  According to the experts, this is very much unlikely for the baby to be exposed to Coronavirus during pregnancy.

What is the hospital’s policy during this time of the COVID-19 pandemic?

This is very difficult to answer because every hospital has a different policy and the policy can change week to week based on the situation of COVID-19. Here, we are presenting the standard operating procedures that the hospitals are currently following. 

Antenatal care

  1. Women should be advised to attend their routine check-up properly with the doctors. In some circumstances, they can do so by scheduling the appointment via phone calls or video calling.
  2. If you are tested positive or experiencing any of the symptoms of Covid-19, you should contact to a hospital immediately.

Intrapartum care

Once settled in an isolation room, a full maternal and fetus assessment should be conducted to include:

  • Assessment of the severity of the COVID-19 symptoms.
  • Proper monitoring of temperature, respiratory rate and oxygen saturations.
  • Confirmation of the onset of labor.
  • Hourly oxygen saturation during labor.

Care in labor

  • Aim to keep oxygen saturation level greater than 94%.
  • Continuous electronic fetus monitoring.

The mode of birth should not be influenced by the presence of COVID-19 until the patient’s respiratory condition demands urgent delivery.

Postnatal care

 This is not known whether the new-born baby with Covid-19 is at high risk for severe complications. The concern is the transmission of the virus via contact from an infected mother. Facilities should be available to temporarily separate the baby from the mother who has been tested positive until the mother’s transmission-based precautions are not discontinued.

Discharge

Discharge of the postpartum women from the hospital should follow the basic guidelines and recommendations described by the medical authorities. RT-PCR test should result in negative and both the mother and baby should be in stable medical condition.

All the health care provided by the hospitals and birth centers should follow the proper instruction regarding their protection provided by the Health Authorities.

Respiratory Protection:  Three-ply surgical mask accompanied by N-95 mask.

Eye protection:  Goggles or face shields

Body protection:  Single piece Water-resistance head to toe complete gown additionally head, shoe cover and properly fitting gloves.

All the health care providers are advised to maintain correct steps while Donning (Wearing PPE) and Doffing (Removing PPE) which are imperative to protect them from contamination.

Currently in this situation of COVID-19 pandemic, if you are to admit to the hospital for whatever reason (including pregnancy), then you will be tested Covid-19 despite not having any such symptoms. In case of any scheduled surgery, you will be asked to provide the test result before the admission but for an emergency, this will be done as soon as you are admitted and based on the result, they will arrange all the required facilities.

The upshot is, all the hospitals are currently adorned with utmost precautionary measures to ensure safety.

How many visitors can I have during and after birth?

This entirely depends on the hospital or the birth centers you are selecting. In this current COVID-19 pandemic, the visitors will be restricted as per the Government rules and recommendations to prevent the spread of COVID-19. Some hospitals or birth centers allow doula with you. So please get in touch with your hospital administration to get the pertinent answers regarding your queries.  

Where will my baby stay after delivery if I have tested Covid-19?

There are several benefits to have your baby in the same room with you after delivery even if you are Covid-19 positive. It helps you to create bonding with the new-born and at the same time, you can start breastfeeding.

As per the current reports, the risk of the baby getting infected does not change whether the baby stays in the mother’s room or any separate place. Although in some circumstances, you can choose a separate location for your baby. If you and your baby stay in a same room, a safe distance (at least six feet) has to be maintained from the baby’s crib. An enclosed plastic crib can be very useful in this regard.

Staying isolated from your baby, you are still encouraged to breastfeed the infant. If you are very sick and the baby is at high risk of getting infected you can use a breast pump to extract the milk which can be fed to the baby by a healthy caregiver.

You should talk to your health care experts about all those concerns before the due date. Be sure to discuss the best ways to reduce the risk of infection for your baby and support the long-term health of you and your baby.

Would a home birth be safer during the Covid-19 outbreak?

 It is always considered that the safest place to give birth is the hospital or hospital-based birth center. This consideration has not been changed during the outbreak of COVID-19. In case of normal uncomplicated pregnancy still, there will be a small percentage of risk associated with it. If any problem transpires at the time of labor, hospital infrastructure can provide the required care and support to you and your baby which is not possible at home. In this current circumstance, parents-to-be are very much worried about going to the hospitals but be assured that every hospitals especially maternity wards are taking adequate sanitization procedures and undergoing proper precaution to ensure safety.   

May I be able to breastfeed my baby if I have suspected or confirmed Coronavirus?

This is a very important question and the answer is ‘yes’ even if the mother is tested positive, doctors encourage breastfeeding. Breast milk contains many elements to protect the baby from many infections. The benefits of breastfeeding overweigh any potential risks of transmission of Coronavirus via breast milk. As of now, no instance has been found that infants are being contracted this virus through breast milk. The main risk factor associated with breastfeeding is the close proximity of the mother and the newborn baby which can cause droplet infection from the mother to the baby while breathing. Here are some steps that are helpful to minimize this risk of transmission.

  • Maintain proper hand hygiene while feeding, touching the baby, or using bottles or a breast pump.
  • Always use a proper face mask while feeding.
  • Try to avoid sneezing or coughing at the time of breastfeeding.
  • Properly sterilize the bottles and pump if those are required to feed the baby. 
  • In case of severe illness (positive mother), expressed milk from the mother’s breasts can be fed to the infant by a healthy caregiver.
  • You along with your family and health care expert should discuss whether and how to start or continue the breastfeeding.

How can I stay physically healthy during this time of pandemic?

Pregnant women can stay healthy by following the usual recommendations during pregnancy, including:

  • Eating a healthy diet and consuming plenty of water.
  • Exercising regularly and be mindful to stay at home or away from other people while exercising.
  • Getting plenty of sleep. 
  • Avoiding alcohol and tobacco.

You can also talk to your medical expert who can suggest you any additional supplements or vitamins if required to boost your immune system. 

How pregnant women can maintain their mental wellbeing amid of COVID-19?

The Voyaging of motherhood journey is always blissful for every woman. During these nine months, expectant mothers go through mood swings, anxiety, depression and many other emotional roller coasters. Statistic says pre-pandemic, about 15% of mother-to-be experience these emotional health-related issues which are currently increased to 41%. This inclining data graph is very much worrying. The possibility of infection from the virus, physical and mental isolation, potential risk factors associated with COVID-19 at the time of pregnancy are the key factors responsible for imbalance the mental state of parents-to-be by increasing their stress and anxiety during this pandemic. 

Symptoms of mental health issue:

  1. a) Feeling sad and hopeless, helpless or worthless most of the time. 
  2. b) Continuous lack of sleep and loss of appetite.
  3. c) Continuous lack of interest in doing anything.
  4. d) Preoccupied mind with constant negative, scary and unwanted thoughts that are hard to get rid of.
  5. e) Experiencing restlessness and losing temper on trivial matters.
  6. f) Panic attacks.

Mental wellbeing is very important to maintain the overall health during pregnancy not only for the mother but also for the baby. Acceptance is the key step. Being positive, doing good and interesting things, keeping yourself busy, pursuing a hobby and indulging in meditation can be effective to mitigate this situation. Getting connected to your loved one through virtual medium could also comfort your mind during this pandemic. 

If you are in crisis and encounter any of the symptoms related to mental health you are advised to contact medical experts. They can suggest you whether you need any psychiatric counseling session and medication or not. 

Can I travel if I am pregnant?

The government is updating the travel recommendation often. Please follow the government’s Covid-19 information for travel-related inquires. As the Virus is continuously spreading, it is a must to follow travel-related recommendations globally and locally. Please check the necessary information from the health department as well as government-based information centers whether you can travel between your current area and your destination.

I want to get pregnant. Should I wait because of this Covid-19 pandemic?

Pregnancy is a personal choice. If you are planning baby, you should definitely consider all the factors that are currently associated with the pregnancy during this pandemic. Researches don’t show that pregnant women are at high risk of this virus or baby gets contracted by this Coronavirus during pregnancy (if so, this will be a very rare example). Presently, All the hospitals are taking the huge precautionary measurement to surefire the safety of the mother and the baby. But it should be remembered that people with some preexisting health conditions are at high risk of getting sick from Coronavirus infection. 

Considering all those factors including potential risks of COVID-19 and discussing all the concerns with your medical expert if you are firmly convinced then you can go ahead to plan baby during this pandemic.  These are strange times and we must not think the worst part of this global pandemic all the time. 

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