Pregnancy is a time of great joy and expectation for most women and their families. Following the declaration of the COVID-19 (coronavirus) pandemic, we understand that all pregnant women will feel a great sense of anxiety about their own health and that of their unborn or newborn baby. The following information is to inform our patients of the knowledge available to us now regarding risks to pregnant women and their offspring, advice regarding self-care during pregnancy and changes to the way that antenatal and postnatal care will be delivered.
How does Covid-19 affect pregnant women and babies?
As this is a new virus, there is only limited information available on the effects to pregnant women and their babies. RANZCOG have based their medical advice on information known from Influenza and the SARS epidemic in 2003.
Influenza is a potentially serious disease for pregnant women, the fetus and newborn babies. A number of changes occur to a woman’s body during pregnancy. Due to these changes, pregnant women have an increased risk of severe complications from influenza.
Are pregnant women a vulnerable or at risk group?
Correctly, pregnant women should be considered a vulnerable or at-risk group. However, at this time, pregnant women do not appear to be more severely unwell if they develop COVID-19 infection than the general population. It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms.
How will Covid-19 affect my pregnancy?
For women who are trying to conceive, or who are in early pregnancy, there is no evidence to suggest an increased risk of miscarriage with COVID-19. Furthermore, there is also no evidence that the virus can pass to your developing baby while you are pregnant (this is called vertical transmission) or that the virus will cause abnormalities in your baby.
Should I have a Caesarean section or an Induction of Labour if I get Covid-19?
There is no evidence a Caesarean or Induction will stop the transmission of Covid-19 to a fetus if delivered earlier. A Caesarean or Induction is not needed unless there are immediate risks to mother’s health, or other obstetric indications.
Should I still get the Flu vaccine and whooping cough vaccine?
Yes, it is very important to have these vaccines during pregnancy
Is it safe to have my baby at the hospital with the Covid-19 virus around?
One of the safest places to birth your baby is in hospital where you have access to highly trained staff and emergency facilities, if they are required. Medical intervention, other than that specifically related to infection control, should not differ significantly from usual practice. Active mobilisation, use of water immersion in labour, nitrous oxide and epidural analgesia are not affected.
Can I Breastfeed my baby?
Women who wish to breastfeed their babies should be encouraged and supported to do so. At the moment there is no evidence that the virus is carried in breastmilk and, therefore, the well-recognised benefits of breastfeeding outweigh any potential risks of transmission of COVID-19 through breastmilk. If the mother has COVID-19 infection she should not be automatically separated from her baby, but should take enhanced precautions with general hygiene and consider a face mask when feeding.
What precautions for pregnant women need to make to avoid Covid-19?
- Hand washing regularly and frequently with an alcohol-based hand rub or soap and water
- Avoidance of anyone who is coughing and sneezing
- Avoid touching eyes, nose and mouth
- Social-distancing and reducing general community exposure
- Early reporting and investigation of symptoms
- Prompt access to appropriate treatment and supportive measures if infection is significant
- Limit support person to one
- If your partner has COVID-19, or is symptomatic, they should not accompany you to the hospital
Pregnant women are advised to avoid all non-essential travel. Generally speaking, it is safest to stay at home and to avoid public spaces. Reduce your use of public transport and work from home, if possible.
Will my care change as a result of Covid 19?
Changes to routine antenatal care, that have been suggested, but are not limited to, include:
- Reducing, postponing and/or increasing the interval between antenatal visits
- Limiting time of all antenatal visits to less than 15 minutes
- Using telehealth consultations as a replacement, or in addition to, routine visits
- Antenatal classes are being offered in a non face to face format (ie: Skype)
- Limiting visitors (partner or support person only) while in hospital
- Considering early discharge from hospital
If I get symptoms of Covid-19 and am pregnant or recently had my baby what do I do?
If you develop cold/flu symptoms (fever, cough, sore throat, nausea, vomiting, diarrhoea, fatigue, difficulty breathing) please arrange an urgent medical review for consideration of COVID-19 testing.
Shoalhaven Hospital Assessment Clinic – 1300 002 108
Wollongong Hospital Assessment Clinic - 42225078
Shellharbour Hospital Assessment Clinic - 42952862
If you have any of these symptoms, or are required to self-isolate, or are diagnosed with COVID-19, you should notify your healthcare provider to reschedule or delay your appointment. This will enable you to continue to receive antenatal or postnatal care and reduce the risk to other pregnant patients or health workers.
Finally, your doctors, midwives and other health workers care about you and your baby. We understand that you will feel worried. Take the opportunity to rest, eat well and maintain your interests and hobbies, where possible. Your baby has the best protection it will ever have i.e. you, so caring for yourself, your emotional and physical health, is what is most important. We want to reassure you that the risk to you, and your baby, is extremely small.
The staff of the Illawarra Shoalhaven Local Health District understand that everyone is very concerned at this time, perhaps more so when you are expecting or have just had a baby.
Please continue to follow the ISLHD updates on our Facebook page at: https://www.facebook.com/IllaShoalHealth/
Discuss with your doctor, midwife or nurse if you feel your mental health is suffering and you would like help. The following links may also be useful:
Beyondblue - https://www.beyondblue.org.au/
PANDA (Perinatal Anxiety & Depression Australia) - https://www.panda.org.au/
COPE (Centre of Perinatal Excellence) - https://www.cope.org.au/
Black Dog Institute - https://www.blackdoginstitute.org.au/
Healthdirect hotline - 1800 022 222
National Coronavirus Information line - 1800 020 080