The world is holding its breath as we face down the pandemic that is the coronavirus or Covid-19. Among those most fearful are pregnant women and new mothers.
Pregnancy is an emotionally vulnerable time for many women. Hormonal and physical changes are part and parcel of growing a baby, but it is thought that up to 25% of women will also encounter mental health difficulties while pregnant. Likewise, women can feel particularly overwhelmed during the postpartum period.
Given these unprecedented times, where we all feel overwhelmed, it’s completely understandable that expectant mothers are extremely concerned about Covid-19.
What are the facts when it comes to the coronavirus?
How are pregnant women affected by COVID-19?
Pregnant women do not appear to be disproportionately affected, or susceptible to more severe forms of COVID-19. There is, as of yet, no evidence to suggest infection with the virus could lead to miscarriage. Yet pregnant women are advised to consider themselves a vulnerable group by most national health systems as some viral infections can be worse in a small proportion of pregnant women.
It must be acknowledged that due to the relatively short history of the disease, data is only currently available for women who were in the later stages of their pregnancies when they were infected with the virus and there is no data on women who became infected in the first trimester.
How are infants and children affected by COVID-19?
Data on how this dreadful disease affects infants and children is, thankfully, largely positive.
New guidance issued by the World Health Organisation on the clinical management of Covid-19 in recent days serves to reassure woman that relatively few cases of infants confirmed with COVID-19 have been reported, while those that have been reported experienced mild
illness. The WHO also states that no vertical transmission – where a disease is passed from mother to baby during the period immediately before and after birth – has been documented.
Although limited data is available, mostly from China, amniotic fluid from six mothers who tested positive for COVID-19 and cord blood and throat swabs from their neonates who were delivered by caesarean section all tested negative for the virus. Breastmilk samples from these mothers were also found to be negative for the virus.
I am pregnant and I think I have contracted COVID-19. What do I do?
If you begin to feel ill and experience symptoms of cough, fever and/or difficulty breathing, you should stay at home. Call your doctor/midwife for advice, stating that you are pregnant.
Do not attend routine hospital appointments if you are symptomatic. Make a plan with your healthcare provider about the remainder of your antenatal care.
Can I still breastfeed if I have COVID-19?
Women who are suspected, probable, or confirmed to have COVID-19 are being encouraged to commence/continue to breastfeed, but with the appropriate precautions taken to avoid infection. The WHO states that the benefits that breastfeeding confers in terms of morbidity and death throughout infancy and childhood are significant, particularly in a world where the novel coronavirus is circulating, and say standard infant feeding guidelines apply.
How do I protect my baby?
The WHO advises that symptomatic mothers who are breastfeeding or practising skin-to-skin contact or kangaroo mother care should practise good respiratory hygiene, including during feeding. For example, wearing a medical mask when near a child if the mother has respiratory symptoms is recommended. Of course, it also includes good hand hygiene before and after
contact with the child, and the routine cleaning and disinfecting of surfaces that the mother may have been in contact with.
In situations when a mother with severe illness from COVID-19 or other complications prevents her from caring for her infant or prevents her from continuing direct breastfeeding, mothers should be encouraged and supported to express milk, and safely provide breastmilk to the infant, if possible.
Even if a mother or infant has suspected/confirmed COVID-19, the WHO explicitly states that they should be enabled to remain together and practise skin-to-skin contact or kangaroo mother care throughout the day and night, especially immediately after birth during establishment of breastfeeding.
How can I protect myself from getting COVID-19?
The best defence against the virus is to practice excellent hand hygiene, respiratory etiquette (coughing into elbow/clean tissue), and avoid touching your face. You should also be practising social distancing by avoiding large gatherings and unnecessary journeys.