Pregnancy is a special event for a woman and her family. During pregnancy, the mother’s emotions can range from happiness to anxiety to depression. At present, when the whole world is dealing with the pandemic brought about by the novel coronavirus (SARS–Cov 2), it is a particularly stressful situation for all moms–to–be. However, if we follow all follow the recommended precautions, we can sail through this time safely.
COVID-19 and Pregnancy – Why should we worry?
Pregnant women are considered a special, high-risk group. This is due to their unique immunological condition wherein the woman’s immune system is altered to prevent the body from rejecting the growing fetus. This makes pregnant women more susceptible to infection, including respiratory infections like the ones caused due to coronavirus.
As it is a novel virus, there is a paucity of information about its risk on pregnancy. Studies published till date are small and conclusions vary as while some pregnant women were found to get asymptomatic and mild infections, others showed an increased need for hospitalization and intensive care.
Effects of COVID-19 infection on mother and fetus
There may be an increased risk of preterm birth according to the CDC, but most studies concluded that the COVID-19 infection does not get aggravated by pregnancy unless there are comorbidities. There is no evidence of any abnormalities in the unborn baby or spread of COVID-19 from the mother to the fetus at present.
However, since there are so many unknown factors about how coronavirus impacts pregnant women, it is imperative to follow guidelines.
What precautions should be taken?
– Stay at home as much as possible unless there is a need to visit the doctor or hospital-related to development of symptoms of infection or related to pregnancy.
– Stock up your daily medications, prenatal vitamins, etc.
– Exercise as per your doctor’s advice. Eat well and build your immunity.
– Limit the traffic of home visitors including homecare personnel, maids, and staff members or avoid completely if possible.
– Always wear a mask while going out. Avoid coming in close contact with others who are not wearing face covers.
– Practice social distancing if at all you need to go out. Keep a distance of at least 1 meter from the next person outside and in the house.
– Avoid non-essential travel. If travel is undertaken, it is preferable to use a private vehicle. If public transport is used, maintain social distancing.
– Wash your hands frequently and properly with soap and water or clean with an alcohol-based hand rub for a minimum of 20 seconds.
– Avoid touching face, eyes, nose and mouth.
– Talk to your employer and work from home, if possible.
Routine care before delivery:
– Do not skip your routine appointment. If you are apprehensive about visits to the clinic, speak to your doctors and enquire about the precautions they are taking to prevent exposure to the infection.
– Call before you visit their office, they might want to cancel or postpone the visits. If there is a minor query, prefer sorting it out telephonically. At present, telephonic consultations are permitted by the Medical Council of India until the situation comes under control.
– Essential milestone visits such as the 12th- and 19th-week scans are needed. Women are advised to note fetal movements every day. The next visit can be at 32 weeks of pregnancy.
– Regular monitoring of blood pressure, weight gain can be done at home. Maintain a record that can be sent to your doctor for telemedicine.
Pregnancy with COVID infection – suspected/confirmed:
Most pregnant women will have mild to moderate symptoms like cough, sore throat, and fever. Few may have difficulty breathing or shortness of breath. Guidelines of admission/home isolation remain the same as for non-pregnant.
Follow these to home quarantine guidelines:
– Separate yourself from other people in your home.
– Wear a surgical, three-layered mask all the time.
– If you have any comorbid conditions like diabetes, hypertension, asthma, you may have added risk.
– Get yourself some medical care right away if you feel difficulty in breathing, chest pain, sudden confusion, blue discoloration of lips or face.
There is no rationale to induce labor or deliver a woman early because of COVID-19 infection. Decisions regarding the route of delivery are according to obstetric practice in most situations. Here are some tips for an easy delivery process:
– Plan the delivery in a well-equipped hospital or hospital-based health center.
– Wear a mask throughout your stay at the hospital.
– Enquire how many visitors will be allowed in the hospital as hospitals may limit this number to avoid overcrowding.
After delivery care – Breastfeeding
Breast milk is the best source of nutrition for most infants. We do not know whether mothers with COVID-19 can transmit the virus via breast milk, but the limited data available suggests that this is not likely. Whether to start or continue breastfeeding should be determined by the mother in coordination with her family and healthcare providers.
Take the following precautions to prevent spreading the infection to your baby.
1. If you are confirmed with COVID-19 infection and have symptoms but wish to breastfeed your baby:
– Wash your hands before and after touching her baby.
– Practice respiratory hygiene by wearing a mask and not sneezing in front of your baby or during breastfeeding.
– Keep the baby cot at a distance of 6 feet.
– Allow only a healthy caregiver to handle your baby for the rest of the essentials.
2. If you are confirmed with COVID-19 infection and have symptoms and wish to express breast milk:
– Use a dedicated breast pump and don’t share it.
– Wash your hands before touching any pump and bottle.
– Keep wearing a mask while your pump out milk.
– Clean the pump kit thoroughly with soap and water. Let it air dry after that.
– Consider asking someone who is well to feed expressed milk to the baby.
– As per the protocol, get your baby tested.
Simple tips to lessen the stress
– If you have any doubts or feel anxious, talk to your healthcare personnel. Most hospitals have protocols in place to prevent the transmission of COVID-19 infection.
– Work out your delivery plan with your doctor to prevent last-minute panic.
– Consider taking up a new hobby or acquiring a new skill.
– Do things that make you happy and put your mind at ease such as taking a long shower, meditating, or reading a book.
– Reach out to your family and friends.
Be positive, stay home, stay healthy.
(The article is reviewed by Dr. Swati Mishra, Medical Editor)