Pregnancy During the COVID-19 Pandemic
The global pandemic of COVID-19 has everyone feeling scared and anxious. Being pregnant can be especially overwhelming because in addition to being worried about your own health, you are equally worried for the health of your unborn baby. In the age of information, it’s hard to know what information to trust and believe. In an effort to ease the anxiety in our pregnant population in such challenging times, this post provides information about what we currently know about COVID-19 and its impact on pregnant women and newborns. Please note that while some of the information in this post can be relevant to the general public, it was written to provide information specifically for pregnant women.
* Disclaimer: The information in this post is only as current as May, 2021. The Novel Coronavirus is a new disease and new findings and information are being released frequently. We have made every attempt to present information from trusted sources but things can change very quickly. New information can always come to light which may change the information in this post. This post is meant for informational purposes only and should not replace information or medical advice provided by your primary health provider.
What is COVID-19?
COVID-19 is a virus in the family of Coronaviruses that causes mild to severe cold or flu-like symptoms in humans. There is a vaccine available now. Speak to your primary care provider about any reason why you should not get the vaccine. The Society of Obstetricians & Gynecologists of Canada currently supports pregnant and breastfeeding individuals getting the vaccine with no contraindications.
Flu-like symptoms of COVID-19 can include:
Cough
Fever
Difficulty breathing or shortness of breath
Other symptoms include:
Fatigue
Muscle aches
Loss of appetite
Loss of smell
Runny nose or nasal congestion
Pink eye
Sore throat
Nausea, vomiting, diarrhea
Symptoms can take up to 14 days to appear after exposure to someone who is positive.
How is COVID-19 Diagnosed?
COVID-19 is diagnosed using a nasal pharyngeal swab. This is a swab that is administered deep into the nasal cavity that can cause gagging or coughing. The swab results can take many days to yield a result. Your testing center will give you information about when to expect results.
How is COVID-19 Spread?
Current evidence suggests that you can contract COVID-19 from:
Touching a surface which contains that virus and then touching your mouth, eyes or nose before washing your hands
Someone who is positive and sneezes or coughs (the virus is contained in droplets spread via sneezing or coughing in a positive person)
Being in close and prolonged contact with someone who is positive (ex: shaking hands)
How to avoid getting infected:
Wear a mask whenever indoors and when physical distancing is not possible
Practice good hand hygiene (i.e. wash your hands frequently and after every outing)
Wipe down commonly used surfaces with antibacterial wipes
Avoid close or prolonged contact with others (physical distancing)
How is COVID-19 Treated?
Treatment is based on symptom management and can be done at home when symptoms are mild. This means you can take some over the counter medications that are deemed safe in pregnancy as discussed with your primary care provider. For example, Tylenol is often helpful for pain and fever relief. Always check with your primary care provider before taking medications as even some over the counter medications are not safe in pregnancy.
The Society of Obstetricians & Gynecologists has a statement regarding vaccination during pregnancy, see the link below:
https://www.sogc.org/common/Uploaded%20files/Latest%20News/SOGC_Statement_COVID-19_Vaccination_in_Pregnancy.pdf
What If I Think I Might Have COVID-19?
If your symptoms are mild, they can be managed with fluids, and over the counter medication deemed safe in pregnancy. If this is the case, you can proceed to a testing center then return home and wait for your test results.
If symptoms are severe and include nausea and vomiting with an inability to drink fluids, difficulty breathing, or suspected pneumonia (heavy chest congestion and difficulty breathing), then proceed to your labour and delivery triage department* for assessment, testing and potential hospital admission.
* Each hospital recommends assessment in labour and delivery triage or the emergency department depending on how many weeks pregnant you are. For example, if you are less than 20 weeks pregnant some hospitals will direct you to the emergency department for assessment instead. Check with your primary care provider for details on which department to get assessment from.
What We Know So Far About COVID-19 Positive Pregnant Cases Worldwide:
Many pregnant women have no symptoms or mild symptoms with outcomes for mom and baby that are generally good
While pregnancy itself is not an added risk factor for the disease, being sick while pregnant may increase the chance of a preterm delivery
As far as we know, there is no transmission of the virus in-utero
Breastfeeding your newborn is safe but extra precautions (explained further below) may be required
The COVID variants during the third wave have affected some pregnant individuals more severely requiring hospitalization and admission to intensive care units in Toronto (April 2021)
What to Expect During Your Hospital Stay for the Birth of Your Baby
If you are asymptomatic or negative for COVID-19:
All hospital personnel (doctors, nurses, service assistants) will be wearing masks. Hospital personnel will be wearing additional protective equipment (face shield and gown) when exposure to bodily fluids is high. You will be restricted to one support person attending the birth. Your support person must be asymptomatic or COVID-19 negative. No other visitors will be able to attend the birth or visit you during your hospital stay. Hospital policy may have restrictions on your support person entering and exiting the hospital. For example, your support person may only be able to leave and return to the hospital once in 24 hours. Your support person may be restricted to getting meals from the hospital food vendors. Your support person will be encouraged to stay in your hospital room as much as possible. To help you deal with these restrictions, you should bring anything you’ll need for a 24-hour stay when you get admitted to hospital. You and your support person must wear a mask when entering the hospital and you will requested to wear one for the duration of your hospital stay including in your hospital room. Talk to your primary care provider about the current policy on mask wearing for you and your support person during your hospital stay.
If you are symptomatic and under investigation for COVID-19 or positive for COVID-19:
All hospital personnel interacting with you will be wearing additional personal protective equipment. This equipment includes a mask, face shield, gown and gloves. No visitors or support persons will be able to attend the birth or visit you during your hospital stay (can vary between hospitals). This is done to limit the spread of the disease to the hospital staff and other patients. Your baby may be tested for COVID-19 after the birth. You can breastfeed but you will be instructed to wear a mask and practice hand hygiene often. If you develop symptoms while in hospital delivering your baby then you are now considered a person under investigation (PUI). If you are a PUI then your support person can stay with you but can no longer leave your hospital room. If you become a PUI speak to your healthcare team about new restrictions to you, your baby and your support person during your hospital stay.
Prenatal Appointments
Speak to your primary care provider during pregnancy about how COVID-19 is changing your prenatal appointment schedule. Many primary care providers are decreasing the number of appointments to essential visits only. The number of essential visits are determined by each care provider based on your and your baby’s health needs. You may be asked to attend these appointments without your support person. If you have concerns regarding your or your baby’s health speak to your primary care provider for information and support.
Many mental health professionals have moved their practices to virtual appointments. If you are feeling anxious and need support, don’t hesitate to ask your primary care provider for a referral to a mental health professional (psychiatrist, psychologist, social worker). These are difficult and stressful times and your mental health during pregnancy and as a new mother is just as important as your physical health. Please don’t hesitate asking for help.
What You Can Do to Stay Safe and Healthy
Stay home and go out only when necessary
Practice hand hygiene and wipe down surfaces with antibacterial wipes
Practice physical distancing and avoid contact with others
Wear a mask whenever indoors and whenever physical distancing is not possible
To help with coping during this time, you should try doing things that make you feel at ease, relaxed and decrease your stress levels. For example:
Cook at home
Exercise at home
Take walks in your neighbourhood (while physically distancing)
Spend quality time with your partner before baby is born
Organize the baby room/space
Stay in touch with family and friends via phone/face-time
Please remember that government and hospital policies are changing very fast and without much notice, so speak to your primary care provider and your hospital about changes in your prenatal care and hospital stay. Sending much love to you and your families at this time!
Additional Resources
https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks.html
https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks.html#hygiene
https://www.sogc.org/en/content/featured-news/Updated-SOGC-Committee-Opinion%E2%80%93%20COVID-19-in-Pregnancy.aspx
https://www.cfpc.ca/Pregnancy/
https://www.healthlinkbc.ca/health-topics/uf9707
https://www.pregnancyinfo.ca/wp-content/uploads/2017/04/PDF_medicationsanddrugsinpregnancy_ENG.pdf