Your questions about how covid-19 can affect your pregnancy and birth
Is Pregnancy a Risk Factor for Coronavirus?
A very important question in regards to pregnancy is whether pregnancy is a risk factor for COVID-19, in terms of being infection, severity of the disease and the death rate in mother and fetus.
The answers seems to be that yes it is a risk factor for at least severity of the disease in the mother and there is insufficient data regarding the fetus outcomes currently. A recent study from Sweden has found a five times greater risk of ICU admission and four times the risk of receiving mechanical ventilation than non pregnant women.
Now the CDC has released the results of its study lasting from January 22–June 7, as part of COVID-19 surveillance. Of the 91,412 women with laboratory-confirmed COVID-19 infections; nine percent were pregnant.
Among pregnant women with coronavirus, almost a third - 31.5% - reported having been hospitalised compared to almost a fifth of that amount - 5.8% - in women who were not pregnant. After adjustments for a variety of known risk factors such as age and other medical conditions, - the relative risk of being hospitalised for a pregnant woman was 1.5 times that of a non-pregnant woman and 1.7 times the risk for intubation and mechanical ventilation. Interestingly however the rate of death was similar suggesting that though the disease is more severe - it does not cause a higher mortality rate -
The CDC wrote that "To reduce occurrence of severe illness from COVID-19, pregnant women should be counseled about the potential risk for severe illness from COVID-19, and measures to prevent infection with COVID-19 should be emphasised for pregnant women and their families”. “We think it’s important to get the information out there that pregnant women need to take precautions,” Dana Meaney-Delman, CDC’s Covid-19 deputy incident manager, said.
The results also indicated that although data on race/ethnicity were missing for 20% of the pregnant women in the study, as with the general population, Black and Hispanic pregnant women were disproportionately impacted.
One issue with the study data needed to distinguish whether the hospitalisation was due to pregnancy related conditions or COVID-19 were not available. Also one can understand that hospitals may have a lower threshold for admitting pregnant women. However ICU admission and receipt of mechanical ventilation are distinct proxies for illness severity and the risks for both outcomes were significantly higher among pregnant women than among non-pregnant women.
The CDC further stated: "Although additional data are needed to further understand these observed elevated risks, pregnant women should be made aware of their potential risk for severe illness from COVID-19. Pregnant women and their families should take measures to ensure their health and prevent the spread of SARS-CoV-2 infection.”
Specific actions pregnant women can take include:
- not skipping prenatal care appointments,
- limiting interactions with other people as much as possible,
- taking precautions to prevent getting COVID-19 when interacting with others,
- having at least a 30-day supply of medicines,
- and talking to their health care provider about how to stay healthy during the COVID-19 pandemic.
While the agency wasn’t able to assess the effects of the virus on the fetuses or babies born to those women since the pandemic hasn’t gone on long enough, pregnant women who get Covid 19 might have an increased risk of preterm labor and birth, when the baby is born before 37 weeks of pregnancy. This seems to be more of a risk in people who get very sick and have pneumonia. Preterm birth can be dangerous, because babies who are born too early can have serious health problems. So it is important to talk to your doctor, nurse or midwife about any symptoms or health concerns you have, even if they don’t appear to be related to Covid 19.
What if I want to breastfeed?
Breastfeeding has many benefits for both you and your baby, but at this time, it’s not known if the virus can be passed to a baby through breast milk.
If you’re sick but still want to have your baby breastfed, you might want to have another healthy adult feed your baby. If that’s not possible, it's important to be extra careful when feeding or holding your baby, whether or not you breastfeed. Even though experts don’t know if the virus can be spread through breast milk, you could pass it to your baby through close contact. You can protect your baby by washing your hands often and wearing a face mask while you feed them.
You might choose to pump breast milk for your baby. Whether you’re sick or not, be sure to wash your hands carefully before pumping, and if you are sick at all or have any symptoms, wear a mask while you pump. If you have the option, it’s a good idea to have someone who isn’t sick, or hasn’t been exposed, to clean your pump thoroughly between uses.
If we are both healthy, can my partner be with me for the birth?
In areas where Covid 19 is spreading quickly, some hospitals have rules about who can be in the room during labor and delivery. Your doctor, nurse, or midwife will be able to tell you what to expect, knowing the situation may change based on the spread of the virus in the area. Your partner won’t be allowed to be with you if they have symptoms of Covid 19, have tested positive for the virus, or might have been exposed to someone who has it. If your partner can’t be with you, talk to your birth team about possibly having them available through phone or video during the birth.
Some people wonder if it would be safer to give birth at home instead of at the hospital. If you are curious about this, talk to your doctor, nurse, or midwife. Home birth has risks, too.
What will my delivery be like?
During your delivery you’ll be checked for fever and other symptoms of Covid 19 when you get to the hospital or birth center. Depending on where you live and if you have symptoms, you might also be tested for the virus. Even if you feel healthy, you should cover your nose and mouth with a cloth mask before going to the hospital. You can also expect to wear a mask during labor and delivery.
If you have Covid 19 when you go into labor, the doctors and nurses will take steps to protect others around you. For example, you will need to wear a medical mask if possible. You will probably still be able to have a vaginal birth, if that is what you planned. You don't need a c-section just because you are sick.
If you’ve tested positive or are suspected positive for Covid 19, you might not be able to hold your baby until you get better. If you do hold your baby, you will need to wear a face mask to lower the risk of spreading the infection. You might need to take other precautions too, and while they may be hard remember, these precaution are to protect your baby.
Will my regular prenatal appointments change?
Your doctor, nurse, or midwife will work with you to make a plan for your visits during pregnancy. If you live in an area where Covid 19 is spreading quickly, there will likely be some changes. For example:
- Your partner might not be able to join you for appointments
- If you have any symptoms of Covid 19, you’ll likely be asked to wear a medical mask during your appointments
- Your doctor, nurse, or midwife might group certain tests together so you don't need to go in as often
- You may be able to have some visits handled via telemedicine, meaning over a phone or video conference.
These changes can feel stressful. It helps to remember that the goal is to help protect you and others.
Can Covid 19 cause problems with pregnancy?
From what experts know so far, most people who get Covid 19 during pregnancy will not have serious problems. But problems can happen if the mother becomes seriously ill.
Pregnant women who get Covid 19 might have an increased risk of preterm labor and birth, when the baby is born before 37 weeks of pregnancy. This seems to be more of a risk in people who get very sick and have pneumonia. Preterm birth can be dangerous, because babies who are born too early can have serious health problems. So it is important to talk to your doctor, nurse or midwife about any symptoms or health concerns you have, even if they don’t appear to be related to Covid 19.
How is Covid 19 treated in pregnant women?
Doctors are studying several different treatments to learn whether they might work to treat Covid 19. In certain cases, doctors might recommend these treatments or taking part in a clinical trial, a scientific study that tests new medicines to see how well they work. But some medicines aren’t safe to take during pregnancy, so you should talk to your doctor about all the risks involved.
Fever is a common symptom of Covid 19. If get a fever while pregnant, ask your doctor, nurse, or midwife what to do. Acetaminophen (for example, Tylenol) can be used to treat a fever and is generally safe to take during pregnancy.
If I am pregnant and get sick, can I pass the virus to my baby?
Experts don’t yet know for sure. They think it’s not likely to happen while the baby is still in the uterus (womb), but mothers with the infection can pass the virus to the baby after it is born.
What should I do if I’m pregnant and have symptoms?
If you have a fever, cough, trouble breathing, or other symptoms of Covid 19, call your doctor, nurse, or midwife. They can tell you what to do and whether you need to be seen in person. They’ll also tell you if you should be tested for the virus.
Are pregnant people at high risk for severe symptoms?
Experts don’t yet know a lot about Covid 19 and pregnancy. But so far, pregnant people don’t seem more vulnerable to the infection than others, nor do they seem to have a higher risk of serious problems (like pneumonia) than other people of similar age. Most people who get Covid 19 during pregnancy recover before having their baby.
What If I'm Pregnant?
If you’re pregnant and you have questions about Covid 19 , talk to your doctor, nurse, or midwife.