Coronavirus and Pregnancy
18th March 2020
The link between coronavirus and pregnancy is worrying for many women. As the novel coronavirus pandemic moves forward, we’re all concerned about the implications this has on our health, and day to day lives. If you’re pregnant you may be more worried than others. We’ve collected the latest health advice here for you.
As this situation is developing, the advice from the government and health professionals is evolving all the time. We’ll update this blog post daily with incoming new information regarding coronavirus and pregnancy.
If you aren’t currently pregnant yet but are concerned about the impact of coronavirus on your fertility journey, read our blog on COVID-19 and fertility.
Are pregnant women more at risk of coronavirus?
Early indications are that pregnant women don’t react more severely to coronavirus than anyone else. However, as this is a new virus, we don’t know for sure if that is the case. The expectation is that most pregnant women with COVID-19 will experience mild or moderate cold or flu-like symptoms. The more severe symptoms such as pneumonia and difficulty breathing seem to be impacting older people who have weak immune systems and pre-existing conditions.
However, it’s important to remember that if you’re pregnant you are more susceptible to infections. “Infections and pregnancy are not a good combination in general and that is why we have taken the very precautionary measure while we try and find out more,” the government’s chief medical adviser, Prof Chris Whitty explained. For this reason, the government has just released new guidelines for pregnant women.
What are the current guidelines for coronavirus and pregnancy?
The government has issued five points that people in at-risk groups should follow. At this time this group includes the over-70s, those with underlying conditions, and pregnant women. You should aim to follow this advice as closely as you can.
- Avoid contact with anyone who is presenting with symptoms of coronavirus. These include high temperature (above 37 degrees) and/or new and continuous cough.
- Do not use public transport unless absolutely essential. You should work from home. Many employers are implementing infrastructure to help their teams do this.
- The government has officially closed schools, pubs, restaurants and non-essential businesses. People are to stay at home, and only leave for absolute essentials like food and medicine. Additionally, people are allowed to take one outdoor exercise a day whilst adhering to social distancing rules (staying 2 meters away from others).
- Use technology to stay in touch with friends and family so you can avoid getting in to close physical contact with them (we know this one will be hard!)
- Use the internet and phone to contact health professionals.
Currently, the advice for pregnant women is to stay at home for 12 weeks. This is also the advice for ‘at-risk’ groups: mainly the elderly or immunosuppressed. The UK government hasn’t yet officially advised this. We will continue to update this blog.
What effect could coronavirus have on my unborn baby?
As this is a new virus we are still learning about its wider effects. Currently, there is no evidence to suggest coronavirus increases the chance of miscarriage. Some babies were born to women in China who were showing symptoms of coronavirus. We’re not currently sure whether this is because doctors decided to induce labour early, since the mother was unwell. As of now, there’s no evidence to suggest the virus can be passed on to your developing baby in the womb. Some newborn babies have tested positive for the novel coronavirus, but we don’t know whether they contracted this in the womb or shortly after delivery. Early research from China shows no traces of the novel coronavirus in the amniotic fluid, breast milk or umbilical cord blood.
Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, said: Research and data are key to monitoring the ongoing situation and the UK Obstetric Surveillance System – UKOSS – will monitor all cases of pregnant women who have a diagnosis of coronavirus.
What is the travel advice for pregnant women?
As of now, you should stay at home and not travel abroad. If you are in the UK, you should follow the advice given by the Foreign and Commonwealth Office, which is being regularly updated as the situation develops.
If you have to travel, or are currently abroad, do ensure your insurance covers birth and care for your newborn baby, should you go into labour whilst abroad.
What should I do if I’m pregnant and think I may have coronavirus?
If you have either a high temperature or a new, continuous cough you should stay at home for 14 days. New government advice is that everyone in your household should also self isolate for the same period.
You do not need to contact 111 or your doctors if you need to self-isolate. However, you should contact your maternity unit to inform them you have potential symptoms of coronavirus and will not be able to make any routine appointments in the next 14 days.
You should only call 111 if your condition gets worse to the point where you are struggling to manage your symptoms at home or if your symptoms continue after 7 days. If you are concerned about the welfare of your or your unborn baby during self-isolation contact your midwife or maternity unit. They will be able to advise you whether you should go to the hospital. If you have to go to hospital, you’ll be asked to travel in private transport, and alert triage before you enter the hospital.
Will I be tested for coronavirus?
The testing process is changing rapidly. Currently, the NHS is testing only those with severe symptoms, who require overnight admission to hospital. If you do require a test, the test is safe for pregnant women. Currently, the test involves swabs from your nose and mouth. You may be tested if you have a productive cough, producing mucus. In the event that you test positive for coronavirus, you should contact your midwife and maternity unit to inform them. Those with mild symptoms should be able to recover at home – as you would with the normal flu. You should obviously self isolate for as long as possible whilst you recover.
What should I do if I need to self isolate?
If you have been advised to self isolate you should stay indoors and avoid contact with other people for at least 14 days.
- Not going to school, work or public places
- Avoiding the use of public transport
- Refraining from having visitors in your home
- Ventilate rooms and open windows to help clear the air
- Ask friends and family to help run errands and get your supplies – or use delivery services. But make sure they leave things outside your front door.
You can use this time as an opportunity to look after yourself and dedicate time to self-care. Try to ensure you are keeping up a healthy diet and low-level exercise routine as much as possible. Self care is more important than ever right now. You can listen to our meditation podcast: Calm Pregnancy for reassurance and to relax.
If I am in self-isolation will I still be able to attend my regular antenatal appointments?
When you tell your midwife or maternity ward that you’ve gone into self-isolation, they’ll give you advice on a case-by-case basis.
It’s likely that routine appointments will be delayed until your isolation ends. If its an important appointment, or you’re a high-risk pregnancy, they may ask you to attend. If so, your midwife or maternity ward should take precautions to ensure your safety and that of others. They might ask that you attend a different clinic, or come at a different time.
What happens if I go into labour during self-isolation?
If you go into labour, call your maternity unit immediately and make sure they know you have suspected or confirmed coronavirus. As with all labours, the NHS will encourage you to stay at home for the early stages, unless they feel you or the baby are at risk.
When your team advise you to attend the maternity unit, there are some pieces of advice you should follow to protect yourself and others:
- Travel to hospital by private transport where possible
- The team will meet you at the hospital entrance with protective wear (e.g. face masks)
- Your partner can stay with you for the birth but limit other visitors
- You’ll be tested for the novel coronavirus if you’re not already a confirmed case
Will being in self-isolation with suspected coronavirus impact where and how I give birth?
If you have a confirmed or suspected case of coronavirus when you go into labour, precautions will be undertaken to protect you, your baby and others. Women in these cases are being asked to attend an obstetric unit to give birth. This means that your plans for a home birth or birth at a midwife-led unit may need to be changed. This is so the baby can be monitored using continuous electronic fetal monitoring, to ensure they are coping with labour, and your oxygen levels can be monitored hourly.
There is currently no evidence to suggest you cannot give birth vaginally. If you’re struggling to breathe, labour ward staff might recommend a Caesarean. Likewise, there’s currently no reason to believe that you can’t have an epidural. However, gas and air could potentially spread the virus. Your maternity team will be able to advise you of all of your pain relief options. There is currently no evidence concerning transmission through genital fluids.
What will happen to me and my baby after birth if I have suspected or confirmed coronavirus?
If there is a chance you have coronavirus, your baby will be tested after you give birth. As long as your baby doesn’t need specialist care, you will be able to stay together after birth. This advice is likely to develop, but ideally, healthcare professionals will want to keep you together so you can bond. Breastfeeding is another hugely important part of bonding for mother and baby. Currently, there is no evidence that the virus can be carried in breastmilk. However, the close proximity between you and your baby could be a cause of concern. If you want to breastfeed you are advised to wash your hands before touching your baby, breast of breast pump. You should also consider wearing a face mask whilst breastfeeding.
Professor Russell Viner, President of the Royal College of Paediatrics and Child Health, said: “Similarly, our advice is that it’s fine to breastfeed – any potential risks are outweighed by the benefits. We will continue to review the evidence as it emerges.”