Are pregnant women more at risk for contracting COVID-19?

When the WHO declared COVID-19 a pandemic on March 11, 2020; most of the data we had as a Society came from our studies on the effects the Influenza virus, H1N1 and SARS had on pregnant women. In these cases, we know that pregnant women tend to experience more severe symptoms than non-pregnant women due to the physiological changes in their respiratory systems. However, as COVID-19 continues to evolve, we have seen a major difference in this aspect. In fact, within the 600 reported cases in the medical global literature, we can see that the vast majority of healthy (no underlying conditions) pregnant women seem to be getting COVID-19 at the same rate as someone that is not pregnant and in most cases (85 per cent) they seem to report mild to moderate symptoms. We encourage women to speak to their healthcare providers and enquire about any underlying conditions they might have that could result in severe symptoms to ensure proper safety measures.

How can pregnant women mitigate the risk of transmission?

As physicians, we encourage pregnant women to be careful in their own pregnancies, maintaining social distancing outside the household, ensuring proper hand hygiene, and wearing a mask in public spaces where social distancing is not possible. We encourage women to speak to their healthcare providers and enquire about any underlying conditions they might have that could result in severe symptoms to ensure proper safety measures.

Is it dangerous to get COVID-19 during pregnancy?

According to the data that we have gathered to date in Canada, we have seen very few significant problems in pregnancy or affecting newborn babies. As we continue to learn more about the disease, please visit SOGC.org regularly for more updates. We want to re-assure all pregnant women that the Canadian health care community is doing everything possible to ensure the safety and health of mother and baby.

Is it safe to give birth at a hospital?

Hospital safety protocols across the country have been put in place to ensure the safety of mother and baby during delivery. Please make sure to check with your hospital for safety protocols to ensure that you and your family are prepared.

Can I have my partner with me when I come to hospital?

A support person in labour is important, and not considered a visitor; their presence, and the support that they give, is valued by the whole team that will be caring for you. Anyone who accompanies a woman in labour must be screened to ensure that they are not sick, and do not develop symptoms. During the pandemic some regions or hospitals have made the difficult decision not to allow anyone to accompany the woman (or pregnant person). We now know that anywhere from 30 to 50 per cent of people who test positive for COVID-19 have no symptoms at all, making screening at the time of labour very difficult. In many places there are shortages of the PPE and staff, to ensure that accompanying persons are not sick, do not become sick, and do not pose a risk to anyone else on the unit. Check with the facility where you are planning to give birth to find out if you will be able to bring someone with you. In almost all cases you will be limited to one person, or possibly to one person plus a doula. A restriction to one person means only one per person with no hand offs/tag teaming. Come prepared to stay with the laboring women throughout labour. In most cases support persons will not be able to re-enter if they leave the room, nor to order in food. The person who you have identified should take extra precautions to avoid exposure to COVID-19 during the weeks leading up to your due date, practicing meticulous hand hygiene and physical distancing.

Can a newborn baby get COVID-19?

We know of approximately 600 cases of pregnancies where there has been a COVID infection reported. Out of the 40 per cent of moms that delivered, we know the vast majority of newborn babies (90 per cent) have been born with no evidence of COVID-19. In a small number of cases, there has been some evidence of non-negative testing, however these are exceptional circumstances of vertical transmission (mother passing on virus to fetus) for which we don’t have any substantial evidence that this is definitive, if anything these cases seem to be exceptionally rare. As we continue to learn more about the disease, please visit SOGC.org regularly for more updates.

Is breastfeeding allowed for a patient with COVID-19 that is not showing any symptoms?

If the patient is not showing COVID-19 symptoms, Canadian health care experts and the Canadian Pediatric Society encourage breastfeeding. Please ensure to wear a mask and practice hand hygiene before feeding the newborn baby. Please visit SOGC.org/COVID for more information on breastfeeding during COVID-19.

Is it necessary to wear PPE with a newborn baby at home?

If both parents have not tested positive for COVID-19, we encourage the family to go back home and take care of their newborn as they normally would do so. PPE inside the household is not needed in this case.

What are the recommendations for visitors once your baby arrives?

We understand a new baby is a very exciting moment in the lives of everyone involved. However, as much as we are starting to see the curve flatten in many parts of the country, this is a time in our history for moms and dads to evaluate who is vital to be seen in the early stages of a baby’s life. This is a personal decision that every parent must make, while a grandparent that is offering childcare support is acceptable, we would not encourage social gatherings to introduce the new baby. As much as possible, we encourage the use of digital apps to introduce your newborn virtually or if weather permits, a short walk around the park maintaining social distancing can be a good option. Please remember to always wash your hands regularly.

Is this a safe time to try and have a baby?

There are many factors that go into deciding when to start or expand a family. Medical factors are certainly one of them. In the reports that we have seen to date, there is no evidence of first trimester problems or congenital malformations for pregnant women who reported infection with COVID-19. We encourage all women to discuss their individual situation with a health care provider to assess all risk factors of pregnancy during COVID-19.

Is it safe to continue working while pregnant?

Every pregnancy is different and very workplace is different. There are several factors affecting whether it is safe to work while pregnant during COVID-19. We encourage you to check with your employer on a few factors such as the provision of PPE during work and safety protocols for employees. If you are a person that is pregnant and you have underlying issues that make you more at risk, we encourage you to have a conversation with your health care provider before making this decision.