Well, it’s here. First came self-isolation, social distancing advising to stay home and now pretty much lockdown. If you’re pregnant, your anxiety is probably through the roof right now and I don’t blame you. Especially if you’re close to giving birth. I am hoping to reassure you with this post and also give you some tools to get through your pregnancy with the Coronavirus outbreak the best you can.
Current advice on Covid-19 and Pregnant Women
This is taken from the current advice for pregnant women and their families on the Royal College of Obstetricians and Gynaecologists (RCOG).
“Generally, pregnant women do not appear to be more likely to be severely unwell than other healthy adults if they develop the new coronavirus. It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms.
As yet, there is no evidence that pregnant women who get this infection are more at risk of serious complications than any other healthy individuals.
If you think you may have symptoms of COVID-19 you should use the NHS 111 online service for information. If you develop more severe symptoms or your recovery is delayed this may be a sign that you are developing a more significant chest infection that requires enhanced care. Our advice remains that if you feel your symptoms are worsening or if you are not getting better you should contact your maternity care team or use the NHS 111 online service for further information and advice.”
If you are diagnosed with Coronavirus during your pregnancy
“As this is a very new virus we are just beginning to learn about it. There is no evidence to suggest an increased risk of miscarriage.
There is also no evidence that the virus can pass to your baby while you are pregnant or during birth (this is called vertical transmission). Two cases of possible vertical transmission have been reported. In both cases, it remains unclear whether transmission was prior to or soon after birth. Another recent report from China of four women with coronavirus infection when they gave birth found no evidence of the infection in their newborn babies. Expert opinion is that the baby is unlikely to be exposed during pregnancy. It is also therefore considered unlikely that if you have the virus it would cause problems with the baby’s development, and none have been observed currently.
Some babies born to women with symptoms of coronavirus in China have been born prematurely. It is unclear whether coronavirus caused early labour, or whether it was recommended that the baby was born early in order to preserve the mother’s health.
The UK is conducting near-real-time surveillance of all women who develop COVID-19 during pregnancy and their newborn babies, through well-established systems already used by all maternity units. We will update this information if and as soon as there is any change in the evidence.”
Your best protection is prevention. Follow the government advice of staying home apart from essential food shopping, medical supplies and a short walk or run per day. If you can, get someone else to do your shopping for you. Maintain social distancing of 2 metres when and if you go out.
You may want to consider wearing a mask to protect yourself when you go into hospital. The best protection is washing your hands, resisting touching your face and using a hand sanitiser (at least 60% alcohol) when handwashing isn’t possible. If anyone in your family or yourself sneezes or coughs, they should do so into a tissue and then throw it away and wash their hands.
Work from home where possible and avoid public transport when you can. If anyone in your household shows signs of Covid-19 you should isolate yourself from them.
“Based on the evidence we have so far, pregnant women are still no more likely to contract coronavirus than the general population. What we do know is that pregnancy in a small proportion of women can alter how your body handles severe viral infections. This is something that midwives and obstetricians have known for many years and are used to dealing with. As yet, there is no evidence that pregnant women who get this infection are more at risk of serious complications than any other healthy individuals.
What has driven the decisions made by officials to place pregnant women in the vulnerable category is caution. We know that some viral infections are worse in pregnant women. At the moment, there’s no evidence that this is the case for coronavirus infection, but the amount of evidence available is still quite limited.” – RCOG
If you cannot work from home (holler to my pregnant Midwives, Nurses and Doctors), then your employer should be able to redeploy you in a non-public facing role or make adjustments.
Advice for pregnant healthcare workers before 28 weeks gestation (from the RCOG)
“If you are in your first or second trimester (less than 28 weeks pregnant), with no underlying health conditions, you should practise social distancing but can continue to work in a patient-facing role, provided the necessary precautions are taken.
You should avoid, where possible, caring for patients with suspected or confirmed coronavirus infection. If this is not possible, you should use personal protective equipment (PPE) and ensure a thorough risk assessment is undertaken.
Some working environments, such as operating theatres, respiratory wards and intensive care/high dependency units, carry a higher risk for all pregnant women of exposure to the virus and all healthcare workers in these settings are recommended to use appropriate PPE.”
Advice for pregnant healthcare workers after 28 weeks gestation, or with an underlying health condition
“If you are in your third trimester (more than 28 weeks pregnant), or have an underlying health condition – such as heart or lung disease – you should avoid direct patient contact. You should work from home where possible, avoid contact with anyone with symptoms of coronavirus, and significantly reduce unnecessary social contact.
We encourage employers to seek opportunities for pregnant healthcare workers in their third trimester to work flexibly in a different capacity, to avoid roles where they are working directly with patients.
Whatever gestation of your pregnancy, you should discuss your individual circumstances with your local Occupational Health department.
The evidence base for this new virus is growing rapidly and, as and when new information emerges, the Government and professional bodies will update the guidance.
If you have underlying health conditions on top of your pregnancy, you should be even more cautious. Although I don’t know how more cautious apart from being in a sealed-off cell.
Attending your Antenatal appointments
It is important to still attend and maintain your antenatal appointments, but some hospitals and clinics are putting in restrictions on the number of people you have with you, so check before you go. Some clinics may be operating remotely or over the phone. It’s a good idea to phone ahead in all cases, because they may be experiencing staff shortages and your appointment may need to be in a different location or with another staff member.
You should have a number to call if you are concerned, but please only phone them if you have a concern regarding your pregnancy, or you think you are in labour. If you think you have Coronavirus, use the 111 online assessment or phone 111. All UK and foreign travel is not advised, nor is seeing family and friends outside your household.
Antenatal classes have on the whole been cancelled. Why not learn online? I recommend The Birth and Baby Academy, but there are others around and some free information out there. Now’s the time to get educated and prepared for not just the birth but life with a baby. The reason I like BABA is it’s realistic and not just breathing techniques and natural birth.
How do they test for Coronavirus?
The testing for Coronavirus is the same whether you’re pregnant or not. It is currently a swab (like a long cotton bud) taken from your nose and throat. You get the results within 24 hours. If you are told to self isolate, you must contact your Midwifery team. If you contract the virus and recover during pregnancy, you will be offered a wellbeing scan two weeks after your recovery.
If you test positive for Covid-19 during pregnancy
If you test positive and are going into labour, you will need to give birth in a high risk hospital. This is so they can check your oxygen levels and monitor the baby after birth. There is no evidence to suggest that how you give birth will be affected as it is not thought to transfer during vaginal or c-section birth. If you are planning on breastfeeding you should continue to do so, even if you have tested positive for Coronavirus. There is no evidence showing that the virus can be carried in breastmilk, and the well-recognised benefits of breastfeeding outweigh any potential risks of transmission of coronavirus through breastmilk.
“If you choose to breastfeed your baby, the following precautions are recommended:
- Wash your hands before touching your baby, breast pump or bottles
- Try to avoid coughing or sneezing on your baby while feeding at the breast
- Consider wearing a face mask while breastfeeding, if available
- Follow recommendations for pump cleaning after each use
- Consider asking someone who is well to feed your expressed breast milk to your baby.
If you choose to feed your baby with formula or expressed milk, it is recommend that you follow strict adherence to sterilisation guidelines. If you are expressing breast milk in hospital, a dedicated breast pump should be used.” – RCOG
If you are self isolating with mild symptoms and go into labour, you must inform the hospital when you phone to discuss your labour progress. You can still stay at home during early labour. When you are advised to come in, you should attend in private transport and you will be met by a staff member who will give you a mask to wear until you are in a single room. They will then arrange testing for you, and your baby when it is born.
If you remain symptom free and do not suspect you have it, why not consider having a home birth, or going to a low risk birthing unit? This is considered a lot safer than hospital birth, even if you end up being transferred in labour and your risk of contracting the virus will be lower.
“As this is a new virus, there is limited evidence about caring for women with coronavirus infection in women who have just given birth. A small number of babies have been diagnosed with coronavirus shortly after birth but it remains unclear whether transmission was prior to or soon after birth. Expert opinion is that the baby is unlikely to be exposed during pregnancy.” – RCOG
Doing your part
Apart from the preventative measures, try and stay as healthy as possible during your pregnancy. Make sure you maintain a healthy well-balanced diet and don’t overeat. Keep hydrated by drinking plenty of water. This will help prevent urine infections, constipation and will keep your organs healthy. It also reduces your chance of passing out. Eating little and often and healthily will keep your blood sugar stable. Exercise and keep mobile to stay flexible and build stamina and to prevent blood clots forming.
To keep yourself from worrying too much, try to keep busy. If you’re working from home, keep working as much as you can. If work has slowed or stopped, or you’re on maternity leave, now’s the time to start a new hobby, clean the house, start a decorating project or keep a journal.
Make a list of all the baby items you’re going to need and stock up on the essentials like nappies and wipes. Make an Amazon baby registry list and send it to friends and family when done. Get them to club together with you and do one big order to save on couriers.
Hypnobirthing / relaxation prep
Practice relaxation techniques, go over your hypnobirthing, listen to affirmations. Meditate, whatever you like to do to relax. Practice deep breathing for labour. If you want to take it further, there are some great hypnobirthing books and audiobooks around, or you can find a virtual class. It’s not just for a home birth or natural birth, it works with all types of births and is a great life skill.
Your mind will feel clearer if you ditch the clutter and you’ll need some room for the baby clutter! Even if you can’t sell or donate it right now, you can keep stuff in the loft, garage or to one side for now.
Join a gym with a creche
If you like your gym and exercise, look around for gyms with a creche to join when you can after the baby is born. They will take babies from their second set of jabs at around 14 weeks. You can exercise at home or go for walks until then. You can still walk outside or go for a run once a day remember, as long as you practice social distancing.
Practice folding and unfolding the buggy/pram/stroller
Trust me, you don’t want to be learning to fold it when the baby’s screaming and you’re all sweating and swearing. Get familiar with it now, and drive it around the garden or around the block.
Practice carrying the car seat and putting it in and out of the car
See above, it’s also often what you carry the baby out of the hospital in, so figure out the straps and how they tighten and release. Make sure you both know how to do it with ease.
Practice tying the sling or putting on the baby carrier.
The baby carrier can be your lifesaver when you have an unsettled baby. and practice makes perfect. Find something weighty to practice with and have a play around.
If you’re planning on bottle feeding, get familiar with the bottles and how they come apart and sterilise
You don’t want to be fiddling about at 3am trying to sterilise bottles and figure out what bit goes where. If you’re not sure, I have a post explaining how to make up a baby bottle correctly.
Buy or make milestone cards
Some more ideas to pass the time whilst you’re stuck at home:
Binge watch those TV shows you wanted to catch up on
Nesting – it will come to you! Do a small redecoration project, get that feature wall up, re-arrange the living room
Wash the baby clothes if you want to
Practice nappy changing with a doll or teddy
Sign up for all the pregnancy freebies if you haven’t already
Sort life insurance out if you don’t have it
Make a will if you haven’t already
Have some home beauty treatments
Do a belly cast (get a friend or your partner to help you)There are kits you can buy online and youtube tutorials.
Have a date night in with your partner
I hope you all stay safe and well and we all get through this without overwhelming the health service too much. It’s a scary time, I have my children and parents to worry about too, and my sister in law is pregnant. It will get back to normal one day, and we’ll all be more prepared should it happen again. Please comment with any questions or if you think I have made an error, I welcome all feedback.