Every mother knows that birth plans rarely go as planned. And certainly none of us could have prepared for giving birth during a coronavirus pandemic. When you add our current health crisis to the normal emotions and anxieties of pregnancy it’s a lot to handle, especially when there's misinformation flying around.
The truth is, because COVID-19 is a novel coronavirus — meaning it's a new strain — there isn’t a lot of data about its long-term effects. "We are still in the early stages of this pandemic,” says Dr. Krutika Kuppalli, an infectious-diseases specialist and biosecurity fellow at Johns Hopkins Center for Health Security. “We're still learning of the health concerns for mother and baby." But what they do know is largely good news for moms and babies. Here, leading ob/gyns and specialists answer all your top questions about coronavirus and pregnancy — including whether or not you should move forward with your home birth.
Do Pregnant Women Have A Higher Risk Of Contracting COVID-19?
While it's always better to err on the side of caution when you're pregnant, so far, experts don't believe pregnancy increases your risk of COVID-19. Nor does it affect how bad of a case you might get. While being pregnant can make illnesses, such as the flu, much more serious, symptoms of coronavirus — fever, coughing, difficulty breathing, and pneumonia — don't appear to be any worse for expectant women than for other healthy adults, according to a World Health Organization (WHO) report. A clinical study published this month supports this — researchers in China tracked coronavirus in nine pregnant women and found their symptoms and its severity to be similar to those of patients who were not pregnant.
Is My Baby At Risk If I Get COVID-19?
So far, no babies born to moms with coronavirus have tested positive for the illness. There is also no evidence to suggest an increased risk of miscarriage, according to the Royal College of Obstetricians & Gynaecologists in the U.K. There have been a few instances of complications, such as premature birth, but experts say it’s too early to tell if these were related to COVID-19.
I Have A Million Doctor's Appointments. How Can I Avoid Getting Sick?
Any time you walk through the doors of a hospital (or a doctor's office, for that matter), you’re at risk for contracting a bacterial or viral infection. It’s a hospital! That said, coronavirus is spread through droplets from coughing or sneezing, so proper hygiene is the easiest way to reduce your risk when you have to go in for checkups or ultrasounds. Wash your hands often, cough or sneeze into a tissue or the bend of your arm, and avoid touching your face. You can also practise social-distancing by sitting at least two arm’s length away from anyone in the waiting room.
At many hospitals across Canada, patients and visitors are being screened for symptoms and about recent travel plans before they're allowed entry. Still, it's a good idea to call ahead to confirm your appointment in case your doctor recommends a virtual check-up at this time.
Should I Prepare for a Home Birth Because Of Hospital Overcrowding?
Not yet. While the Association of Ontario Midwives is anticipating an increase in demand for home births, reports the CBC, (there's already been a jump in home births in B.C., according to the Surrey-Now Leader), so far it seems to be status quo at hospitals across the country. Our experts told us health centres are taking measures to free up beds and resources as they prepare for an increase in patients as more Canadians contract COVID-19. This involves cancelling elective surgeries (like cosmetic enhancements), and even some non-life-threatening cancer procedures or follow-ups. For now, all caesarean sections and inductions will continue as planned. "Prenatal care is going to be exactly the same if it wasn’t for the virus," says Dr. Jonathan Tankel, an obstetrician-gynecologist at Royal Alexandra Hospital in Edmonton and professor at the University of Alberta.
What About My Home Birth? Is the Hospital Safer Now?
Some provinces, like Nova Scotia, are suspending home births until April 30, reports the CBC. Otherwise, so far across Canada, if you're healthy, a home birth is still your call. However, if you have coronavirus, the Society of Obstetricians and Gynaecologists of Canada does recommend a hospital birth rather than a home birth or delivery in a birth centre. This allows for your midwife to use the hospital's electronic fetal monitoring to keep an eye on baby — just in case.
Your midwife can remain your primary care provider, Elizabeth Brandeis, a registered midwife and president of the Association of Ontario Midwives tells Refinery29, as long as it's considered safe for you and your baby. "We would use the same guidelines [that we had pre-coronavirus] — if we don't have any concerns about fetal well-being or the well-being of the labouring person."
Will My Partner Still Be Allowed In The Delivery Room?
That depends on the hospital and province, so be sure to check with the health-care centre where you’re planning to give birth. Most will allow you at least one support person, but some hospitals are capping it there, and not even allowing visitors in the waiting room. So tell friends and family to send the flowers and champagne directly to your home address.
How Else Might My Delivery Be Affected?
Everything else should be status quo — unless you have coronavirus. If so, you’ll be isolated from the rest of the ward, and probably have to wear a mask giving birth. You and your little one will also have to self-isolate afterwards. On the bright side, this is probably something you would be doing with a newborn anyway — and it gives you a good reason to deny overbearing relatives from visits in those early days of new-mom life. Everyone should be practising social distancing right now anyway!
Can I Still Breastfeed If I Have COVID-19?
“There’s no transmission in breast milk as far as we know,” says Tankel. In fact, the amniotic fluid, placenta, and breast milk of mothers who tested positive for the virus were all negative. Still, you may be asked to wear a mask while breastfeeding. (Remember, COVID-19 is spread through droplets.)
As for what happens if your baby gets coronavirus, in general, cases are rare and not that complicated. One of Ontario’s COVID-19 cases is a baby boy under the age of one, and a newborn baby in Europe tested positive and is thought to be the youngest patient with the virus. Both children are reportedly in self-isolation, but doing well. “Infants seem to rarely contract this infection and seem to have a mild case if they do,” says Dr. Deborah Money, an OB/GYN professor at the University of British Columbia.
*This story was originally published on March 24, 2020, additional reporting was added.