Pregnancy: COVID-19 Frequently Asked Questions

Every day we learn more about COVID-19. At this time, there have been published reports of over 40 pregnant women with this disease who have gone on to deliver their babies. This is a summary of what we understand at this time:

Pregnancy does not seem to increase a woman’s chances of becoming infected.

We recommend that pregnant women follow the same practices as other adults to prevent infection: practice social distancing, wash hands often with soap and water, avoid touching your face, cough or sneeze into your elbow rather than your hands, avoid others who are unwell, and stay home when you are sick.

Are you concerned about a possible COVID-19 exposure or infection during pregnancy?

  • DO NOT attend your regular prenatal appointment or the Labour and Delivery Department for care.
  • You should call 811 for direction and referral to a testing clinic.
  • If your symptoms are severe, call 911 and provide relevant travel or exposure history to dispatch. 

Pregnant women should practice social distancing while working.

We recommend that pregnant women discuss with their employers whether they can work from home or otherwise modify their work duties to limit public exposure. 

Health care professionals (HCP) who have received appropriate PPE and training may continue to work. Wherever possible however, HCP who are pregnant should avoid providing care for persons with COVID-19 as well as avoiding areas where aerosol generating procedures occur.  It is recognized that repeated exposures to COVID-19 may increase the risk of transmission for all HCP.

Pregnancy does not appear to increase the chance of serious complications such as pneumonia or sepsis should infection occur.

The majority of pregnant women who become ill can expect to have only mild to moderate cold or flu symptoms such as fever, dry cough, sore throat, headache or gastrointestinal symptoms.
If more severe symptoms such as shortness of breath or difficulty breathing are present, these should be treated promptly.
Women with underlying health problems as well as pregnancy may become more unwell with this infection.

    The best way to take care of the fetus is to take care of you!  

    Many medications and tests can be used in a way that is safe for both.

    • Acetominophen (Tylenol) can usually be used in pregnancy if a woman is otherwise healthy and can help with fever, sore throat and muscle aches.  
    • Anti-inflammatories (Advil, Aleve, Ibuprofen etc.) are generally to be avoided in pregnancy.
    • It is important to drink well and stay hydrated in pregnancy.

    Infection does not appear to pass from the mother to the baby in utero (called vertical transmission).

    Viral particles have not been found in the amniotic fluid, placenta or cord blood. There have been two cases where vertical transmission to babies has been questioned, but it is thought more likely that the infection occurred shortly after birth. If infection does not pass to the baby on the inside then it is unlikely that the infection can cause birth defects to occur.

    How will COVID-19 affect my office prenatal appointments?

    You may notice that your prenatal care has been transitioned earlier than usual to an OBGYN.  This is to allow our family medicine and nurse practitioner colleagues time to concentrate on other health issues while your care continues.

    Prenatal appointments may either be booked as usual or perhaps spaced out or even provided by telephone to allow you to continue social distancing. To further minimize gathering of many individuals, you will be asked to attend routine appointments by yourself. Changes to your visit schedule will be decided in a safe manner according to expert guidance as the situation unfolds.

    Self-Isolation and Pregnancy

    If you are pregnant and self-isolatating due to a COVID-19 exposure or confirmed infection, call your are provider for further instructions.  

    An otherwise normal, low risk pregnancy may not require follow up until the isolation period had ended and special arrangements may be made if an appointment is necessary before then.  

    Ultrasound(s) for fetal growth and wellbeing may be recommended after resolution of the illness.

    Infection does not appear to cause early pregnancy loss or miscarriage although the chance of preterm birth may be higher in the setting of active illness.  

    Preterm delivery has been noted in some of the reported cases although it is difficult to know whether this happened because of interventions provided to the mother for the care of her ill-ness, or due to the infection itself.

    Infection does not appear to cause early pregnancy loss or miscarriage although the chance of preterm birth may be higher in the setting of active illness. 

    Preterm delivery has been noted in some of the reported cases although it is difficult to know whether this happened because of interventions provided to the mother for the care of her illness, or due to the infection itself.

    Delivery

    Both vaginal and cesarean deliveries are acceptable methods of delivery.

    The type of delivery recommended by your care provider will be based on your own personal situation and not on the basis of infection alone. Delivery does not always have to occur simply because of a COVID-19 infection. Most deliveries in women with COVID-19 infections in published reports have been by cesarean section.

    Delivery is recommended in a hospital setting rather than at home.

    This will allow for appropriate monitoring of both mother and baby.  There may be a higher chance that babies will show heart rate abnormalities if the mother is ill with COVID-19 and timely intervention may be necessary.

    Breast feeding may be considered.

    The virus has not yet been found in breast milk, although the number of cases is small, therefore the many benefits of breast feeding may outweigh the risks to the newborn.  

    If breast feeding is chosen, care should be taken to prevent transmission of COVID-19 to the newborn through close contact with the infected mother (i.e. good hand hygiene, use of a facemask, feeding of expressed milk by healthy caregiver).  

    Consideration may also be given to establishing and/or maintaining milk supply to ensure success of feeding once illness has resolved.

    How will COVID-19 affect my hospital visit/stay?

    We are working hard at both the QEH and PCH to continue to provide good quality care to families.  As in the office, we have a screening process in place to be sure that everyone is treated with the care they require. For routine appointments you will be asked to attend alone to allow us to meet proper social distancing requirements. 

    When you are in labour, you may have one support person with you.  Movement around the hospital may be fairly limited, so please consider this while packing - your support person may wish to bring extra clothes, toiletries, food, snacks, own medications etc. for their comfort and well-being.  And don’t forget your cameras/cellphones (and charging cables).  As always, we know lots of people are waiting to meet your new baby!

    You may find that you wish to be discharged early from the hospital following delivery.  Arrangements are being made to provide support for new moms and their babies in the community to safely allow you to go home early.

    If at any time you have questions or concerns, you are invited to call your care provider’s office OR the labour and delivery unit of your local hospital  @ QEH 902-894-2242, PCH 902-438-4490

    Information in this area is changing rapidly and this advice may continue to change as more becomes known.

    Published date: 
    March 30, 2020