Caring For Pregnant Women And Newborn During Covid-19 Pandemic!

Pregnancy is a special time full of delight and expectations. But being pregnant can also be stressful. Understandably, you may be worried about the impact of coronavirus disease (COVID-19) on your as well as your baby’s health.

Is the Risk of COVID-19 Higher for Pregnant Women?

Research is currently being undertaken to evaluate the impacts of COVID-19 infection on pregnant women. Data are limited, as per the ICMR (Indian Council for Medical Research) at present, there is no evidence of scientific literature to suggest that pregnant women are at higher risk of developing a serious illness as compared to the general population.

However, pregnancy itself alters the body’s immune system. Pregnant women can be badly affected by certain respiratory infections, including COVID-19. Hence, pregnant women must take precautions to protect themselves and inform their doctor if they develop any symptoms such as fever, cough or difficulty in breathing.

If you have or think you have COVID-19, you must isolate yourself at home. Mothers can still hold baby skin-to-skin and stay in the same room as them but should wash hands and wear a mask, especially when bonding and breastfeeding.

Dr. M.G. Kartheeka, MBBS, MD(Pediatrics)

Here is what you Should Know if you are Pregnant or Planning to Become Pregnant:

If you are pregnant, you should take the same precautions to avoid COVID-19 infection as other people. You can help protect yourself with these steps:

• Wash your hands frequently with soap and water or with an alcohol based hand sanitizer.
• Make sure you wear a face mask and follow social distancing while going outdoors (keeping space between yourselves and others), avoid crowded areas.
• Avoid touching your eyes, nose and mouth.
• Practice respiratory hygiene. Cover your mouth and nose with a tissue or your bent elbow when you sneeze or cough. Dispose of the used tissue immediately.
• Clean and then disinfect frequently touched surfaces and objects, be sure to follow instructions for safely and effectively using disinfectants.

Pregnant and postpartum women have a higher risk for more severe illness from COVID-19 than non pregnant women.

Dr. Ashish Bajaj, M.B.B.S., M.D. in Clinical Pharmacology and Toxicology

Can COVID-19 be Transmitted from the Mother to the Baby?

Emerging evidence now suggests that passage of COVID-19 from mother to baby is probable, although the proportion of pregnancies affected and the significance to the neonate has yet to be determined. At present, there are no recorded cases of breastmilk or secretions from the vagina that have been tested positive for COVID-19. There is currently no scientific evidence suggesting an increased risk of miscarriage or early pregnancy loss concerning COVID-19. (ICMR, Guidance document, dated 12 April 2020).

Stay healthy by getting a COVID-19 vaccine, following guidelines from your doctor, and keeping your prenatal and postpartum care visits, as there is an increased risk of pre-term birth.

Dr. Ashish Bajaj, M.B.B.S., M.D. in Clinical Pharmacology and Toxicology

Should I Continue my Regular Prenatal Visits to the Doctor During COVID-19?

Prenatal visits are important to ensure maternal and fetal health. However, given the current global pandemic, we are facing, many obstetricians are either increasing the interval between visits or encouraging telehealth visits.

As per ICMR guidance, pregnant women are advised to attend routine prenatal checkups at 12, 20, 28 and 36 weeks of gestation, unless they meet current self-isolation criteria. For women who have had symptoms of COVID-19, appointments can be postponed until 7 days after the start of symptoms, unless they become severe.

For women who are self-quarantined because someone in their household has possible symptoms of COVID-19, appointments should be deferred for 14 days.

If you are concerned about attending your appointment due to COVID-19, talk to your doctor. Establish a trusting relationship with your doctor and freely ask them any doubts or concerns you may have regarding your pregnancy and delivery.

How can I Protect my Newborn from COVID-19?

An important thing to do once your baby is born is to discourage visitors. Also, ensure that all those who are caring for the baby (you and your family) frequently wash hands and wear face masks.

You can safely touch, hold and breastfeed your baby since transmission of the virus through breast milk has not been reported to date (limited scientific data available suggest this is not likely to be a source of transmission). Wear a medical mask when you are in any contact with the baby, even while feeding. Mothers should also follow other measures of preventing infections, such as washing hands, sneezing or coughing in a tissue, wiping down surfaces, etc. 

In case of temporary separation of the newborn from a mother with suspected or confirmed COVID-19 (to reduce the risk of spreading the virus to the newborn) following precautions should be taken.

• If the mother chooses a temporary separation to reduce the risk of spreading the virus and would like to breastfeed, she should express breast milk and have a healthy caregiver bottle-feed the newborn. 
• If possible, use a dedicated breast pump. Mothers should practice hand hygiene before using the breast pump. After each session of the pump, every part that comes into contact with breast milk should be completely washed and the whole pump should be properly disinfected in line with the manufacturer’s instructions. A healthy caregiver should then feed the newborn.

Coping with Stress

Pandemics can be stressful for everyone. Fear and anxiety about a disease can be overwhelming for both adults and children. Depression during and after pregnancy is common and can be treated. Postpartum depression is the depression that can happen after having a baby. If you think you may be experiencing depression, seek treatment from your doctor as soon as possible. 

As the saying goes, it helps to be prepared, not scared. Simple steps like regular hand washing and avoiding crowds can go a long way in protecting you and your baby. Do not stress if your due date is coming close. Hospitals have systems in place to ensure safe deliveries and reduce the risk of infection to newborns. Stay healthy and stay protected.

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