Pregnancy in Covid-19 Times
It can be a challenging experience for parents who are expecting a baby during the Covid-19 pandemic. There may be many doubts and fears in the minds of the couples on the new do’s and don’ts to be followed during these nerve-wracking times.
SUBURB In-Conversation with renowned gynecologist Lt Col (Dr) Nonika Goyal, to demystify the fears and myths around pregnancy amidst Covid-19.
Q1. Are pregnant women more vulnerable to infection or at increased risk of severe illness or mortality with Covid19?
Dr: The experience of COVID-19 in pregnant women has shown that they are neither more vulnerable to contracting the virus nor are at any increased risk of morbidity or mortality of COVID-19. However, pregnancy itself alters the body’s immune system and response to any viral infections in general, which can occasionally be related to more severe symptoms and this will be the same for COVID-19.
Reported cases of COVID-19 pneumonia in pregnancy have been milder with good recovery. However, pregnant women with heart disease (congenital or acquired) are at highest risk.
Q2. If a pregnant woman tests COVID positive, will the virus be passed to the baby?
Dr: If a woman tests COVID positive, there is no evidence to suggest that the virus can be passed on to her baby across the placenta, unlike in a number of other viral illnesses such as HIV.
Q3. Will a pregnant woman be tested for COVID-19 before delivery? Are advance test results acceptable?
Dr: Women who come from a containment zone will be tested for COVID-19. The COVID test should be performed as close to the timing of delivery as is possible. Rapid tests such as TrueNet can be performed even in early labour.
Q4. Is stepping out for routine scans and ultrasound risky for pregnant women?
Dr: When there is extensive community penetration of the virus, stepping out of the house is certainly a little more risky than staying back. However, if you take the routine precautions such as wearing a mask, maintaining social distance and hand hygiene, then there is not much risk in going out for essential pregnancy care like USG scans. Your gynecologist is likely to advise you to reduce the number of visits during your pregnancy from the usual 13 to just 4-5 and resorting to teleconsult for any other queries.
Q5. What extra precautions should an expecting mother take other than the general stipulated ones?
Dr: None. She should eat normally and avoid stepping out to crowded areas. If she resides in a clean zone, she can undertake walks in parks and gardens.
Q6. Can a COVID positive mother breastfeed the baby?
Breastfeeding does place the baby very very close to the COVID positive mother. Yet, it is recommended that the mother can breastfeed the baby after wearing her mask. COVID positive mother, if otherwise asymptotic, can breastfeed if she desires (and should be supported for that). If she doesn’t want, then she should be encouraged to express her milk and give to the baby.
However, if symptomatic, then she should avoid. Her family members should take care of the baby at all other times till she tests negative.
Q7. What are the important post delivery dos & don’ts for both mother and baby?
Dr: Pregnant women should be advised to increase their social distancing to reduce the risk of infection and practice hand hygiene. Keep the baby away from the mother except during breastfeeding if mother is COVID positive.
Baby should be tested for COVID on day 2 and again on Day 6-7 and monitored for development of symptoms (fever / feed intolerance/ respiratory illness etc.). If everything is fine, then both, mother and baby, can be discharged early and kept in home quarantine for 2 weeks and monitored telephonically and reviewed in the hospital sos….!
Lt Col (Dr) Nonika Goyal (Retd) is a gynaecologist with more than 25 years of experience in various clinical and administrative roles in healthcare.
She has served with the Army Medical Corps and was awarded the Chief of Army Staff Commendation for her distinguished service. She is founder partner of La Santé Enterprises, a consulting firm for the professional management of hospitals (in India and abroad) and other healthcare solutions.