Many new and expectant mothers feel more anxious due to Covid. Dr Ellie Rayner answers some of the most pressing questions posed by women that are pregnant and worried about coronavirus.
If you’re pregnant and trying to take in the daily swarm of updates and restrictions about the coronavirus pandemic, you probably have lots of questions.
‘Is it ok for my family to visit after the baby is born?’, ‘What happens if I get coronavirus while pregnant?’, ‘How worried should I be?’
Information on the risk to pregnant women seems to be changing by the hour – and there’s a lot we still don’t know about how the virus affects pregnant women and their babies.
Here, Dr Ellie Rayner, NHS obstetrician and gynaecologist, hypnobirthing teacher and founder of The Maternity Collective – which provides expert-led antenatal classes – helps to answer some frequently asked questions from women that are pregnant and worried about coronavirus.
There is currently no evidence that pregnant women are more likely to get seriously ill from coronavirus. But, pregnant women have been included on the list of vulnerable people. This is because, according to the World Health Organisation (WHO), “due to changes in their bodies and immune systems, pregnant women can be badly affected by some respiratory infections”.
Researchers from Oxford University, in collaboration with the Royal College of Obstetricians and Gynaecologists, looked at 427 pregnant women who were admitted to hospital with Covid-19 between March 1st and April 14th 2020. The study revealed that fewer than 0.5% of all pregnant women were admitted to hospital with the disease, and only around 1-in-10 of those needed intensive care.
Most women who became severely ill with Covid-19 were in their third trimester and 1 in 20 babies born to the mothers in the study tested positive for Covid-19, but only half of these positive tests were immediately after birth – which suggests transmission of infection from mother to baby is low.
There is also no evidence to suggest that coronavirus infection in early pregnancy increases the chance of a miscarriage.
“If you are pregnant at the moment, you should follow the latest guidance on staying alert and safe using social distancing, hand washing, appropriate use of face coverings and avoiding anyone who has symptoms suggestive of coronavirus,” says Dr Rayner. “Amongst pregnant women, the highest chance of becoming severely unwell appears to be in those greater than 28 weeks of pregnancy, so it is particularly important to follow social distancing and hygiene measures if you are in your third trimester.”
“This advice is changing all the time,” says Dr Rayner. “A number of different vaccines are already routinely and safely offered to pregnant women, but specific clinical trials have not yet been carried out of the Covid-19 vaccines in pregnant women.”
Basically, there is currently insufficient evidence to recommend the Covid-19 vaccine during pregnancy, she says. “They do however advise that should a pregnant woman be at very high risk of catching the infection, then they should discuss getting the vaccine with their doctor.”
The Joint Committee on Vaccination and Immunisation (JCVI) published updated advice on 30 December 2020 to say that women who are trying to become pregnant do not need to avoid pregnancy after vaccination. While Public Health England guidance on Covid-19 vaccination from November 2020 recommends that if you find out you are pregnant after you’ve had one dose of the Covid-19 vaccine, you should complete your pregnancy before you have your second dose.
There is currently no evidence to suggest that Covid-19 can be carried or passed on via breastmilk – and the well-recognised benefits of breastfeeding outweigh any potential risks of transmission of coronavirus through breastmilk.
“The main risk of infant feeding is close contact between you and your baby as
coughing or sneezing could contain droplets infected by the virus leading to infection
in your baby,” explains Dr Rayner. “If you have suspected or confirmed Covid-19 then it is really important to discuss the pros and cons of breastfeeding between yourself and your midwife or doctor based on your individual situation.”
Maternity services are working around the clock to support your choice about where and how you give birth. But, due to staffing and other concerns, some of these choices may not always be possible.
“All maternity services are dedicated to providing safe and effective care to all mothers and babies and to ensuring women’s pregnancy and birth choices are maintained despite the pandemic,” says Dr Rayner. “Unfortunately, like all areas of the NHS, some maternity units have had to adapt and change the services they offer and the way they offer them in order to provide safe staffing for emergencies and to manage any additional pressures they may be under.”
This means, you may need to be flexible with your birth plan and be prepared to do things differently from what you wanted.
“In some areas of the country, maternity services have had to make difficult decisions
to limit birthplace options, such as pausing home births. Whilst the majority of areas have reinstated these services this is an ever-evolving issue and it is important to stay up to date with the information being released by your maternity unit and to prepare for different eventualities,” Dr Rayner advises.
“There are lots of ways you can personalise your birth environment to make it feel more familiar and safer for you, even if it isn’t your first choice birth place such as bringing your own music, using aromatherapy oils in an electric diffuser, bringing battery operated tea-lights and wearing your own clothes can help you feel comfortable and more at ease.”
Giving birth is stressful enough without additional pandemic rules around birthing partners and potentially giving birth alone. Rest assured, you'll be able to have a birth partner during labour and the birth – if they do not have symptoms of coronavirus or have tested positive for coronavirus. But, there may be limits on how long they can stay after the birth or if they can stay with women on antenatal or postnatal wards. Of course, both you and your birth partner must wear a mask.