Navigating Pregnancy During COVID-19

Pregnancy is a special time full of excitement and anticipation. But for many expectant mothers, the COVID-19 pandemic has clouded this time with fear, anxiety and uncertainty. 

To help women navigate this time, we spoke to experts about pregnancy and COVID-19 vaccines, as well as tips on how to have a safe pregnancy during the COVID-19 pandemic.

Pregnancy and covid-19 vaccines

The development of safe and effective COVID-19 vaccines is a huge step forward in our global effort to end the pandemic and to get back to doing more of the things we enjoy with the people we love. Here are the answers to come commonly asked questions about pregnancy and COVID-19 vaccines.

Should I get the COVID-19 vaccine if I’m pregnant?

Although the overall risk of severe illness from COVID-19 remains low, pregnancy puts you at higher risk of severe illness compared to people who are not pregnant.

Research is still ongoing to understand the safety and effects of COVID-19 vaccination in pregnant women, but there is no known reason that would outweigh the benefits of vaccination for pregnant women. For this reason, all provincial Ministries of Health across Canada are recommending that pregnant women - regardless of what trimester they are in - receive COVID-19 vaccines.

If you have additional concerns about being vaccinated against COVID-19, please consult your family doctor, OB-GYN or midwife.

Can COVID-19 vaccines affect fertility?

No, you may have seen false claims on social media, but there is no evidence that any vaccine, including COVID-19 vaccines, can affect fertility in women or men. If you are currently trying to become pregnant, you do not need to avoid pregnancy after receiving a COVID-19 vaccine.

Should I get the COVID-19 vaccine if I’m breastfeeding?

Researchers are currently studying COVID-19 vaccination in breastfeeding women, but there is still limited information at this time. WHO advises that vaccinations are offered if a lactating woman is part of a priority group for vaccinations, for example if you are a health worker. Breastfeeding can continue after vaccination and remains one of the best ways to protect your child from diseases and to help them stay healthy.

If you have additional questions about receiving a COVID-19 vaccine while breastfeeding, please consult your family doctor or OB-GYN.

Having a safe pregnancy during covid-19

To learn more about how women can protect themselves and their baby, we spoke with Franka Cadée, President of the International Confederation of Midwives.

Am I safe to continue my prenatal checkups?

Many expectant mothers are fearful of going to appointments while they are taking precautions, such as staying home and practicing physical distancing when outside. “You do see a lot of adaptation happening at the moment in the world where doctors and midwives are doing clinics or certain appointments by phone, so that the actual looking at the baby and the growth of the baby appointment can be short,” says Cadée. “I expect that pregnant women will find they’re seeing their healthcare professional less, to protect them and the healthcare professional from getting infected and that they will be seen live when it’s necessary.” Modifications may also be tailored for individual patients depending on their respective conditions, for example lower vs. higher-risk pregnancies.

Cadée advises mothers to find out what options are available to them from their healthcare professional and in their communities. “The person who’s taking care of you is perfectly geared to you and your own needs, so your midwife or obstetrician will know best.”

After your child is born, it is also important to continue receiving professional support and guidance, including routine immunizations. Speak to your healthcare provider about the safest way to have these appointments, for you and your baby.

If I have COVID-19, will I pass it to my baby?

We still do not know if the virus can be transmitted from a mother to her baby during pregnancy. “The COVID-19 virus has not been found in vaginal fluid, in cord blood or breastmilk,” says Cadée, although information is still emerging. To date, COVID-19 has also not been detected in amniotic fluid or the placenta.

The best thing you can do is to take all necessary precautions to prevent yourself from contracting the COVID-19 virus. However, if you’re pregnant or have just given birth and feel ill, then you should seek medical care promptly and follow instructions from your health care provider.

I was planning on giving birth at a hospital - is this still a safe option?

“Women should ask their [health care professional] what they feel is the safest place for them and how precautions are being taken from situation to situation,” recommends Cadée. “It depends on the woman, on her situation and on the healthcare system.” 

Different provinces and hospitals will have different guidelines and/or restrictions for giving birth - including guidelines around masks in the delivery room, vaccination requirements for support persons, and others - so be sure to consult with your hospital before your delivery date.

Given current precautions, can my partner or family member be present when I give birth?

While policies vary by country, Cadée believes women should have someone nearby to support them, as long as the proper precautions are taken, such as wearing a mask while in the delivery room and washing their hands. “We are finding that in certain countries people are not being allowed to be with women, and that is worrying me. I can understand that you want to reduce the number of people with a woman while she is giving birth because you’re trying to reduce contact, and that is very very logical, but let’s make sure that a woman has someone, one person, with her while she’s giving birth – her partner, a family member, a friend, [or the closest person of her choice]. And please keep the babies with the mothers.”

“We have to be compassionate and understand each situation as it is and that the healthcare professionals together with the family members are doing their best, using their common sense and listening to each other. I think that’s very important: that we try to work as a community.”

The Government of Canada website - in their section on pregnancy and childbirth during the COVID-19 pandemic - provides some additional guidelines for women in Canada:

If you plan to give birth in a hospital or birth centre, talk to your health care provider about:

• your birth plan
• how your plan may need to change due to COVID-19
• the COVID-19 policies regarding support and visitors.

If you plan to give birth at home, talk to your midwife about:

• precautions to make sure your home environment is safe
• whether home births are still an option in your province or territory

If you have COVID-19, talk to your health care provider about how this may affect giving birth. With proper precautions, breastfeeding, skin-to-skin and rooming-in are recommended at birth.

Your health care provider may consult other specialists for you or your baby as required.

I'm feeling very anxious about giving birth. What should I do to cope?

Having a plan in place for your birth can help ease feelings of anxiety by giving you more of a sense of control, but recognizing that the current situation means there may be less predictability depending where you live. “This should include who to phone when the labour begins, who will provide support during labour and where. Establish what restrictions will be in place for hospital birth regarding support people and family members,” advises Cadée.

She also recommends doing simple things at home to relax, “like [stretching] exercises, breathing exercises and giving your midwife a call if you need to.” Focus on taking care of yourself as much as you possibly can. “Eat well, drink well, put your hands on your belly and enjoy being pregnant.”

What questions should I be asking my healthcare professional?

Cadée underlines the importance of establishing a trusting relationship with your healthcare provider. “All of those questions that have to do with you and your health, I would ask them freely. If you have an open relationship with your healthcare provider – with your midwife, with your obstetrician – they will discuss these things with you and answer you openly. It is your absolute right to know these things because it’s your body and your baby.”

“Midwives are responding to increased demands on their services as are doctors and nurses, and so may take a little longer to respond,” Cadée notes. She suggests establishing a system of how and when to communicate with your healthcare professional. For example, organize routine around appointments, and how to get in touch for urgent care. It may also be helpful to talk to care providers in advance about obtaining a copy of your health records including record of prenatal care, in case of any disruption or change in services.

When it comes to your plan for giving birth, it is important to ask as many questions as you need to. Cadée suggests the following:

• Am I at risk of coronavirus disease (COVID-19) in this space? Has someone else been here with the COVID-19 virus?
• How do you separate people with the COVID-19 virus from people who have not?
• Is there enough protective clothing for the healthcare professionals?
• Am I allowed to take someone with me? If not, why not?
• Am I allowed to keep my baby with me? If not, why not?
• Am I allowed to give birth vaginally or do you give Caesarean section sooner? If so, why is that? 

What should women pack to go into hospital during the pandemic?

“I don’t think women need to take anything extra, but they should take precautions well into account,” advises Cadée.

She expects some hospitals may ask women to go home more quickly than normal if they’re healthy. “Again, that will be different from area to area, from woman to woman, from hospital to hospital,” she says, recommending expecting mothers to “ask their midwife or their obstetrician for advice that’s really tailor made for them.”

Once I've given birth, what do I need to do to protect my newborn from COVID-19?

The best thing you can do is to keep it simple: stick to just your family and don’t ask for visitors right now. “Also make sure that your children (if you have other children) that they’re not with other children. Get your family to wash their hands and take good care of themselves,” says Cadée.

Although it’s a difficult time, Cadée recommends trying to see the positive side of having this time to bond as a family. “Sometimes it can be very busy for young mothers and fathers to have so many visitors. Enjoy the quietness of your [immediate] family together for this time. It’s quite special to be able to bond with your baby alone, discover that new human being and enjoy that.”