Dubai - If you are expecting a child or have just had a baby, what are the precautions you should be taking to keep yourself and your child safe from COVID-19?
The UAE’s health authorities have issued basic guidelines that mothers can follow, whether they have tested positive or negative for the new coronavirus.
Speaking to Gulf News, Dr Shiva Harikrishnan, obstetrics and gynaecology consultant at Medcare Women and Children Hospital, said: “As pregnancy is a condition when the immune system is altered, pregnant women are at a risk of acquiring COVID-19 just like any other viral infection.”
Dr Harikrishnan advised the following basic guidelines that women should follow when they are pregnant:
• Avoid going out of your home as much as possible.
• If you are working, opt for working from home if the nature of work permits.
• Keep a safe social distance of at least one metre outside and even at home.
• Safe distancing is more important especially in the third trimester of pregnancy.
• It is preferable to stay at home in one room with proper ventilation and washroom facility.
• Wash your hands as much as possible with soap and water or sanitiser for at least for 20 seconds.
• Do not touch your face, nose, eyes or mouth unnecessarily.
• Don’t let staying at home affect your sleep schedule. Staying up late at night and waking up late in the morning will affect proper hydration and nutrition.
• Consume plenty of warm water, fruits and vegetables.
• Try to avoid watching negative information on social media and television. Instead, engage in positive activities like yoga, meditation, reading and listening to good music.
As pregnancy is a condition when the immune system is altered, pregnant women are at a risk of acquiring COVID-19 just like any other viral infection.
Are pregnant women at greater risk?
Dr Maryam Khodamoradi, Obstetrics And Gynaecology Specialist at Aster Hospital, Al Qusais, said that while there was, so far, no evidence that pregnant women were more vulnerable to catch the infection or a more severe form of COVID-19, compared to the general population, pregnant women could sometimes be more at risk from viruses like the flu.
“At the moment, it is expected that most pregnant women - without an underlying health condition - will experience mild or moderate cold or flu-like symptoms. That is why and just as a precaution, pregnant women are categorised as being at moderate risk,” Dr Khodamoradi said.
Get some sun
It is essential to get the right amount of Vitamin D during the day, especially during pregnancy. However, longer time spent indoors can man that women do not get enough Vitamin D from sunshine. Dr Khodamoradi recommended taking Vitamin D supplements, as prescribed by yoru doctor, on a daily basis.
“There have been some reports about vitamin D reducing the risk of coronavirus infection. However, there is no evidence to confirm it,” Dhr Khodamoradi said.
During the third trimester, however, there are additional concerns for pregnant women, considering the challenges in caring for women who are in the last stage of their pregnancies – particularly from the 28th week of pregnancy.
“In addition, a recent study in the United Kingdom showed that the majority of pregnant women with COVID-19 who became severely ill were in their third trimester of pregnancy,” Dr Khodamoradi added.
She added that women should immediately inform their doctors if they notice symptoms of a COVID-19 infection, including:
- high temperature
- continuous cough
- shortness of breath
- changes in sense of smell or taste
What happens if you contract COVID-19?
While a COVID-19 infection can lead to a stressful time during pregnancy, doctors have advised women to stay calm and continue following basic precautions to minimise the negative impact of the infection.
“The good news is, so far, there is no evidence that coronavirus causes miscarriage or affects the baby’s development. Therefore, pregnant women who have a positive test result do not need to be worried about the effect of infection on their babies. Although uncommon, but there have been some reports on transmission from a woman to her baby during pregnancy or birth - vertical transmission. In almost all such cases however, the newborn babies were well,” Dr Khodamoradi said.
She, however, advised against water births, as the virus can sometimes be found in faeces.
“This means it could contaminate the water, causing infection to pass to the baby. It may also be more difficult for healthcare staff to use adequate protection equipment during a water birth,” she said.
The good news is, so far, there is no evidence that coronavirus causes miscarriage or affects the baby’s development. Therefore, pregnant women who have a positive test result do not need to be worried about the effect of infection on their babies. Although uncommon, but there have been some reports on transmission from a woman to her baby during pregnancy or birth - vertical transmission. In almost all such cases however, the newborn babies were well.
Inform your doctor immediately if you test positive for COVID-19
Dr Jasbir Chhatwal, Specialist Obstetrics and Gynecology in Zulekha Hospital Dubai, urged women to always stay in close contact with their obstetricians to ensure the doctor is aware of the mother’s health status.
“If you have no COVID-19 symptoms or mild symptoms, you will be advised to self-isolate at home and asked to inform the doctor if you observe any abnormal symptoms like high grade fever, coughing, breathing difficulty, loss of taste or smell, pain in abdomen, bleeding, vaginal discharge or reduced fetal movement. In such cases, the woman will be admitted to a special isolation ward to care for the mother and baby,” she said.
Impact on antenatal visits
If a woman contracts COVID-19, it is likely that routine antenatal appointments will be delayed until isolation ends, unless the check-up is urgent.
“As per Royal College of obstetricians and gynaecologist (UK) guidelines, at least six face-to-face antenatal visits should be done, following general precautionary measures,” Dr Harikrshnan said.
“In the midst of a global pandemic it can be hard and confusing whether one can have a birth plan or not. Surely, you can put together your preferences but you should also be prepared to be flexible if the condition demands,” she added.
While antenatal visits can take place as normal, having someone accompanying you can depend on the hospital’s policies.
“If you are concerned about attending your appointment due to COVID-19, talk to your healthcare provider or doctor over phone and ask them about the steps they are taking to separate healthy patients from sick ones,” Dr Chhatwal said.
She also advised women to not delay any emergency care because of COVID-19 as last minute risks are higher and difficult to manage.
Can teleconsultation replace pre-natal visits?
Because antenatal visits involve careful physical examination to determine the health of the mother and child, a physical visit is required. For general consultations and raising queries with your doctor, however, teleconsultations can work.
Can my spouse or birth partner be present during labour?
“Different hospitals have different rules of about the number of birth partners, but in general most units allow not more than two partners who can take turns visiting the patient,” Dr Harikrishnan said.
“Allowing doulas in labour rooms, in the current climate, depends on the rules of the individual unit and the hospital. Generally, this idea is not welcomed in most of the facilities in the UAE. Alternatively, the concept of virtual doulas – that is receiving their services online – can be tried if the woman is desperate to have them,” she added.
If the birth partner is showing any symptoms of COVID-19, they would not be allowed to be with the woman, to ensure everyone’s health and safety.
What about newborns?
While studies are still being done to understand the risks of COVID-19 during pregnancy and to the baby, Dr Chhatwal said that mother-to-child transmission of COVID-19 during pregnancy is unlikely.
“A small number of babies have tested positive for the virus shortly after birth, according to limited published reports. However, it is unknown if these babies got the virus before, during, or after birth. A small number of other problems, such as preterm birth, have been reported in babies born to mothers who tested positive for COVID-19 late in their pregnancy. However, we do not know if these problems were related to the virus,” she added.
A small number of babies have tested positive for the virus shortly after birth, according to limited published reports. However, it is unknown if these babies got the virus before, during, or after birth. A small number of other problems, such as preterm birth, have been reported in babies born to mothers who tested positive for COVID-19 late in their pregnancy. However, we do not know if these problems were related to the virus.
Can I breastfeed if I am COVID-19 positive?
In guidelines issued to breastfeeding mums by MOHAP, women were asked to follow basic precautions when feeding their babies.
“Breastmilk is the best food for your baby because it works to strengthen the immune system and protect them from infections by transferring antibodies directly from the mother to baby,” the guidelines read.
Precautions to follow if the mother is COVID-19 positive:
1. Wear a face mask or medical mask
2. Wash your hands with water and soap or use sanitiser before and after touching your baby.
3. Routinely clean and disinfect all surfaces around your baby.
4. Keep a distance of six feet – or two metres – when you are not breastfeeding your baby.
For women who are severely sick and are unable to feed the child directly, MOHAP recommends using double electric breast pumps to express milk.