Although pregnant women are no more likely to catch coronavirus than anyone else, pregnancy can alter the way that the body is able to handle severe viral infections for a small proportion of women. For this reason, pregnant women are seen as being in the vulnerable category when it comes to Covid-19 - meaning that it’s advisable for to take some extra precautions when it comes to the pandemic.
"In pregnancy, the immune system is altered, and new research suggests that the immunity is in flux during this time," says Dr Shiva Harikrishnan, Consultant Obstetrician & Gynaecologist at Medcare Hospitals & Medical Centres. "Pregnant women are at the same risk of catching this virus as they would be of catching any other virus.
"However, if a pregnant woman contracts coronavirus infection in advanced pregnancy there is high probability that she may experience difficulty in breathing, as her respiratory capacity is already reduced due to the pregnant uterus pressing the diaphragm. In this situation, the attending obstetrician may have to take a decision to deliver the baby earlier than the expected due date, after a thorough discussion with the couple."
Pregnant women at higher risk of being hospitalised with the virus
Recent research by the Centers for Disease Control and Prevention (CDC) analysed more than 325,000 reports of Covid-positive pregnant women over the course of around six months and found that pregnant women were 5.4 times more likely to be hospitalised than non-pregnant women.
However, the good news is that pregnant women don't seem any more likely to die than any other groups, and "it has not been noted that coronavirus infection increases the risk of miscarriage rate or that it is teratogenic (can cause congenital abnormalities in the foetus)", says Dr Harikrishan.
She adds: "Please remember there is no need to panic about the infection, but at the same time you need to be careful and cautious to protect yourself. Approximately 90% of coronavirus infection in pregnant women will be of a milder variety and Covid-positive pregnant women can deliver normally and caesarean section is reserved only for obstetric indications."
Play:Date App has helped us gather up some of the most common concerns for pregnant women, along with some answers from professionals around the world, about what you should and should not do while pregnant in the pandemic.
General Advice on Protecting Yourself During Pregnancy
The general advice for protecting pregnant women against catching coronavirus is the same as it is for the general population, although you may want to take some extra precautions. Dr Amelie Hofmann-Werther, Specialist Gynecology and Obstetrics, and Nightingale - a UAE-based Home Care Nursing Service – share some tips below:
• We’ve all understood this by now but it bears repeating – Do, of course, wash your hands frequently with soap and water for at least 30 seconds, and avoid touching your nose, mouth and eyes. If you can’t get to a sink then a hand rub containing at least 60% alcohol can be used.
• Do avoid crowded spaces as much as possible. If someone else can get groceries for you, it might be best to take them up on it.
• Do practice respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately.
• Do get tested as soon as possible if you feel you may have come into contact with someone who is infected. The World Health Organisation (WHO) recommends that pregnant women with symptoms get prioritized for testing, and the UAE is currently offering free tests to pregnant women – check with your health authority for details.
• Don’t let your husband have a long beard, as it could be an additional cause for viruses to stay if not washed properly.
• Don’t wear jewellery or watches as these can often be difficult to be kept clean.
• Don’t feel that you have to rush for a caesarean – the WHO advises that Covid-19 infection itself is not an indication for caesarean section, and that caesarean should only be performed when medically justified.
Going to The Hospital for Prenatal Check-Ups
• DO call your hospital ahead of time to understand its rules and guidance for prenatal appointments as these can sometimes change from week to week depending on the situation.
• DO ask about telemedicine options. "Avoid unnecessary visits to hospitals and try to have contact with your obstetrician and team through Whatsapp, telephone or video call," says Medcare's Dr Shiva Harikrish. "The number of antenatal visits should be minimized through tele-consultation." If it's not immediately offered then ask about it.
• DO keep the communication open with your doctor or midwife – they are trained to give you the best care in these situations.
• DO write a flexible birth plan or preferences list for how you would like your labour and birth to go if possible. Although there will always be some things that you cannot influence, this helps give you some control in the current unpredictable situation. “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 your hospital birth regarding support people and family members,” advises Franka Cadée, the President of the International Confederation of Midwives.
• DON’T worry that you are seeing your doctor less than before. Although in the UAE pregnant women often have very frequent antenatal visits, it's no problem to scale them down to the international standard of around 8-10 visits. "Scans can be limited to at least three important scans: at 12 weeks (Nuchal Translucency Scan), 20 weeks (Foetal Anatomy scan) and 32 weeks (Growth scan and Doppler)," says says Dr Shiva Harikrishnan from Medcare. Rest assured that your doctor will always do what is best for you and your baby. Some may have a higher-risk pregnancy – in which case, your doctor will advice if you need to see them more frequently.
• DON’T meet with other people who could possibly be infected, and if you do make sure you give a good and detailed history to your caring team regarding your symptoms as this has very important implications for your baby’s and your family’s health, says Dr George Michailidis, Consultant in Obstetrics & Gynecology and Maternal & Fetal Medicine at Genesis Clinic.
• Whatever you do, DO NOT delay getting emergency care due to Covid-19. If you are worried about something to do with your pregnancy, call your doctor or hospital if you can, or head to the emergency department.
Coping with Anxiety and Worry About Giving Birth During the Pandemic
Pregnancy can be stressful in the best of times, let alone during a pandemic. Here are some things to remember:
- Breathe and Relax! Keep active at home by doing some light exercise and stretches.
- Take your mind off the current situation - read a book you have always wanted to or watch a funny movie.
- Keep in touch with your friends and family, to reduce stress levels and anxiety, this will also help in retaining a level of normality. Speaking out about what is on your mind always helps!
- Look after your health much more than before by eating well and drinking lots of liquids.
- Try and enjoy being pregnant – and take the time to connect with your baby.