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Covid-19 and Childbirth

 

The Corona Virus pandemic is a new disease causing massive confusion, uncertainty, suffering,
and death. We all have questions, many of which cannot be answered at this early stage of the
pandemic. We do know that the virus is spread mostly through respiratory droplets produced
when someone who is infected coughs or sneezes. We do know that the virus can live up to a
week on plastic and metal and even up to 24 hours on cardboard, making wiping down
contaminated things like doorknobs very important. We are all still learning if it spreads in
other ways, but no matter what your questions, the primary and most effective precautions to
take whether pregnant or not remain:

1. Washing your hands with soap completely and for 20 seconds including between the
fingers and thumb under the nails

2. Respect social distancing. Stay at home with your families whenever possible. Avoid
people who are sick and treat other people wo do not appear sick as symptomatic
carriers of COVID-19 i.e. keep your distance at least six feet to help prevent the further
spread of the virus. We must all do our part to help prevent the further spread of the
virus. It is only when the world works together as a team, that we can fight this invisible
disease.

3. Cover your cough and sneeze and cough or sneeze into your elbow.

4. Wipe down any surfaces that could be contaminated with alcohol wipes of at least 65-
90% isopropyl alcohol. The good news is that even though the viruses are easily
transmitted, they are also easily eradicated upon contact with alcohol.

5. Wear Personal Protective Equipment (PPE) if you are a health care worker, and follow
all the protocols and instructions for when and how to use and change PPE, to ensure
your own safety.

These recommendations hold true for most questions surrounding pregnancy, labor, birth, and
the postpartum period. This is an invisible disease that must be taken seriously. Here are
questions you may have concerning Covid 19 and birth:

Mothers testing positive for COVID-19 who have tested positive at birth for the virus: There
have been no babies born to mothers testing positive for COVID-19, who have tested positive at
birth for the virus.

If I test positive, will it spread to my baby when I’m pregnant? We still do not know at this
time but precautions must be taken like coughing into the elbow and following other
recommendations above to prevent transmission to others at birth. So far, no infants born to  mothers with COVID- 19 have tested positive for the Covid 19 virus at birth. The virus was not
found in samples of the placenta, amniotic fluid, or breastmilk.

Are my young children more or less likely to get COVID-19: At this time, it seems from the
data that very young children are much less likely to get the disease, however, since little is
known about COVID-19 all precautions above are strongly recommended. Thus far, only one
infant less than one year of age has tested positive for COVID-19.

Will pregnant women be more ill with the disease than non-pregnant women? It has always
been important for pregnant women to protect themselves as much as possible as they have a
higher risk of developing severe illnesses in general, including from influenza viruses. COVID-
19 is no exception. It is especially important for them to follow the recommendations above.

What should I do if I’m pregnant and test positive for COVID-19? Pregnant women with
confirmed COVID-19 or who are PUIs (Pregnant persons under investigation) should notify the
obstetric unit prior to arrival so infection control preparations can be anticipated.

When I’m in labor, can my partner and doula be with me? Many, but not all hospitals are
allowing only one person with a woman in labor and some even allow nobody else in the room
except caretakers. Social isolation is seen as one of the most effective ways to prevent the
spread of COVID-19 and unfortunately this includes women in labor. It is best to call your
hospital to find out what policies they have regarding these questions and they can change
quickly or sometime be negotiated separately with your care provider for special
circumstances.

Can I stay with my baby after birth if I test positive for COVID-19? Infants born to mothers
with confirmed COVID-19 should be considered PUIs. As such, infants should be isolated
according to the Infection Prevention and Control Guidance for PUIs. However, it is
recommended that separation of the mother from her baby should be made on a case-by-case
basis.

If I test positive for COVID-19, can I breastfeed my baby? “Breastmilk provides protection
against many illnesses and is the best source of nutrition for most infants. The CDC has no
specific guidance for breastfeeding during infection with similar viruses like SARS-CoV or
Middle Eastern Respiratory Syndrome (MERS-CoV). However, much is unknown about
COVID-19. Whether and how to start or continue breastfeeding should be determined by the
mother, in coordination with her family and healthcare providers. A mother with confirmed
COVID-19 or who is a symptomatic PUI should take all possible precautions to avoid spreading
the virus to her infant, including washing her hands before touching the infant and wearing a face
mask, if possible, while feeding at the breast. If expressing breast milk with a manual or electric
breast pump, the mother should wash her hands before touching any pump or bottle parts and  follow recommendations for proper pump cleaning after each use. If possible, consider having
someone who is well feed the expressed breast milk to the infant.” 2

For more information visit
1. Prevention for 2019 Novel Coronavirus.
2. Interim Guidance on Breastfeeding for a Mother Confirmed or Under Investigation for
C”OVID-19.
3. Interim Considerations for Infection Prevention and Control of 2019 Coronavirus Disease
2019 (COVID-19) in Inpatient Obstetric Healthcare Settings.