This document discusses pregnancy and coronavirus. It begins by noting that birth plans are often disrupted and the emergence of COVID-19 has heightened uncertainty for expecting families. It then provides guidance on protecting oneself while pregnant, including that pregnant women do not appear more at risk of contracting the virus but should take standard precautions. It also addresses concerns around effects on the baby, getting pregnant during the pandemic, limitations to prenatal and postnatal support, and access to abortion. The document concludes by answering frequently asked questions about the virus's impacts and recommendations for pregnant women.

1. PREGNANCY AND CORONA VIRUS
Apurv Charles Sonawane
Master’s Of Public Health –Nutrition (student),
Dr . Shankar rao Chavan Government Medical College,
Nanded.

3.  Most pregnant women, mid pandemic or not,
will be asked to create a birth plan, a brief
document outlining preferences on
everything from the setting to pain
management to medical interventions.
 But, as anyone who’s drawn up one for
themselves knows, birth never really goes as
planned.
 For families who are currently expecting, the
emergence of COVID-19 has heightened that
feeling dramatically.

5.  An effort to limit potential additional
exposure to the virus, the move would leave
women to labor without a trusted person to
rely on and advocate on their behalf.
 So what should pregnant women consider as
they’re adjusting birth plans and taking
precautions? Here is what you should know
about pregnancy and the corona virus.

6. Protecting Yourself While
Pregnant
 Because the virus has only been active for about four
months, there’s very limited data that can be
validated.
 But from what experts have seen with cases in China
and Italy, pregnant women don’t appear to be at an
increased risk of contracting COVID-19, as is the case
with the flu or other respiratory illnesses.
 “Pregnancy itself is a state in which a women’s
immune system is suppressed, so theoretically a
pregnant woman may be more susceptible, but
based on the limited experience with COVID-19, it
hasn’t been seen .”

8.  What we don’t yet know is what might
happen if COVID-19 is contracted in early
pregnancy. “All the information we have at
this point is for women who developed
COVID-19 in their third trimester,” .
 What is reassuring is that children seem to be
protected: Unlike with the flu, which qualifies
newborns and infants as a high-risk group
(along with the elderly and pregnant), they
are not more vulnerable.

9.  It’s also comforting that there’s zero
evidence to date of vertical transmission
(when a disease is passed from mother to
fetus via the placenta).
 “Testing of amniotic fluid and umbilical cord
blood and throat and nasal swabs of
newborns born to parents positive for the
virus do not show any signs of it,”

10.  Because pregnant women aren’t at a
heightened risk for acquiring COVID-19, they
should employ the same precautionary
measures as everyone else: social
distancing and isolating as much as possible,
frequent and thorough hand washing, not
touching your face.
 If you’re pregnant and think you may have
been exposed, you may still be asked to stay
home and monitor symptoms as access to
tests remains limited.

11. Getting Pregnant
 For those who are trying to conceive, all the
uncertainty around COVID-19 can feel especially
unnerving.
 It’s not a bad idea to consider reaching out to a
mental health professional for some guidance.
 When it comes to resources, many health care
providers and hospitals are stretched thin. But if
personal safety is your main concern, from what
we know now, as long as you follow the
guidelines to protect yourself from the virus, you
should be okay.
 “Hopefully people becoming pregnant now, by
the time they give birth we will be done with all
of this.”

14. Pre and Postpartum Support
 The postpartum support network (doulas,
lactation consultants, and yes, grandparents and
family too) must, for the time being, be limited
to online contact.
 Lactation consultants are also shifting to a
virtual model to assist women with any
breastfeeding issues in those first months
postpartum.
 Most doctors and midwives are drastically
scaling back in-person visits, extending the
interval between them, and relying heavily on
telemedicine.

16.  Pregnancy and the post-partum period have
always been times of increased anxiety, so
emotional-support networks are still vitally
important. “The emotional landscape is
different for pregnant women and new
mothers,”
 “It is that women are already in a heightened
state of vigilance where they’re hyper-
protective of their fetus or newborn, and
COVID-19 is throwing their anxiety into
overdrive.”

17. Abortion Access
 Another concern for women amid COVID-19
may be:Will I be able to terminate a
pregnancy, since abortion is considered an
elective procedure?
 “There are doctors who do perform elective
abortions in their offices, and outpatient
abortion clinics staffed with board-certified
obstetricians are still able to see patients.”
 And if it’s early enough, access to medical
termination (using medication such as Plan B
to end a pregnancy) is also an option.

19. Frequently Asked Questions

20. Q1.What effect does corona virus have on
pregnant women?
 Generally, pregnant women do not appear to
be more likely to be severely unwell than
other healthy adults if they develop the new
corona virus.
 It is expected the large majority of pregnant
women will experience only mild or moderate
cold/flu like symptoms.

21.  More severe symptoms such as pneumonia
appear to be more common in older people,
those with weakened immune systems or long-
term conditions.
 As yet, there is no evidence that pregnant
women who get this infection are more at risk of
serious complications than any other healthy
individuals.
 If you develop more severe symptoms or your
recovery is delayed this may be a sign that you
are developing a more significant chest infection
that requires enhanced care then you better
contact the maternal help centre or an hospital.

22. Q2. What effect will corona virus have on my
baby if I am diagnosed with the infection?
 As this is a very new virus we are just beginning
to learn about it.There is no evidence to suggest
an increased risk of miscarriage.
 There is also no evidence that the virus can pass
to your baby while you are pregnant or during
birth (this is called vertical transmission).
 Two cases of possible vertical transmission have
been reported. In both cases, it remains unclear
whether transmission was prior to or soon after
birth.

24.  Another recent report from China of four
women with corona virus infection when they
gave birth found no evidence of the infection
in their newborn babies.
 Expert opinion is that the baby is unlikely to
be exposed during pregnancy.
 It is also therefore considered unlikely that if
you have the virus it would cause problems
with the baby’s development, and none have
been observed currently.

25.  Some babies born to women with symptoms of
corona virus in China have been born
prematurely.
 It is unclear whether corona virus caused early
labour, or whether it was recommended that the
baby was born early in order to preserve the
mother’s health.
 The UK is conducting near-real-time surveillance
of all women who develop COVID-19 during
pregnancy and their newborn babies, through
well-established systems already used by all
maternity units.
 The information will be updated soon if we get
any new evidences.

26. Q3. What can I do to reduce my risk of catching
corona virus?
 For pregnant women, this includes:
 Regular hand washing
 Use a tissue when you or anyone in your family
coughs or sneezes, discard this and wash your
hands
 Avoid contact with someone who is displaying
symptoms of corona virus.These symptoms
include high temperature and/or new and
continuous cough
 Avoid non-essential use of public transport when
possible

28.  Work from home, where possible.
 Avoid large and small gatherings in public
spaces, noting that pubs, restaurants, leisure
centers and similar venues are currently shut
as infections spread easily in closed spaces
where people gather together.
 Avoid gatherings with friends and family.
Keep in touch using remote technology such
as phone, internet, and social media
 Use telephone or online services to contact
your GP or other essential services.

29. Q4.Why are pregnant women in a vulnerable
group?
 Pregnant woman were placed in a vulnerable
group by the Chief Medical Officer on 16th
March.
 This means you have been advised to reduce
social contact through social distancing
measures.
 Based on the evidence we have so far,
pregnant women are still no more likely to
contract corona virus than the general
population.

31.  What we do know is that pregnancy in a small
proportion of women can alter how your
body handles severe viral infections.
 This is something that midwives and
obstetricians have known for many years and
are used to dealing with.
 As yet, there is no evidence that pregnant
women who get this infection are more at risk
of serious complications than any other
healthy individuals.

32.  What has driven the decisions made by
officials to place pregnant women in the
vulnerable category is caution.
 We know that some viral infections are worse
in pregnant women.
 At the moment, there’s no evidence that this
is the case for corona virus infection, but the
amount of evidence available is still quite
limited.

33. Q5.What do I need to do now?
 As a precaution, you should follow
government advice about social distancing;
stay away from public places and avoid
anyone who has symptoms suggestive of
corona virus.
 If you are in your third trimester (more than
28 weeks pregnant) you should be
particularly attentive to social distancing and
minimizing contact with others.

35. Q6. Can I still go to work? What if I work in a
public-facing role?
 We understand that it must be an anxious time if
you are pregnant and you work in a public facing
role , all pregnant women should minimize
social contact as a precautionary measure.
 If you are in your third trimester (more than 28
weeks pregnant), or have an underlying health
condition – such as heart or lung disease - you
should work from home where possible, avoid
contact with anyone with symptoms of corona
virus, and significantly reduce unnecessary social
contact.

37. Q7. What is the advice if I am a healthcare worker
and pregnant?
 Advice for pregnant healthcare workers before
28 weeks gestation:-
 If you are in your first or second trimester (less
than 28 weeks pregnant), with no underlying
health conditions, you should practice social
distancing but can continue to work in a patient-
facing role, provided the necessary precautions
are taken.
 You should avoid, where possible, caring for
patients with suspected or confirmed corona
virus infection.

39.  If this is not possible, you should use personal
protective equipment (PPE) and ensure a
thorough risk assessment is undertaken.
 Some working environments, such as
operating theatres, respiratory wards and
intensive care/high dependency units, carry a
higher risk for all pregnant women of
exposure to the virus and all healthcare
workers in these settings are recommended
to use appropriate PPE.

40.  Advice for pregnant healthcare workers
after 28 weeks gestation, or with an
underlying health condition:-
 If you are in your third trimester (more than
28 weeks pregnant), or have an underlying
health condition – such as heart or lung
disease – you should avoid direct patient
contact.
 You should work from home where possible,
avoid contact with anyone with symptoms of
corona virus, and significantly reduce
unnecessary social contact.

42.  We encourage employers to seek opportunities
for pregnant healthcare workers in their third
trimester to work flexibly in a different capacity,
to avoid roles where they are working directly
with patients.
 Whatever gestation of your pregnancy, you
should discuss your individual circumstances
with your local Occupational Health Department.
 The evidence base for this new virus is growing
rapidly and, as and when new information
emerges, the Government and professional
bodies will update the guidance.

43. Q8.What should I do if I think I may have
corona virus or been exposed?
 If you are pregnant and you have either:
 A high temperature
 A new, continuous cough
 At the present time, only people with severe
symptoms who require overnight admission
to hospital will be tested..
 You should contact your maternity unit to
inform them that you have symptoms
suggestive of corona virus.

45. Q9. How will I be tested for corona virus?
 The process for diagnosing corona virus
infection is changing rapidly. At the current
time, only people with severe symptoms who
require at least overnight admission to
hospital will be tested.
 If you do require a test, you will be tested in
the same way as anyone being tested,
regardless of the fact that you are pregnant.
 Currently, the test involves swabs being taken
from your mouth and nose.
 You may also be asked to cough up sputum, a
mixture of saliva and mucus.

48. Q10. Could I pass corona virus to my baby?
 As this is a new virus, there is limited
evidence about caring for women with corona
virus infection in women who have just given
birth.
 A small number of babies have been
diagnosed with corona virus shortly after
birth but it remains unclear whether
transmission was prior to or soon after birth.
 Expert opinion is that the baby is unlikely to
be exposed during pregnancy.

50. Q11.Will my baby be tested for corona virus?
 Yes, if you have suspected or confirmed
corona virus at the time your baby is born,
your baby will be tested for corona virus.

51. Q12. Will I be able to stay with my baby/give skin-to-
skin if I have suspected or confirmed corona virus?
 Yes, if that is your choice. Provided your baby is well
and doesn’t require care in the neonatal unit, you
will stay together after you have given birth.
 There are some reports from China which suggest
women with confirmed corona virus have been
advised to separate from their baby for 14 days.
 However, this may have potential negative effects
on feeding and bonding.
 A discussion about the risks and benefits should take
place between you and your family and the doctors
caring for your baby (neonatologists) to individualise
care for your baby.

53. Q13.Will I be able to breastfeed my baby if I
have suspected or confirmed corona virus?
 Yes.There is no evidence showing that the
virus can be carried in breast milk, the well-
recognized benefits of breastfeeding
outweigh any potential risks of transmission
of corona virus through breast milk.
 The main risk of breastfeeding is close
contact between you and your baby, as you
may share infective airborne droplets, leading
to infection of the baby after birth.

55.  This guidance may change as knowledge
evolves.
 If you choose to breastfeed your baby, the
following precautions are recommended:
 Wash your hands before touching your baby,
breast pump or bottles
 Try to avoid coughing or sneezing on your baby
while feeding at the breast
 Consider wearing a face mask while
breastfeeding, if available
 Follow recommendations for pump cleaning
after each use
 Consider asking someone who is well to feed
your expressed breast milk to your baby.

57. References
 CDC- Centers for Disease Control
(https://www.cdc.gov/coronavirus/2019-
ncov/prepare/pregnancy-breastfeeding.html)
 The Guardian
(https://www.theguardian.com/us-
news/2020/mar/25/pregnant-during-
coronavirus-pandemic-how-will-it-affect-me-
and-my-baby)

58.  Vogue
(https://www.vogue.com/article/pregnancy-and-
coronavirus-everything-you-need-to-know-now)
 Royal College of Obstetricians And
Gynaecologists, UK
(https://www.rcog.org.uk/en/guidelines-
research-services/guidelines/coronavirus-
pregnancy/covid-19-virus-infection-and-
pregnancy/)
 TimesNowNews
(https://www.timesnownews.com/health/article/
pregnancy-and-coronavirus-faqs-heres-what-
expectant-mothers-need-to-know-about-the-
covid19/569598)

59. If you are worried about being a good mother ,it
means you are already one.
Apurv Charles