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COVID-19 and breastfeeding

Prepare for Coronavirus in Pregnancy

To prepare for Coronavirus in pregnancy carry on reading. As an Independent Midwife, one of the most important things I can do is to empower you with information.

  • Pregnant women do not appear to be more severely affected if they develop COVID-19 infection than the general population, unless they have an underlying condition such as asthma or diabetes.
  • Most women will experience mild or moderate cold/flu like symptoms, cough, fever (above 37.8 degrees) and shortness of breath.
  • There are no current reported deaths in pregnant women.
  • Amniotic fluid, cord blood, neonatal throat swabs and breastmilk samples from infected mothers and all samples tested negative for the virus (2). Three placentas of infected mothers tested negative for the virus (3).
  • The risk of vertical transmission (transmission from mother to baby during pregnancy and birth) is low.
  • There is currently no evidence to favour one mode of birth over another.
  • Delayed cord clamping is still recommended following birth, provided there are no other contraindications.

Prepare for coronavirus in pregnancy    COVID-19 and virus detection

To prepare and minimise risk for Coronavirus in pregnancy

  1. Practice good hygiene: wash hands regularly and minimise touching your face.
  2. Please practise social distancing (keep 2metres distance from others in the street).
  3. Work from home (if possible).
  4. Try to avoid public transport.
  5. Strengthen your immunity: take vitamin C, eat and sleep well, keep active. Continue doing light exercise such as pregnancy yoga or walks. If self-isolating, consider following an online yoga class or do a home workout.
  6. Latest government update: avoid “non-essential social contact” with other people. (5)

Preparing for labour and birth with no signs of infection

  • Follow your birth plan as normal.
  • There is a limit in numbers of non-essential birth supporters/visitors. However, you should still have access to maternity professionals such as your independent midwife, and other birth workers such as doulas.
  • You may opt for a home birth to minimise contact with others. This is what happened with one of my clients who decided to change from planned hospital birth to stay at home.
  • However, home birth services on the NHS may be restricted, as they will need all their employees at hospitals. A way around this is by hiring independent midwives who are dedicated to come to you.
  • Independent Midwives UK (IMUK), have written to the NHS England with an offer of supporting the NHS to continue to staff their homebirth services. At the time of writing, we are awaiting response from NHS England.

** Update: NHS England have accepted IMUK’s help. Several NHS Trusts around the country are providing Independent Midwives with special contracts which will allow them to work. Ask whether your Trust is taking part in this scheme. 

What to do if you have Coronavirus symptoms

Stay at home for 14 days, self-isolate with your entire family. Inform your maternity unit (5). If you feel your condition gets worse, or you have any concerns please use the online NHS 111 tool or call NHS 111. (This is for residents of England, Wales or Northern Ireland).

If you have an antenatal appointment

Inform your maternity care providers – your routine appointments, such as growth scans, oral glucose tolerance test, antenatal checks, are likely to be rescheduled until after you are out of self-isolation.

For high risk maternity care such as fetal medicine surveillance, speak to your doctor about the urgency and potential risks/benefits of keeping/rescheduling your appointment.

Currently, some NHS trusts are implementing telephone antenatal checks rather than asking you to come to the clinic. Please check with your local provider what their policy is.

Labour and birth if possible/confirmed infection with COVID-19

  • If you have mild symptoms remain at home in early labour.
  • Once in established labour you can attend the labour ward.
  • Doctors will monitor your baby’s heart rate continuously, as well as keeping an eye on your oxygen levels.

Your elective caesarean birth and planned inductions of labour may be delayed. Your doctors should discuss your case and make an individual assessment regarding the urgency and safety for your care.

To prepare for Coronavirus and minimise infection risk you may like to join my online pregnancy yoga classes. To join – get in touch!

 

Contact me for Online Yoga Classes

 

Online pregnancy yoga class

 

For more information: Q&As relating to Coronavirus (COVID-19) and pregnancy.

DISCLAIMER: The global picture of COVID-19 is constantly evolving. The information I’m sharing with you is the most up to date version of guidelines from Royal College of Obstetrics and Gynaecologists (RCOG) as of Friday March 13th 2020. [RCOG (2020) Coronavirus (COVID-19) Infection in Pregnancy: Information for healthcare professionals, Version 2] and the latest press conference by the Prime Minister.

References:

(1) Rasmussen S, Smulian J, Lednicky J, et al. (2020) Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know. American Journal of Obstetrics and Gynecology.

(2) Chen H, Guo J,Wang C, et al. (2020) Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet.

(3) Chen S, Huang B, Luo DJ, et al. (2020) Pregnant women with new coronavirus infection: a clini- cal characteristics and placental pathological analysis of three cases. Zhonghua Bing Li Xue Za Zhi 2020;49(0):E005-E05.

(4) Wang X, Zhou Z, Zhang J, et al. (2020) A case of 2019 Novel Coronavirus in a pregnant woman with pre-term delivery. Clinical Infectious Diseases

(5) Boris Johnson warns UK population to avoid non-essential contact as UK coronavirus death toll rises to 55 – politics live. Press Conference March 16th 2020.