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Safe pregnancy and coronavirus (COVID-19)

Information for expectant families and clinicians for a safer pregnancy during coronavirus outbreak. 

We understand that pregnant women and their families are feeling anxious about their safety and the safety of their baby during this outbreak of coronavirus. In our efforts to provide information you can trust, together with advice backed by the medical professionals in antenatal care, Still Aware will endeavour to keep you updated with the latest safe pregnancy information during the coronavirus outbreak.

It is important to understand that as this outbreak is worldwide, so there may be conflicting advice online from multiple countries. Still Aware recommend that you only listen to advice from the government and medical professionals in your country of residence.

What is also important to remember during any pandemic is to:

Seek medical care just as quickly as you would in non pandemic times. It is common that people hesitate to seek promt medical care for all kinds of concerns during a pandemic, but the health systems actually support us all better and use fewer resources if we engage early. When you feel you need urgent care or advice it is safest to act as quickly as you would normally.

According to the latest advice from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, pregnant women should be considered a vulnerable or at-risk group. This means that if you are pregnant, you should be taking all precautions necessary to reduce your risk of contracting COVID-19. This page will be updated regularly with any new advice from Australia. 

Updated 05/06/2020

This information is based on guidance from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG).

In light of the successful flattening of the curve in Australia and New Zealand, RANZCOG has updated their advice regarding routine antenatal care and birth. 

A) Antenatal visits may now be undertaken face to face and at usual intervals.
B) Antenatal face to face classes can now resume within the limitations of social distancing requirements.
C) Accompanying partner at routine visits, hospital visitors and number of support persons in labour as per local protocols, allowing for social distancing measures.
D) Routine screening for gestational diabetes (GDM), refer here.
 
The College recognises that individual institutions and other jurisdictions will have their own protocols in place and these should be adhered to. There remains a risk of a second wave of infection and all social distancing and hygiene precautions should remain in place.

Updated 20/04/2020

This information is based on guidance from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the Australian College of Midwives (ACM), and health advice from the Australian government. You can find additional links at the bottom of the page that we recommend for further reading, as well as a direct link to the COVID-19 symptom checker. 

Are pregnant women more at risk of contracting COVID-19?

Pregnant women should be considered a vulnerable or at-risk group. Although there is limited data available to suggest that pregnant women are more at risk than the general population. However any respiratory illness (such as influenza) can cause serious complications, so it is advised that pregnant women take extra precautions.

Limited data compounded by testing shortages make it difficult to understand the total number of cases and full import of COVID-19 on the population, including pregnant women. Reliable data and testing are needed to make informed recommendations.  

Also see our What We Know for a Safer Pregnancy

What can I do to protect myself from COVID-19?

Pregnant women are advised to follow the Australian Government Department of Health guidelines in preventing COVID-19 infection and take precautions to minimise exposure to the virus, including regular handwashing, social distancing, and for those in health care professions, wearing appropriate personal protection equipment. 

What is the difference between self-isolating and social distancing?

As like everyone else, pregnant women are being advised to avoid unnecessary contact with people and going outside of the house - except for essential needs. This is called social distancing. Self-isolating involves staying at home and only going outside for exercise, and avoiding contact with others, for 14 days. 

What effect does coronavirus have on pregnant women and their babies?

At the moment, pregnant women do not appear to be more unwell if they develop COVID-19 than the rest of the general population. It is expected that most pregnant women will experience mild or moderate cold or flu-like symptoms. 

This virus is still very new, and so the data regarding the impact of COVID-19 infection on pregnant women is limited. Therefore the pregnancy advice from RANZCOG is based on what they know from influenza infection, and also the medical response to the SARS epidemic in 2003. Read more here.

At the moment, there is no evidence that the virus can pass to your baby while you are pregnant. Therefore, it is considered unlikely the virus can cause harm to your baby.

Should I keep attending antenatal care appointments?

Having regular check-ups during your pregnancy is important to monitor the health of you and your baby. A continuity of care is vital for a safe pregnancy.

Pregnant women should still continue to have their antenatal care as per their original schedule with their care provider. It might be that now some of your appointments will be done over the phone or through video conferencing. However when there is a requirement for a physical check /clinical assessment such as fundal height, blood pressure, fetal heart rate - you should always see your care provider in person.

Can pregnant women attend antenatal classes?

Due to the social distancing requirements and restrictions on gatherings greater than two people, including all face-to-face educational sessions will have been postponed or cancelled until further notice.

A number of providers are creating innovative ways to connect with prospective parents to provide education and support in an online format. Ask your care provider if their hospital is providing any online programs.

For example, an ACM midwife in Victoria is offering free online antenatal classes here: www.facebook.com/events/589925751734702/

What to do if you become unwell or worried about your baby?

If you have any concerns, contact your care provider or out-of-hours care team immediately. They will provide you with guidance and will advise you whether you need to go to hospital. It is important not to wait, or to feel anxious on whether you will be allowed to get checked. The health of you and your baby is paramount, and any concerns should always be raised with your care provider. Trust your instincts, even in these uncertain times. 

What do I do if I think I have coronavirus?

If a woman is suspected or diagnosed as COVID-19 positive then it is most likely that the planned appointment may be delayed until after the woman tests negative.

You should let your care provider know about your symptoms, especially if you have any routine appointments in the next 7 days. Where the check-up is urgent and cannot be delayed – if the care provider has personal protective equipment there may be scope for the woman to be seen in her home/the community – or more likely she will be asked to attend a hospital for her appointment where they are set up with the PPE and dedicated space.

Can having coronavirus affect how I give birth?

If you have COVID-19 when your baby is due, the safest place for you to have your baby is in a hospital. Women who are positive are likely to see a lot more health providers wearing personal protective equipment – gloves, gowns, masks, eye protection. They may also be asked to have a continuous CTG in labour and regular temperature and oxygen saturation checks. Their options for use of water – as a bath, may be reduced/removed.

Extra care will be given to make sure you, your baby and the hospital staff assisting you are kept safe.

Is it safe for me to give birth in hospital?

Pregnancy care providers and other health professionals will likely be undertaking a higher level of vigilance as far as reducing contact, social distancing, hand washing and hand hygiene. While these extra precautions may add an increased clinical feel to an otherwise healthy pregnancy, they will be implemented to safeguard the woman, her baby and the care provider and other health workers.

At this time births in hospital are occurring as usual. The advice from ACM is that if you are not COVID-19 positive or suspected positive that there are NO CHANGES to your options in labour. 

If you’re feeling anxious about how COVID-19 will affect your pregnancy?

The best thing women can do as a start is to talk about their fears and concerns with their midwife or clinician. It is possible that having that initial conversation can help the woman to understand her options and work through each of the elements.

Your doctors, midwives and other health workers care about you and your baby. They should understand that you will feel worried. Take the opportunity to rest, eat well and maintain your interests and hobbies, where possible. Your baby has the best protection it will ever have i.e. you, so caring for yourself, your emotional and physical health, is what is most important.

An important COVID-19 update from RANZCOG from RANZCOG on Vimeo.