Information for pregnant women and their families<\/p>\n\n\n\n
These Q&As relate to the Coronavirus (COVID-19) infection and pregnancy \u2013 guidance for healthcare professionals: Version 3 – 18 March 2020 published by the Royal College of Obstetricians and Gynaecologists, Royal College of Midwives and Royal College of Paediatrics and Child Health, with input from the Royal College of Anaesthetists, Public Health England and Health Protection Scotland.<\/p>\n\n\n\n
?Q1. What effect does coronavirus have on pregnant women?<\/p>\n\n\n\n
Generally,\n pregnant women do not appear to be more severely unwell than the \ngeneral population if they develop coronavirus. As this is a new virus, \nhow it may affect you is not yet clear. It is expected the large \nmajority of pregnant women will experience only mild or moderate \ncold\/flu like symptoms.<\/p>\n\n\n\n
More severe symptoms such as pneumonia \nappear to be more common in older people, those with weakened immune \nsystems or long-term conditions.<\/p>\n\n\n\n
If you are pregnant you are more \nvulnerable to getting infections than a woman who is not pregnant. If \nyou have an underlying condition, such as asthma or diabetes, you may be\n more unwell if you have coronavirus.<\/p>\n\n\n\n
If you develop more severe \nsymptoms or your recovery is delayed this may be a sign that you are \ndeveloping a more significant chest infection that requires enhanced \ncare, and our advice remains that if you feel your symptoms are \nworsening or if you are not getting better you should contact your \nmaternity care team or use the NHS 111 online service for further \ninformation and advice.<\/p>\n\n\n\n
?Q2. What effect will coronavirus have on my baby if I am diagnosed with the infection?<\/p>\n\n\n\n
As\n this is a very new virus we are just beginning to learn about it. There\n is no evidence to suggest an increased risk of miscarriage. There is \nalso no evidence that the virus can pass to your developing baby while \nyou are pregnant (this is called vertical transmission). Two cases of \npossible vertical transmission have been reported. In both cases, it \nremains unclear whether transmission was prior to or soon after birth. \nAnother recent report from China of four women with coronavirus \ninfection when they gave birth found no evidence of the infection in \ntheir newborn babies. Expert opinion is that the fetus is unlikely to be\n exposed during pregnancy. It is also therefore considered unlikely that\n if you have the virus it would cause abnormalities in your baby and \nnone have been observed currently.<\/p>\n\n\n\n
Some babies born to women with \nsymptoms of coronavirus in China have been born prematurely. It is \nunclear whether coronavirus caused this or the doctors made the decision\n for the baby to be born early because the woman was unwell. As we learn\n about the risk of pre-term birth and coronavirus infection, we will \nupdate this information.<\/p>\n\n\n\n
?Q3. What can I do to reduce my risk of catching coronavirus?<\/p>\n\n\n\n
The\n most important thing to do is to wash your hands regularly and \neffectively as soon as you come from public places to your home or \nworkplace. There is useful advice on the NHS website on the best way to \nreduce any infection risk, not just for coronavirus, but for other \nthings like colds and flu. <\/p>\n\n\n\n
Questions 4-7 added following the announcement on 16 March 2020 that pregnant women have been placed in a \u2018vulnerable group\u2019<\/p>\n\n\n\n
? Q4. Why are pregnant women in a vulnerable group?<\/p>\n\n\n\n
Pregnant\n woman were placed in a vulnerable group by the Chief Medical Officer on\n 16th March. This means you have been advised to reduce social contact \nthrough social distancing measures.<\/p>\n\n\n\n
Based on the evidence we have \nso far, pregnant women are still no more likely to contract coronavirus \nthan the general population. What we do know is that pregnancy in a \nsmall proportion of women can alter how your body handles severe viral \ninfections. This is something that midwives and obstetricians have known\n for many years and are used to dealing with. As yet, there is no \nevidence that pregnant women who get this infection are more at risk of \nserious complications than any other healthy individuals.<\/p>\n\n\n\n
What has\n driven the decisions made by officials is a desire to be very cautious \nabout pregnant women. We know that some viral infections are worse in \npregnant women. At the moment, there\u2019s no evidence that this is the case\n for coronavirus infection, but the amount of evidence is still quite \nlimited.<\/p>\n\n\n\n
? Q5.What do I need to do now?<\/p>\n\n\n\n
All pregnant women should follow the PHE advice:<\/p>\n\n\n\n
Guidance on social distancing for all vulnerable people including pregnant women<\/p>\n\n\n\n
Guidance for individuals and households with possible coronavirus infection<\/p>\n\n\n\n
? Q6. Can I still go to work?<\/p>\n\n\n\n
Pregnant\n women who can work from home should do so. If you can\u2019t work from home,\n if you work in a public-facing role that can be modified appropriately \nto minimise your exposure, this should be considered and discussed with \nyour occupational health team.<\/p>\n\n\n\n
More detailed advice for pregnant \nwomen, including those who cannot work from home, such as healthcare \nworkers, is being developed and will be made available as soon as \npossible.<\/p>\n\n\n\n
? Q7. Should I attend my antenatal appointments?<\/p>\n\n\n\n
Attending\n antenatal and postnatal care when you are pregnant and have a new baby \nis essential to ensure the wellbeing of you and your baby.<\/p>\n\n\n\n
If you \nare well, you should attend your antenatal care as normal. If you have \nsymptoms of possible coronavirus infection, you should postpone routine \nvisits until after the isolation period is over.<\/p>\n\n\n\n
The following practical advice may be helpful:<\/p>\n\n\n\n
If\n you have a routine scan or visit due in the coming days, please contact\n your maternity unit for advice and a plan. You will still need to \nattend for a visit but the appointment may change due to staffing \nrequirements.<\/p>\n\n\n\n
Some appointments may be conducted on the telephone \nor using videoconferencing, provided there is a reasonable expectation \nthat maternal observations or tests are not required.<\/p>\n\n\n\n
If you are between appointments, please wait to hear from your maternity team.<\/p>\n\n\n\n
If you are attending more regularly in pregnancy, then your maternity team will be in touch with plans.<\/p>\n\n\n\n
If you miss an appointment and haven\u2019t heard from your maternity team, please contact them to rearrange the appointment.<\/p>\n\n\n\n
Whatever your personal situation please consider the following:<\/p>\n\n\n\n
If\n you have any concerns you will still be able to contact your maternity \nteam but please note they may take longer to get back to you<\/p>\n\n\n\n
If \nyou have an urgent problem related to your pregnancy but not related to \ncoronavirus, get in touch using the same emergency contact details you \nalready have. Please do not contact this number unless you have an \nurgent problem<\/p>\n\n\n\n
If you have symptoms suggestive of coronavirus \ncontact your maternity services and they will arrange the right place \nand time to come for your visits. You should not attend a routine \nclinic.<\/p>\n\n\n\n
You will be asked to keep the number of people with you at appointments to a minimum, including children.<\/p>\n\n\n\n
There\n may be a need to reduce the number of antenatal visits. This will be \ncommunicated with you. Do not reduce your number of visits without \nagreeing first with your maternity team.<\/p>\n\n\n\n
? Q8. What is the travel advice if I am pregnant?<\/p>\n\n\n\n
If\n you are in the UK, you should follow the advice given by the Foreign \nand Commonwealth Office, which is being regularly updated in line with \nthe evolving situation.<\/p>\n\n\n\n
All individuals, including pregnant women,\n should ensure they have adequate insurance arrangements prior to \ntravel. You should also check that your travel insurance will provide \ncover for birth and care of your newborn baby if you give birth while \nabroad.<\/p>\n\n\n\n
? Q9. What should I do if I think I may have coronavirus or been exposed?<\/p>\n\n\n\n
If you are pregnant and you have either:<\/p>\n\n\n\n
– a high temperature<\/p>\n\n\n\n
– a new, continuous cough<\/p>\n\n\n\n
You\n should stay at home for 7 days. Do not go to a GP surgery, pharmacy or \nhospital. You do not need to contact NHS 111 to tell them you are \nstaying at home. You do not need a test for coronavirus. At the present \ntime, only people with severe symptoms who require overnight admission \nto hospital will be tested. <\/p>\n\n\n\n
You should contact your maternity \nunit to inform them that you have symptoms suggestive of coronavirus, \nparticularly if you have any routine appointments in the next 7 days.<\/p>\n\n\n\n
You should use the NHS 111 online coronavirus service, or call NHS 111 if:<\/p>\n\n\n\n
– you feel you cannot cope with your symptoms at home<\/p>\n\n\n\n
your condition gets worse<\/p>\n\n\n\n
– your symptoms do not get better after 7 days<\/p>\n\n\n\n
If\n you have concerns about the wellbeing of yourself or your unborn baby \nduring your self-isolation period, contact your midwife or, \nout-of-hours, your maternity team. They will provide further advice, \nincluding whether you need to attend hospital.<\/p>\n\n\n\n
? Q10. How will I be tested for coronavirus?<\/p>\n\n\n\n
The\n process for diagnosing coronavirus infection is changing rapidly. At \nthe current time, only people with severe symptoms who require at least \novernight admission to hospital will be tested.<\/p>\n\n\n\n
If you do require a\n test, you will be tested in the same way as anyone being tested, \nregardless of the fact that you are pregnant. Currently, the test \ninvolves swabs being taken from your mouth and nose. You may also be \nasked to cough up sputum, a mixture of saliva and mucus.<\/p>\n\n\n\n
? Q11. What should I do if I test positive for coronavirus?<\/p>\n\n\n\n
If\n you test positive for coronavirus, you should contact your midwife or \nantenatal team to make them aware of your diagnosis. If you have no \nsymptoms, or mild symptoms, you will be advised to recover at home. If \nyou have more severe symptoms, you might be treated in a hospital \nsetting.<\/p>\n\n\n\n
? Q12. Why would I be asked to self-isolate (as opposed to reducing social contact)?<\/p>\n\n\n\n
You may be advised to self-isolate because:<\/p>\n\n\n\n
– You have symptoms of coronavirus, such as a high temperature or new, continuous cough<\/p>\n\n\n\n
– You have tested positive for coronavirus and you\u2019ve been advised to recover at home<\/p>\n\n\n\n
? Q13. What should I do if I\u2019m asked to self-isolate?<\/p>\n\n\n\n
Pregnant\n women who have been advised to self-isolate should stay indoors and \navoid contact with others for 7 days. If you live with other people, \nthey should stay at home for at least 14 days, to avoid spreading the \ninfection outside the home.<\/p>\n\n\n\n
The NHS guidance on self-isolation currently recommends people should:<\/p>\n\n\n\n
– Not go to school, work, NHS settings or public areas<\/p>\n\n\n\n
– Not use public transport<\/p>\n\n\n\n
– Stay at home and not allow visitors<\/p>\n\n\n\n
– Ventilate the rooms where they are by opening a window<\/p>\n\n\n\n
–\n Separate themselves from other members of their household as far as \npossible, using their own towels, crockery and utensils and eating at \ndifferent times<\/p>\n\n\n\n
– Use friends, family or delivery services to run errands, but advise them to leave items outside.<\/p>\n\n\n\n
– You may wish to consider online fitness routines to keep active, such as pregnancy yoga or Pilates.<\/p>\n\n\n\n
? Q14. Can I still attend my antenatal appointments if I am in self-isolation?<\/p>\n\n\n\n
You\n should contact your midwife or antenatal clinic to inform them that you\n are currently in self-isolation for possible\/confirmed coronavirus and \nrequest advice on attending routine antenatal appointments.<\/p>\n\n\n\n
It is \nlikely that routine antenatal appointments will be delayed until \nisolation ends. If your midwife or doctor advises that your appointment \ncannot wait, the necessary arrangements will be made for you to be seen.\n For example, you may be asked to attend at a different time, or in a \ndifferent clinic, to protect other patients.<\/p>\n\n\n\n
? Q15. How will my care be managed after I have recovered from coronavirus?<\/p>\n\n\n\n
If\n you have confirmed coronavirus infection, as a precautionary approach, \nan ultrasound scan will be arranged 14 days after your recovery, to \ncheck that your baby is well. This 14 day period may be reduced as more \ninformation on how infected people are as they recover becomes \navailable.<\/p>\n\n\n\n
If you have recovered from coronavirus and tested \nnegative for the virus before you go into labour, where and how you give\n birth will not be affected by your previous illness.<\/p>\n\n\n\n
?Q16. What do I do if I feel unwell or I\u2019m worried about my baby during self-isolation?<\/p>\n\n\n\n
Pregnant women are advised not to attend maternity triage units or A&E unless in need of urgent pregnancy or medical care.<\/p>\n\n\n\n
–\n If you have concerns about the wellbeing of yourself or your unborn \nbaby during your self-isolation period, contact your midwife or, \nout-of-hours, your maternity team. They will provide further advice, \nincluding whether you need to attend hospital.<\/p>\n\n\n\n
– If attendance at \nthe maternity unit or hospital is advised, pregnant women are requested \nto travel by private transport, or arrange hospital transport, and alert\n the maternity triage reception once on the premises, prior to entering \nthe hospital.<\/p>\n\n\n\n
? Q17. Will being in self-isolation for suspected or confirmed coronavirus affect where I give birth?<\/p>\n\n\n\n
As\n a precautionary approach, pregnant women with suspected or confirmed \ncoronavirus when they go into labour, are being advised to attend an \nobstetric unit for birth, where the baby can be monitored using \ncontinuous electronic fetal monitoring, and your oxygen levels can be \nmonitored hourly.<\/p>\n\n\n\n
The continuous fetal monitoring is to check how \nyour baby is coping with labour. As continuous fetal monitoring can only\n take place in an obstetric unit, where doctors and midwives are \npresent, it is not currently recommended that you give birth at home or \nin a midwife led unit, where only midwifes would be present.<\/p>\n\n\n\n
We will keep this advice continually updated as new evidence emerges.<\/p>\n\n\n\n
? Q18. Will being in self-isolation for suspected or confirmed coronavirus affect how I give birth?<\/p>\n\n\n\n
There\n is currently no evidence to suggest you cannot give birth vaginally or \nthat you would be safer having a caesarean birth if you have suspected \nor confirmed coronavirus, so your birth plan should be followed as \nclosely as possible based on your wishes.<\/p>\n\n\n\n
However, if your \nrespiratory condition (breathing) suggests that urgent delivery is \nneeded, a caesarean birth may be recommended.<\/p>\n\n\n\n
It is not \nrecommended that you give birth in a birthing pool in hospital if you \nhave suspected or coronavirus, as the virus can sometimes be found in \nfaeces. It may also be more difficult for healthcare staff to use \nadequate protection equipment during a water birth.<\/p>\n\n\n\n
There is no \nevidence that women with suspected or confirmed coronavirus cannot have \nan epidural or a spinal block. In our previous version of the guidance \nit was suggested that the use of Entonox (gas and air) may increase \naerosolisation and spread of the virus, but a review of the evidence \nsuggests there is no evidence that Entonox is an aerosol-prone \nprocedure, so there is no reason you cannot use this in labour.<\/p>\n\n\n\n
? Q19. What happens if I go into labour during my self-isolation period?<\/p>\n\n\n\n
If\n you go into labour, you should call your maternity unit for advice, and\n inform them that you have suspected or confirmed coronavirus infection.<\/p>\n\n\n\n
If you have mild symptoms, you will be encouraged to remain at home (self-isolating) in early labour, as per standard practice.<\/p>\n\n\n\n
Your\n maternity team have been advised on ways to ensure that you and your \nbaby receive safe, quality care, respecting your birth plan as closely \nas possible.<\/p>\n\n\n\n
When you and your maternity team decide you need to \nattend the maternity unit, general recommendations about hospital \nattendance will apply:<\/p>\n\n\n\n
You will be advised to attend hospital via private transport where possible, or call 111\/999 for advice, as appropriate<\/p>\n\n\n\n
You\n will be met at the maternity unit entrance and provided with a surgical\n face mask, which will need to stay on until you are isolated in a \nsuitable room<\/p>\n\n\n\n
Coronavirus testing will be arranged<\/p>\n\n\n\n
Your birth partner(s) will be able to stay with you throughout, but visitors should be kept to a minimum<\/p>\n\n\n\n
? Q20. Could I pass coronavirus to my baby?<\/p>\n\n\n\n
As\n this is a new virus, there is limited evidence about managing women \nwith coronavirus infection in women who have just given birth; however, \nthere are no confirmed reports of women diagnosed with coronavirus \nduring the third trimester of pregnancy having passed the virus to their\n babies while in the womb.<\/p>\n\n\n\n
? Q21. Will my baby be tested for coronavirus?<\/p>\n\n\n\n
Yes, if you have suspected or confirmed coronavirus at the time your baby is born, your baby will be tested for coronavirus.<\/p>\n\n\n\n
?Q22. Will I be able to stay with my baby\/give skin-to-skin if I have suspected or confirmed coronavirus?<\/p>\n\n\n\n
Yes,\n if that is your choice. Provided your baby is well and doesn\u2019t require \ncare in the neonatal unit, you will be kept together after you have \ngiven birth.<\/p>\n\n\n\n
There are some reports from China which suggest women\n with confirmed coronavirus have been advised to separate from their \nbaby for 14 days. However, this may have potential negative effects on \nfeeding and bonding.<\/p>\n\n\n\n
A discussion about the risks and benefits \nshould take place between you and your family and the doctors caring for\n your baby (neonatologists) to individualise care for your baby.<\/p>\n\n\n\n
This guidance may change as knowledge evolves.<\/p>\n\n\n\n
? Q23. Will I be able to breastfeed my baby if I have suspected or confirmed coronavirus?<\/p>\n\n\n\n
Yes.\n At the moment there is no evidence that the virus can be carried in \nbreastmilk, so it\u2019s felt that the well-recognised benefits of \nbreastfeeding outweigh any potential risks of transmission of \ncoronavirus through breastmilk.<\/p>\n\n\n\n
The main risk of breastfeeding is \nclose contact between you and your baby, as you may share infective \nairborne droplets, leading to infection of the baby after birth.<\/p>\n\n\n\n
A\n discussion about the risks and benefits of breastfeeding should take \nplace between you and your family and your maternity team.<\/p>\n\n\n\n
This guidance may change as knowledge evolves.<\/p>\n\n\n\n
If you choose to breastfeed your baby, the following precautions are recommended:<\/p>\n\n\n\n
– Wash your hands before touching your baby, breast pump or bottles<\/p>\n\n\n\n
– Try to avoid coughing or sneezing on your baby while feeding at the breast<\/p>\n\n\n\n
– Consider wearing a face mask while breastfeeding, if available<\/p>\n\n\n\n
– Follow recommendations for pump cleaning after each use<\/p>\n\n\n\n
– Consider asking someone who is well to feed your expressed breast milk to your baby.<\/p>\n\n\n\n
–\n If you choose to feed your baby with formula or expressed milk, it is \nrecommend that you follow strict adherence to sterilisation guidelines. \nIf you are expressing breast milk in hospital, a dedicated breast pump \nshould be used.<\/p>\n\n\n\n
? Q24. What is the advice if I am a healthcare worker and pregnant?<\/p>\n\n\n\n
We\n understand that it must be an anxious time if you work in healthcare \nand you are pregnant, especially following the Chief Medical Officer\u2019s \nadvice on 16 March 2020 for all pregnant women to minimise social \ncontact as a precautionary measure. To the best of our knowledge, most \npregnant healthcare professionals are no more personally susceptible to \ncatching the virus than their non-pregnant colleagues.<\/p>\n\n\n\n
There is no\n convincing evidence that coronavirus infection can affect your baby\u2019s \ngrowth, but as other similar viruses have been known to cause fetal \ngrowth restriction, an extra ultrasound scan 14 days later is advised, \nas a precaution.<\/p>\n\n\n\n
If you become unwell due to infection with \ncoronavirus, it may occasionally be necessary to deliver your baby early\n to help you to recover. In this situation, the baby may need to be \ndelivered prematurely.<\/p>\n\n\n\n
You should discuss your individual circumstances with your local Occupational Health department.<\/p>\n\n\n\n
Further\n guidance for pregnant healthcare workers is being sought urgently and \nwill be published in our next update to the guidance.<\/p>\n","protected":false},"excerpt":{"rendered":"
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