This different and difficult time is bringing a lot of concern to many generations. Talking about fertility, trying to get pregnant and pregnancy can be particularly stressful. It can bring along worry, anxiety and loneliness. We are going into unchartered waters and this, in its own right, brings fear.
The most important thing is to give yourself permission to be upset with the current situation if you find you’re pregnant or have a newborn whilst in lockdown. It’s not what you might have planned or expected. But there can also be hope.
In this article, King Edward VII’s consultant and renowned fertility expert Mr Michael Dooley aims to alleviate some fears that expecting or new mothers might be feeling. Remember, you are not alone. Healthcare professionals are here to help and guide you through this difficult time.
Coronavirus and pregnancy
We are still in the early days of understanding Covid-19 and new information and data is coming in every day – this can be difficult for patients as facts change, and they can get confused. Currently, it does not appear that pregnant women are any more likely to get Covid-19, or if they do catch it, to be seriously unwell. Usually, they will get mild flu-like symptoms, although pregnancy may give slightly more aggravated symptoms. Obviously, severity increases as you get older, if you’re immune-compromised or have another medical condition.
If you’re pregnant and have a dry and persistent cough, a temperature, shortness of breath, or loss of taste or smell, the advice is still to call 111 and seek advice. The Covid-19 symptom tracker, which is organised by Kings College Hospital, Guy’s and The Wellcome Institute is particularly good. At the time of writing, over 3.5 million people have contributed to it.
Will Covid-19 affect my baby?
There is no evidence that it increases the risk of miscarriage and no evidence that it increases the risk of abnormality. It may transmit vertically at birth and this is how newborn babies can obtain it. This has been documented anecdotally as well as from two small studies.
You can reduce your chance of catching Covid-19 by routine hand washing, using tissues for facial contact and discarding the tissues in a safe container, and, obviously, avoiding social contact. Social isolation is important and if you’re concerned you’ve been in contact with someone who has contracted Covid-19, don’t panic. Self-isolate and monitor your symptoms.
It is especially important that you continue to listen to and follow the latest Government guidelines.
Ante-natal care and labour during Covid-19
Understandably, people are often worried about ante-natal care and how they will be affected. It is important that you talk to your midwife and your medical team – fear of the unknown can be reduced this way. A pregnancy is there to be enjoyed and cherished, so talking to your care team if you feel overwhelmed will really help alleviate worry.
Scans are still being arranged but there may be some restrictions on when your partner can attend. Certain appointments may also be conducted via phone and approximately 6 visits will be required. However, it is extremely important that if you have any concerns, whatever they are, including decreased movement, bleeding, etc, that you still call your midwife or maternity unit or 111.
If you develop a cough, fever or shortness of breath, it is important that you call 111 and do not attend your scheduled appointment. A lot of these symptoms could be due to other medical conditions, such as a urinary tract infection. The appropriate care will be offered by specialists who will be well equipped to look after you and a lot of health professionals will be wearing PPE. If you have indeed contracted the virus, many hospitals arrange for a check-up scan to be done 2 weeks afterwards.
If your partner gets symptoms, it is essential that they do not attend the hospital, follow government guidelines and make your hospital aware. Your hospital will be able to help you.
During labour, there will be local policies and again, it is important that you talk to your hospital about their policy. It is important that a plan is put together, and the involvement of your partner is discussed. This is true for spontaneous labour, induced labour or for caesarean section. There obviously will be a difference in the environment and a lot of the staff may be wearing PPE.
Breastfeeding and Covid-19
A lot of new parents are worried about breastfeeding, understandably. At present, there is no evidence you cannot continue with this. If you do contract Covid-19, speak to your midwife and follow the latest guidelines but it is currently advisable that you wear masks and take the usual precautions. All visitors should be avoided.
It’s important to remember that yes, your pregnancy and being a new mum is going to be slightly different whilst the pandemic is ongoing. You might find you struggle with feeling alone, but remember there are so many apps and online ante-natal classes which can help.
Social media has also been a beacon of support for pregnancy and post-natal socialising. Just be sure not to seek medical advice in these groups: only accept medical advice from a trained professional (your midwife or health worker).
Getting pregnant during Covid-19
If you’re trying to get pregnant, it is possibly more important now than ever to discuss this with your doctor before trying, if you can. There are arguments for and against, and with the help of your doctor you can weigh up your situation.
If you’re thinking of trying for a baby in the near future, it’s especially important to take regular vitamin supplements of folic acid, as well as Vitamin D, along with addressing any lifestyle changes you might want to make to help you conceive.
All forms of assisted conception have started again and most consultations are done remotely. Scans can be arranged and home blood testing via finger prick tests are becoming the norm. We are running a full service at King Edward VII’s Hospital, so please do call if you want help and guidance.
As we mentioned at the beginning of this article, the advice is changing as new data comes in, so it’s important to speak with your healthcare team if you have any concerns.
For further reading around pregnancy and coronavirus, The Royal College of Obstetricians and Gynaecologists have released a joint paper with the Royal College of Midwives which provides a particularly detailed overview.