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Coronavirus (COVID-19) and Pregnancy

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Right now very little is known about Coronavirus and, more particularly, its effect on pregnant women and their babies (both unborn and newborn). However I thought it important to share what is currently known even though this information may change shortly. If it does I will keep you updated.

This information sheet is based upon the American College of O and G’s (ACOG) Practice Advisory: Novel Coronavirus 2019 (Covid-19). I will directly quote from it so please remember one of my favourite sayings: It ain’t plagiarism if you name the source.

There is some good news in all of this. The value of my Super fund has plummeted in the last week so I now can’t afford to retire and I will be looking after pregnant women for some years to come.

Travel

Currently do not travel to mainland China and I (but not, to be fair, the ACOG) think significant caution needs to be applied to travel to Japan (I suspect the 2020 Olympics will be off), Hong Kong, South Korea and Macau. Iran is definitely out. There is little information coming out of Indonesia regarding Coronavirus so we don’t know whether it is a problem there or not.

I have always planned to go to my grave not having been on a cruise but right now you would just have to be insane to consider the possibility. Anywhere in the world.

Pregnant Women

Based on very limited data and previous experience (with SARS, for instance) pregnant women may be at higher risk of severe illness, complications and death when compared with the general population. If any pregnant woman is very unwell (regardless of the cause) then there are risks for her unborn baby. More specific adverse outcomes such as premature labour have been reported in women positive for Coronavirus but it is not yet known if these events were related to maternal infection.

We are currently unsure as to whether Coronavirus crosses the placenta. Some unsubstantiated reports have suggested babies have been tested positive; but in limited scientific studies no infants born to Coronavirus positive mothers have tested positive.

I don’t believe there is any evidence to suggest that pregnant women who are Coronavirus positive should give birth in any particular way (e.g. by caesarean as we currently advise for HIV positive women). The ACOG is silent on this issue – for now.

It seems the greatest risk to an unborn will be simply that of having a very unwell mother.

Breastfeeding

In – again limited – studies reported so far, there is no evidence of Coronavirus being found in the breast milk of Coronavirus positive mothers. A higher risk for the baby would seem to arise from the risk of droplet spread of infection while breastfeeding so assiduous infection control measures including wearing a mask (its ok I will steal one from the hospital for you) will be very important in this – for us at least – unlikely situation.

The ACOG (and all other professional bodies I’m aware of) haven’t got as far as considering the risk of transmission to the baby if it has chewed its mother’s nipples such that she is bleeding from them. I think we should be very cautious in that specific situation.

The usual stuff

All of the advice that applies to the general population (such as the need for self-isolation if exposed) applies to pregnant women. The World Health Organisation says you only need to wear a mask if you have Coronavirus to prevent infecting others. Well if everyone with Coronavirus wore a mask (and of course many may not know they have it) this thing would be over in a jiffy. So if I was pregnant and travelling on an international flight I would wear a mask as much as possible.

However

Please, please remember that in Australia at least you and/or your baby are vastly more likely to be harmed by Influenza or Whooping Cough than Coronavirus.

GET YOUR VACCINATIONS DONE!

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