9 FAQs on Pregnancy during the Coronavirus Pandemic, Answered

Claudia Canavan and Ellen Wallwork
·10-min read

From Women's Health

Coronavirus and pregnant women are not an easy match. Given the natural worries that surround preparing for your baby's birth, the added layer of a global health pandemic is, of course, completely unnerving.

As ever, knowledge around the situation is likely to imbue your thinking with more clarity – and, perhaps, assuage some degree of your anxiety. Scroll down for answers to some frequently asked questions, around expecting during this complicated time.

1. I'm pregnant. Can I get the vaccine?

Given the continuous chat around both the Oxford-Astrazeneca and Pfizer-BioNTech vaccines as our collective route out of this mess, you're likely curious as to if you can be inoculated, while you're expecting.

Hold tight, as this is a bit of a confusing one. Initially, the government, via the Joint Committee on Vaccination and Immunisation (JCVI), advised that, until we have further information, if you're pregnant or breastfeeding, you should not have the vaccine. This was because specific clinical trials of the vaccines on pregnant women have not been carried out – this is typical of most pharmaceutical launches, due to fears around potential problems.

This advice has recently changed, however. The JCVI has stated that the data we have right now does not suggest that there is a safety concern when it comes to the vaccine and pregnant people. But, at the same time, there is not enough evidence to recommend a jab for all who are expecting.

However, if you meet the 'clinically extremely vulnerable' definition, then you are advised to discuss the possibility of vaccination with your doctor. Why? Because you could be at risk of serious issues with the virus, should you contract it. As such, vaccination might be a sensible precaution.

Given how complex this all sounds, the benefits and risks of being vaccinated should be approached individually. This is especially crucial because, while there is not a known issue with administering non-live vaccines to pregnant people, right now, we do not have data that drills into the safety of the COVID-19 vaccines, specifically, in pregnancy.

The RCOG says that the most likely relevant groups of pregnant women are:

  • Solid organ transplant recipients

  • Those with severe respiratory conditions including cystic fibrosis and severe asthma

  • Those who have homozygous sickle cell disease

  • Those receiving immunosuppression therapies sufficient to significantly increase risk of infection

  • Those receiving dialysis or with chronic kidney disease (stage 5)

  • Those with significant congenital or acquired heart disease

You can also discuss being vaccinated if you are frontline health or social care worker, because you may be at higher risk of exposure to the virus.

2. Can I have someone with me, for scans and when I give birth?

Scans and appointments

Since the nation went into lockdown 1.0, there have been restrictions of some type, pertaining to pregnant people being allowed to have a partner with them for scans and appointments. This has meant that many women have reported attending scans, and, in some cases, hearing devastating news of miscarriage or foetal abnormality, alone.

Because NHS Trusts have the power to make their own rules on this matter, there have been discrepancies. Some people have indeed been allowed to have someone with them for certain scans and appointments; others have not. Recently, NHS England chiefs released updated guidance which said that all trusts need to work towards partners being permitted, in a COVID-secure way, to be with pregnant people for scans, appointments, the whole of labour and the postnatal window.

While some trusts have implemented this, not all have. Please check with your midwife or doctor to find out what the rules are, in your hospital.

Labour

Across NHS trusts, partners are allowed for 'active labour (when the cervix is 4-5cm dilated). However, the rules before and after this time frame, again, differ from trust to trust. And, in practice, this restriction meant some partners missing the birth entirely, as well as being asked to leave as soon as the baby had been delivered.

Again, updated NHS England advice is that your partner should be able to be with you for the whole of labour, but not all trusts have worked this out, yet. Talk to your midwife or doctor to understand what you can expect.

3. Are pregnant women more at risk of contracting the virus?

According to the Royal College of Obstetricians and Gynaecologists, the current evidence from UK studies show that you are not more likely to get seriously sick from the virus, if you are pregnant. However, you are on the list of people at 'moderate risk,' or 'clinically vulnerable,' as a precaution.

'Early case study reports suggest that pregnant women are not more susceptible, but the disease may play out differently in them,' says immunologist Dr Jenna Macciochi, author of Immunity: The Science of Staying Well. 'This is based upon the knowledge that pregnancy suppresses immunity slightly.'

'Pregnant women should follow the latest government guidance on staying alert and safe (social distancing) and avoid anyone who has symptoms suggestive of coronavirus,' says the RCOG. 'If you are in your third trimester (more than 28 weeks’ pregnant) you should be particularly attentive to social distancing.'

4. Are any groups at greater risk of hospitalisation with the virus?

Yes. Research, from the University of Oxford and The UK Obstetric Surveillance System, published in the British Medical Journal in June 2020, shows that there are shocking racial disparities at play. This data found that, of pregnant people admitted to hospital with COVID-19, 56% of were from a Black, Asian or Minority Ethnic background – despite these communities only making up 13% of the population.

This is in line with other data exposing a clear disproportionate effect of the coronavirus on ethnic minority groups, and was recognised by the study's authors as requiring 'urgent investigation.' The academics noted that this statistic cannot be explained by people from Black, Asian and Minority Ethnic backgrounds being statistically more likely to live in densely populated areas, as the evidence shows that the effect was seen when women from London, the West Midlands and the North West were excluded from analysis. 'The effect also persisted despite adjustment for age, BMI and co-morbidities,' they added.

When it comes to further groups who were found to be at greater risk of being hospitalised with the virus while pregnant, the analysis showed that:

  • 70% were overweight or obese

  • 40% were aged 35 or over

  • a third had pre-existing comorbidities

5. What should I do, to keep myself as safe as possible?

The RCOG offers up the following advice to pregnant people at this time.

6. What is the specific advice for Black women?

Given the alarming data mentioned above, as well as the terrible reality that Black women are five times as likely to die in childbirth than white women, it pays to be clued up on advice. Here’s how Tinuke Awe and Clotilde Rebecca Abe, of the Five X More campaign, recommend that Black women advocate for themselves in maternity care.

1. Speak up

No one knows your body better than you, and gut feelings are almost always right. So, if you feel like something isn’t right, trust your gut, then make sure you speak to a medical professional; don’t stay silent.

2. Find an advocate

This could be your partner, a family member or a friend – someone you can rely on for support during appointments and who will speak on your behalf, if necessary.

3. Get a second opinion

You’re allowed to ask for a second opinion from another medical professional if you feel you need to.

4. Do your research

Go to trusted sources such as the NHS and NICE websites and patient.info to read up on the stages of care during pregnancy and labour.

5. Document everything

Make sure any treatment or medication you are given – or refused – is written down in your maternity notes by your doctor or midwife, stating their name and reason why. Go a step further and keep your own personal journal in which you write down all of this information, so you can cross-reference.

7. Should I still attend antenatal classes, hospital appointments and scans?

Your antenatal care is still important, which is why Gill Walton, chief executive of the Royal College of Midwives says: 'We would urge all pregnant women who are well, to attend their care as normal. If you are pregnant and have symptoms of possible coronavirus infection, you should call to defer routine visits until after the isolation period is over.

'I would also advise women to speak to their midwife who will be able to keep them informed and tailor their care around their local situation.'

If you have booked antenatal classes, you should speak to your provider, as they may have come up with clever work-arounds to avoid meeting face-to-face - for instance the NCT is now running virtual courses.

8. If I develop COVID-19, could I pass it on to my unborn baby?

Right now, the evidence suggests that if transmission from you to your baby during pregnancy or birth does happen, it's rare. This also appears to be unaffected by how you give birth, or how you feed your baby. The RCOG emphasises that 'in most reported cases of newborn babies developing coronavirus very soon after birth, the babies were well.'

9. What should I do if I have COVID-19 symptoms?

If you develop any of the key COVID-19 symptoms – a high temperature, a new, continuous cough or a loss or change to your normal sense of smell or taste – take the following action.

Please remember that as the situation with coronavirus is developing daily, the advice may well change, so it’s important to keep up to date with reliable sources of information such as the NHS and the RCOG.

The information in this story is accurate as of the publication date. While we are attempting to keep our content as up-to-date as possible, the situation surrounding the coronavirus pandemic continues to develop rapidly, so it's possible that some information and recommendations may have changed since publishing. For any concerns and latest advice, visit the World Health Organisation. If you're in the UK, the National Health Service can also provide useful information and support, while US users can contact the Center for Disease Control and Prevention.

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