Is it safe to continue prenatal check-ups?
Many expectant mothers are fearful of going to appointments while they are taking precautions, such as staying home and practicing physical distancing when outside. āYou do see a lot of adaptation happening at the moment in the world where midwives are doing clinics or certain appointments by phone, so that the actual looking at the baby and the growth of the baby appointment can be short,ā says CadĆ©e. āI expect that pregnant women will find theyāre seeing their healthcare professional less, to protect them and the healthcare professional from getting infected and that they will be seen live when itās necessary.ā Modifications may also be tailored for individual patients depending on their respective conditions, for example lower vs. higher-risk pregnancies.
CadĆ©e advises mothers to find out what options are available to them from their healthcare professional and in their communities. āThe person whoās taking care of you is perfectly geared to you and your own needs, so your midwife or obstetrician will know best.ā
After your child is born, it is also important to continue receiving professional support and guidance, including routine immunizations. Speak to your healthcare provider about the safest way to have these appointments, for you and your baby.
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If I have coronavirus disease (COVID-19) will I pass it to my baby?
We still do not know if the virus can be transmitted from a mother to her baby during pregnancy. āThe COVID-19 virus has not been found in vaginal fluid, in cord blood or breastmilk,ā says CadĆ©e, although information is still emerging. To date, COVID-19 has also not been detected in amniotic fluid or the placenta.
The best thing you can do is to take all necessary precautions to prevent yourself from contracting the COVID-19 virus. However, if youāre pregnant or have just given birth and feel ill, then you should seek medical care promptly and follow instructions from your health care provider.Ā
I was planning on giving birth in a hospital or healthcare clinic. Is this still a good option?
āWomen should ask their midwife [or health care professional] what they feel is the safest place for them and how precautions are being taken from situation to situation,ā recommends CadĆ©e. āIt depends on the woman, on her situation and on the healthcare system.āĀ
āYou would hope that most healthcare facilities have different facilities where those with the COVID-19 virus go in one entrance and the others in another. But in some situations thatās totally not possible,ā says CadĆ©e. āIn certain high-income countries like in the Netherlands where I come from, we have a system whereby home birth is integrated within the system. So home birth within the system is safe and you are seeing more women give birth at home [but this is certainly not the case in most countries]. And even certain hotels are being used in the Netherlands by midwives for women to be able to give birth in the hotel which is made safe for a woman to give birth, so she doesnāt have to go to the hospital. But that is very much within that local context.āĀ
For the safest option for you, it important to speak to the healthcare professional who is supporting you throughout your pregnancy and birth.
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Can my partner or family member be nearby when I give birth?
While policies vary by country, CadĆ©e believes women should have someone nearby to support them, as long as the proper precautions are taken, such as wearing a mask while in the delivery room and washing their hands. āWe are finding that in certain countries people are not being allowed to be with women, and that is worrying me. I can understand that you want to reduce the number of people with a woman while she is giving birth because youāre trying to reduce contact, and that is very very logical, but letās make sure that a woman has someone, one person, with her while sheās giving birth ā her partner, her sister, her mother, [or the closest person of her choice]. And please keep the babies with the mothers.ā
āWe have to be compassionate and understand each situation as it is and that the healthcare professionals together with the family members are doing their best, using their common sense and listening to each other. I think thatās very important: that we try to work as a community.ā
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Iām feeling incredibly anxious about giving birth. What should I do to cope?
Having a plan in place for your birth can help ease feelings of anxiety by giving you more of a sense of control, but recognizing that the current situation means there may be less predictability depending where you live. āThis should include who to phone when the labour begins, who will provide support during labour and where. Establish what restrictions will be in place for hospital birth regarding support people and family members,ā advises CadĆ©e.
She also recommends doing simple things at home to relax, ālike [stretching] exercises, breathing exercises and giving your midwife a call if you need to.ā Focus on taking care of yourself as much as you possibly can. āEat well, drink well, put your hands on your belly and enjoy being pregnant.ā
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What questions should I be asking my healthcare professional?
CadĆ©e underlines the importance of establishing a trusting relationship with your healthcare provider. āAll of those questions that have to do with you and your health, I would ask them freely. If you have an open relationship with your healthcare provider ā with your midwife, with your obstetrician ā they will discuss these things with you and answer you openly. It is your absolute right to know these things because itās your body and your baby.ā
āMidwives are responding to increased demands on their services as are doctors and nurses, and so may take a little longer to respond,ā CadĆ©e notes. She suggests establishing a system of how and when to communicate with your healthcare professional. For example, organize routine around appointments, and how to get in touch for urgent care. It may also be helpful to talk to care providers in advance about obtaining a copy of your health records including record of prenatal care, in case of any disruption or change in services.
When it comes to your plan for giving birth, it is important to ask as many questions as you need to. CadƩe suggests the following:
- Am I at risk of coronavirus disease (COVID-19) in this space? Has someone else been here with the COVID-19 virus?
- How do you separate people with the COVID-19 virus from people who have not?
- Is there enough protective clothing for the healthcare professionals?
- Am I allowed to take someone with me? If not, why not?
- Am I allowed to keep my baby with me? If not, why not?
- Am I able to breastfeed my baby? If not, why not?
- Am I allowed to give birth vaginally or do you give Caesarean section sooner? If so, why is that?Ā
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What should women pack to go into hospital given the coronavirus disease (COVID-19) outbreak?
āI donāt think women need to take anything extra, but they should take precautions well into account,ā advises CadĆ©e.
She expects some hospitals may ask women to go home more quickly than normal if theyāre healthy. āAgain, that will be different from area to area, from woman to woman, from hospital to hospital,ā she says, recommending expecting mothers to āask their midwife or their obstetrician for advice thatās really tailor made for them.ā
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Once I have given birth, what can I do to protect my newborn from the COVID-19 virus?
The best thing you can do is to keep it simple: stick to just your family and donāt ask for visitors right now. āAlso make sure that your children (if you have other children) thatĀ theyāreĀ not with other children. Get your family to wash their hands and take good care of themselves,ā says CadĆ©e.
Although itās a difficult time, CadĆ©e recommends trying to see the positive side of having this time to bond as a family. āSometimes it can be very busy for young mothers and fathers to have so many visitors. Enjoy the quietness of your [immediate] family together for this time. Itās quite special to be able to bond with your baby alone, discover that new human being and enjoy that.ā
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