KOCHI: Pregnancy is a very special period in a woman’s and her family’s life. However, going through it during a pandemic can be stressful. The chances of a pregnant woman contracting Covid is similar to the rest of the healthy population. Roughly around 75% of pregnant women with Covid shows no symptoms at all or shows only mild symptoms like cold or flu. However, a small number of them can become seriously ill if they contract the virus, which may even lead to loss of life.
Pregnant women are at an increased risk of becoming severely ill when compared to non-pregnant women, especially after the 28th week. They are included in the moderate-risk group. Usually, severe illness is seen in women who are above 35 years, obese or have associated diseases like diabetes, Mellitus and hypertension.
On unborn babies
All pregnant women are concerned about the effect of Covid on their unborn babies. Studies so far have shown infection during pregnancy is unlikely to cause miscarriages or fetal anomalies, though it has been linked to low birth weight, growth delays and preterm deliveries (before 37 weeks). Premature deliveries can occur due to severe infection itself, most often it is due to early caesarean deliveries undertaken by the obstetrician to promote recovery of the sick mother.
Another concern is whether the Covid infection will be transmitted from the mother to the baby during pregnancy or childbirth. Studies so far have not shown an in utero transmission of the virus to the fetus. Routinely all babies are tested for the virus after birth. If at all a newborn is infected, they have been found to remain well without any consequences.
Regarding breastfeeding in Covid positive mothers, the World Health Organization (WHO) has recommended encouraging it so long as adequate precautions are taken like using hand hygiene and facemask. The covid virus has not been detected in breast milk. In spite of this directive by the WHO, many institutions still isolate the baby from the mother and give expressed breast milk. Finally, it is a combined decision of the mother and the caregiver regarding whether to breastfeed or not.
Support
Hospitals and care providers have made adjustments in antenatal care to avoid the risk of getting exposed to Covid by reducing the number of visits a pregnant woman makes to the hospital with extra support provided over telephone or telemedicine. It is important to counsel pregnant mothers with Covid that during delivery she must be prepared to have fewer visitors and family support in the labour room in view of the protocol of the hospital. This may result in mental health issues like anxiety and loneliness, which needs to be dealt with by counselling. A birth companion is definitely encouraged in the labour room during delivery though it is not followed in most of the delivery points.
Fertility treatment
In the initial days of the pandemic, there was a trend towards discouraging pregnancy and assisted fertilisation which is no more believed to be practical or necessary. Women can definitely plan a pregnancy as well as take treatment for infertility unless there is a rampant infection in their vicinity. Whether the Covid virus affects a couple’s fertility is still not clear though some studies have demonstrated an adverse effect on the sperm count in men.
Vaccination
Women undergoing fertility treatment and pregnant women should be encouraged to receive Covid vaccination. Since it is a live vaccine, there is no reason to delay pregnancy attempts because of the vaccine administration or to defer treatment until the second dose has been administered. Neither does the vaccine increase the risk of infertility nor miscarriage. Finally, it is a shared decision between a woman and care providers when considering vaccinating during pregnancy.
WHO has recommended the Covid vaccine to all pregnant women and the Indian government only recently approved vaccination to be given any time in pregnancy and lactation. The benefits of vaccination outweigh the potential risk of Covid infection, especially since the second wave hit pregnant and lactating women more severely. Following social distancing, hand hygiene, using a facemask, keeping well hydrated and mobile, regular exercise and a balanced diet can help a healthy pregnancy and reduce infections.