Coronavirus and Pregnancy
By: Eve Daures
Tags: Doula, Newborn, Covid 19, San Francisco, Pregnancy

Photo by Fusion Medical Animation on Unsplash

Hello parents!

I wanted to talk about the main concern at this moment: the risks of CoVid 19 on pregnancy and newborn.

I know we kind of talk about it everyday but I also know that the fear is big, especially for pregnant women. Giving birth should be a very special and happy moment but it’s turning into a very stressful event when we miss information.

As a french midwife and a passioned doula in San Francisco, I’ve collected all the data I could find online for you, all published and scientifically approved: these studies are pretty reassuring and I wish you can be a bit more at peace after reading it. If I can make your childbirth experience more enjoyable and confident, then my objective and my heart will be satisfied.

Data

Here is what I found:

Pregnant women are not more frequently positive to covid 19 than the general population.

If you respect the hygiene rules religiously as well as the shelter in place order, you will more likely be fine. The risks are not higher to get the virus than anyone else.

The virus has not been found in amniotic liquid and milk.

That means if you are positive to Covid 19, the virus is not transmitted to your baby during your pregnancy/Labor. So the reasons to go for a C-section or an induction should remain the same as before: the decision needs to be made for a medical reason, due to Covid 19 complications for the mom or for other reason related to the labor/pregnancy itself.

No baby defect

The virus doesn’t cause any abnormalities to the fetus development.

No death among moms.

All the moms that were positive to Covid 19 improved after treatment.

When a mom is positive to Covid 19, if the case is severe, the symptoms get worsen pretty fast.

If you have fever or any other severe symptoms (shortness of breath, tight chest…), you should definitely call your OBGYN to take care of it.

Miscarriage in the first trimester might be elevated due to the fever, if we consider other Covid viruses.

We don’t have a lot of data concerning the first trimester but what we know is that fever leads to contractions. In case of fever, for any reason (bacterial infection; viral infection, food poisoning…) there is always a risk of miscarriage or premature birth. So the risk is more related to the fever than to the virus itself.

Premature birth and C section rate are more elevated at 3rd trimester due to mom’s respiratory distress

The baby might be impacted by the mom’s respiratory condition, not necessarily directly related to the virus. If a mom has difficulty breathing during labor, then the baby is less oxygenated, leading to baby’s heart rate decelerations.

In that case, a C section is more likely to be decided.

The cases of baby’s respiratory distress born from a mom positive to covid 19 are either due to prematurity or virus.

It’s hard to say if the Covid 19 is the cause of the distress, or if the distress is due to the premature age of the baby who was born with C section due to mom’s respiratory difficulty.

Only one baby has been tested positive after 36 hours of life without contact with the mom. We are not sure if it was transmitted by a medical team member after the birth or by the mom herself during the labor (it might be less likely the case as the virus has not been found in the amniotic liquid)

For other babies that have had respiratory difficulties, the diagnostic test was negative for Covid 19 at birth. All the babies in the study were healthy in the end.

As a conclusion, these studies have been done on a few number of cases during the 3rd trimester mostly.

We need more data to confirm these hypothesis and to be statistically significant and to know more about 1st and 2nd trimesters. The first outcome is pretty reassuring.

Also, in the general population, it seems that women are less likely to get Covid 19 infections than men. Estrogen being a good part of women immunity system, they would protect the women against infections and so Covid 19. Estrogen along with progesterone is one of the top hormones during pregnancy. Even though during pregnancy, immune system is weaker to allow the baby to grow in utero without being considered like a foreign body, estrogen, being at a high level at that time, might be a protector against infections, including Covid 19.

WHO recommendations

Considering all this data, here are The WHO recommendations:

One person at least should be present to support the mom in labor. The partner should always be accepted in Labor & Delivery room.

A C section is not recommended except for classical medical reasons.

Separating the newborn to the mom is NOT recommended as the skin-to-skin is beneficial in baby’s neurological development and for the attachment.

For mom being positive, it’s recommended to breastfeed the baby as the milk contains antibodies, antiviral and antibacterial agents to protect the baby against infections. The mom should respect the hygiene rules: wear a mask 24H/24h, wash your hands + hydrogel before touching baby, wash as much as possible your hands and the surfaces that you touched, don’t touch your face before washing your hands.

Prevention

To finish on a positive note, here are some advices to boost your immune system and to avoid Covid 19 infection:

Diet

Avoid sugar and coffee as they reduce the immunity.

Eat regularly to maintain a good level of energy and prefer:

Raw garlic is antiviral and very tasty in any meal!

Fermented food are probiotics so they help to build the microbiota: this is the first defense in our immune system to fight infections.

mushrooms

bone broth: helps to seal the gut so it strengthens the microbiota. Also has anti-inflammatory properties.

seaweed (iodine)

sweet potato: vit A increases white blood cells count and help to destroy the virus.

Ginger is spicy and warm and help to expel exterior pathogenic invasion.

Vitamine C, D, Zinc are supplements that help for immunity.

Regular exercise

Helps the circulation of the blood in your body, to distribute all the nutrients/oxygen to your cells in your internal organs involved in the immune system.

Sleep

A good quality of sleep allows your cells to regenerate and get more energy. Don’t go to bed too late, eat diner early.

For more info, please visit my website : evedaures.com

Eve Daures doula, San francisco

References

Wang, S., Guo, L., Chen, L., Liu, W., Cao, Y., Zhang, J., & Feng, L. (2020). A Case Report of Neonatal 2019 Coronavirus Disease in China. Clinical Infectious Diseases. doi: 10.1093/cid/ciaa225

Yu, N., Li, W., Kang, Q., Xiong, Z., Wang, S., Lin, X., … Wu, J. (2020). Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. The Lancet Infectious Diseases. doi: 10.1016/s1473–3099(20)30176–6

Liu, D., Li, L., Wu, X., Zheng, D., Wang, J., Yang, L., & Zheng, C. (2020). Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis. American Journal of Roentgenology, 1–6. doi: 10.2214/ajr.20.23072

Chen, Y., Peng, H., Wang, L., Zhao, Y., Zeng, L., Gao, H., & Liu, Y. (2020). Infants Born to Mothers With a New Coronavirus (COVID-19). Frontiers in Pediatrics, 8. doi: 10.3389/fped.2020.00104

Zhu, H., Wang, L., Fang, C., Peng, S., Zhang, L., Chang, G., … Zhou, W. (2020). Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Translational Pediatrics, 9(1), 51–60. doi: 10.21037/tp.2020.02.06