Coronavirus tips: How worried should pregnant women be about coronavirus?

As the UK experiences increasing numbers of coronavirus deaths, should pregnant women be worried about the risk to their unborn baby?

Matt Mathers
Monday 11 May 2020 12:00 BST
UK 'will see many thousands infected with coronavirus' says Deputy chief medical officer

Prime Minister Boris Johnson and his fiancee Carrie Symonds have both now recovered from coronavirus. But, while the couple have tested negative and no longer have symptoms, Symonds has since confirmed she was "obviously worried" about the impact on her pregnancy.

In a tweet on 4 April, Symonds said: "Being pregnant with Covid-19 is obviously worrying. To other pregnant women please do read and follow the most up to date guidance which I have found to be v reassuring."

The couple announced the birth of their first child together on 29 April with a statement that confirmed both mother and baby were “doing very well”. Johnson and Symonds later revealed that the baby was a boy, who they chose to name Wilfred Lawrie Nicholas Johnson.

So how does coronavirus affect pregnant women, are they at greater risk from Covid-19, and what should they do if they experience symptoms?

The Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives has reassured women that there is no evidence to suggest pregnant women are at greater risk from Covid-19.

In a statement the bodies said: “[This self-isolation for 12 weeks] is a precautionary measure to reduce the theoretical risk to the baby’s growth and risk of preterm if the mother becomes unwell.”

Covid-19 shares many of the same symptoms as the winter flu, and it appears that cases are most serious in the elderly and those living with existing health conditions, particularly respiratory problems.

Are pregnant women more likely to catch coronavirus?

The RCOG says pregnant women do not appear to be more susceptible to the virus than the rest of the public, although at this point the data available is limited.

There is also no evidence which suggests that Covid-19 increases the risk of miscarriage or early pregnancy loss.

“It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms,” says the RCOG.

Dr Edward Morris, president of the RCOG says: “We would like to reassure pregnant women that, as things stand, no new evidence has come to light suggesting they are at higher risk of becoming seriously unwell compared with other healthy individuals.”

Can coronavirus be passed to your baby?

On 9 April scientists in China said there is a chance Covid-19 may be passed from mother to baby during pregnancy, despite no direct evidence pointing to this method of transmission.

Their findings are based on a retrospective study of four newborn babies, born in Wuhan, China, published in the European Respiratory Journal.

Dr Zhi-Jiang Zhang, of Wuhan University, said: "Covid-19 is highly contagious and our study suggests that intrauterine transmission cannot be ruled out, but that the prognosis is good for both pregnant women and newborn babies."

On 9 March, Dr Morris said: “While the data is currently limited it is reassuring that there is no evidence that the virus can pass to a baby during pregnancy.

“It is therefore considered unlikely that if you have the virus it will cause abnormalities in your baby.”

But he did add that guidance will be kept under regular review as new evidence emerges.

Some babies born to women with symptoms of coronavirus in China have been born prematurely. It is unclear whether coronavirus caused this or the doctors made the decision for the baby to be born early because the woman was unwell.

On 18 March, the RCOG published a report in which it stated that two cases of “possible vertical transmission (transmission from mother to baby antenatally or intrapartum)” had been reported.

“In both cases, it remains unclear whether transmission was prior to or soon after birth,” the report stated. “Expert opinion is that the foetus is unlikely to be exposed during pregnancy.”

Is it safe to breastfeed?

At present, there is no evidence that the virus can be carried in breast milk, so it is felt the benefits of breastfeeding outweigh any potential risks of transmission of coronavirus through breast milk.

Gill Walton, Chief Executive of the Royal College of Midwives, said: “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.”

In the report published on 18 March, the RCOG stated that in “six Chinese cases tested, breastmilk was negative for Covid-19”.

“However, given the small number of cases, this evidence should be interpreted with caution,” the organisation added.

If a pregnant woman infected with Covid-19 gives birth will she be separated from her baby?

On the current information available, medics say there is no evidence to suggest that separating a baby from an infected mother will be helpful. Instead, this could cause significant distress for the mum and baby.

Professor Russell Viner, President of The Royal College of Paediatrics and Child Health, said: “The situation is now developing very quickly and this guidance is based on a thorough review of the evidence – limited though that is.

“Based on current evidence, we don’t believe that babies born to women who test positive for coronavirus should be separated.

“The impact of this separation, even as a precaution, can be significant on both the baby and the mother. We will review this recommendation as we see more evidence in the weeks and months ahead.”

In the recent RCOG report, it stated that “literature from China has advised separate isolation of the infected mother and her baby for 14 days”.

“However, routine precautionary separation of a mother and a healthy baby should not be undertaken lightly, given the potential detrimental effects on feeding and bonding,” the RCOG stated.

“Given the current limited evidence we advise that women and healthy infants, not otherwise requiring neonatal care, are kept together in the immediate post-partum period.”

How can pregnant women protect against getting Covid-19?

The RCOG says: “The most important thing to do is to wash your hands regularly and effectively.”

Public Health England and the World Health Organisation continue to advise the best way to avoid contracting coronavirus are to wash your hands regularly, get a flu jab and avoid contact with people who are unwell.

What should pregnant women do if they think they might have coronavirus?

The RCOG says: “You should phone NHS 111 or use the NHS’s 111 online tool for further advice, and say you are pregnant.”

At the current time, if you need a test for coronavirus, you will be advised to self-isolate and diagnostic swabs will be arranged. You will be tested in the same way as anyone being tested, regardless of the fact that you are pregnant.

Pregnant women who are due to attend routine maternity appointments in the UK should contact their maternity care provider, to inform them that they are currently in self-isolation for possible/confirmed COVID-19, and request advice on attendance.

They are also advised not to attend maternity triage units or A&E unless in need of urgent obstetric or medical care.

If women are concerned and require urgent medical advice, they are encouraged to call the maternity triage unit in the first instance.

If attendance at the maternity unit or hospital is advised, pregnant women are requested to travel by private transport and alert the maternity triage reception once on the premises, prior to entering the hospital.

PHE advice states that anyone who is feeling unwell and has recognised symptoms of Covid-19 should contact NHS 111 and seek further assistance.

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