There are still many uncertainties about the behavior of the new coronavirus in specific groups of society. Researchers are developing studies to understand the impact of Covid-19 on pregnant women, for example. At the beginning of April 2020, the Ministry of Health included pregnant women and new mothers in the risk group. The decision is to protect and pay more attention to this population. However, there is no evidence that future mothers run more risks to develop the disease more seriously than other people in general.
To clarify some very common questions, Dr. Marcos Loreto, Omit Technical Director of Omint, talked to Dr. Lívio Dias, Maternity Infectologist for Matre Paulista. Check out the full video:
In this article, you will find out:
- Pregnancy and Covid-19: current scenario
- The risks of the last trimester of pregnancy
- The time of childbirth in times of pandemic
- Postpartum and breastfeeding
1. Pregnancy and Covid-19: current scenario
Because it is a new disease, information about Covid-19 has been changing all the time. Therefore, it is important that pregnant women and their support network seek updated data from reliable sources. Dr. Lívio Dias, an infectious disease specialist at Maternidade Pro Matre Paulista, points out that so far there is no evidence of transmission of Covid-19 to the fetus during pregnancy. “In addition, no fetal malformations were identified due to Covid-19”, he highlights.
The first guidance of specialists is essential for the health of the mother and baby: keeping up to date with specialized and personalized monitoring. However, with so many changes in the functioning of medical offices, hospitals and health posts, it is important that the pregnant woman makes arrangements with the professionals who are accompanying her so that she is protected in face-to-face meetings.
The infectologist also points out that pregnant women with diabetes, hypertension or other complications need to pay more attention to avoid developing a more severe condition in case of infection. For this group, the Ministry of Health recommends care similar to that of the general population:
- wash your hands with soap and water and use hand sanitizer;
- maintain social distancing whenever possible;
- avoid touching eyes, nose and mouth;
- cover your mouth and nose with your arm or with a handkerchief when you cough or sneeze;
- if you have a fever, cough or difficulty breathing, seek medical attention immediately.
If you suspect Covid-19 infection, it is necessary to follow the testing protocols of the municipality, but the recommendation of the World Health Organization is that pregnant women with symptoms of the disease be prioritized for testing.
2. The risks of the last trimester of pregnancy
According to Dr. Lívio, the last trimester of pregnancy is considered the most delicate of pregnancy in case of contagion by the new coronavirus. “In most pregnant women it evolves in a less delicate way, but in the more severe forms, mainly with pulmonary involvement, there may be an anticipation of delivery. After all, the pregnant woman needs to oxygenate the body for her and the baby ”, she emphasizes.
To make room for the fetus, with the expansion of the uterus, the size of the woman’s chest cavity decreases during pregnancy, leaving the lungs with less space to act. Therefore, at the end of pregnancy – when the belly gets even bigger – it is common to have difficulty breathing and even shortness of breath. This mechanical change in breathing may hinder the detection of Covid-19 symptoms in pregnant women.
Remember: immunization against the influenza virus is very important during this period. Therefore, pregnant women should get the flu vaccine.
3. The time of childbirth in times of pandemic
Childbirth is an idealized and even planned time for many women. In the midst of the pandemic, institutions, hospitals and maternity hospitals needed to make changes to their protocols, such as changing the rules on companions and blocking postpartum visits. The choice of delivery method will be determined by the patient’s clinical condition.
In the past few weeks, women with habitual risk pregnancies – that is, in which the mother and child have no problem – should maintain the care related to the new coronavirus and the common recommendations for that period. Thus, when she goes into labor, the pregnant woman can go to a peaceful maternity.
According to the infectious disease specialist at Pro Matre Paulista, there is a risk of transmission at birth through the baby’s contact with the mother’s secretions. Therefore, the orientation must be individualized and the environment prepared for the mother’s conditions.
4. Postpartum and breastfeeding
The WHO advocates that breastfeeding takes place in the first hours of the baby’s life, protecting the newborn from infections and reducing neonatal mortality. At the moment, there is no scientific evidence on the transmission of coronavirus through breast milk. Therefore, this recommendation is maintained: mothers with Covid-19 can and should breastfeed. “Already in the postpartum period, if the patient is a confirmed case of Covid-19 and is in the period of transmission of the disease – which is two weeks after the first symptoms – care is important to avoid transmission to the baby and establish protocols” , points out Dr. Lívio.
In the case of Pró Matre, when leaving the maternity unit, the orientation is that the patients have help with routine activities that require greater contact with the baby, such as bathing and changing diapers. If the infected mother has contact with the baby, she must wear a mask (check all information on wearing masks against the coronavirus).
As for breastfeeding, the specialist considers that it should be stimulated and always with due care. “In no way do we contraindicate breastfeeding, we even recommend it. However, if the mother is in the process of transmitting a new coronavirus, she must clean hands, breasts and wear masks while breastfeeding ”, she stresses
Newborn babies already receive special attention that must be maintained in the context of a pandemic. Regardless of the state of health of the pregnant or new mother, the most important thing is that the woman can get the support of good professionals throughout the process.
Customers of the Omint plans have the Boa Hora Program, in which an obstetrical nurse monitors them throughout the pregnancy and the postpartum period, bringing more security to the woman. During the pandemic, Boa Hora’s guidelines are carried out by telephone or videoconference. If the patient still prefers the nurse’s face-to-face visit, Omint provides all the personal protective equipment (PPE) necessary for this approach.
In addition to this specific benefit for pregnant women, Omint customers can activate the Dr. Omint Digital service when guidance from a pediatrician or general practitioner is required.