Pregnancy in the time of COVID-19: An obstetrician’s expert view


What does it mean to be pregnant in the time of a pandemic such as COVID-19? Are mothers and babies at risk of contracting the virus? What symptoms can they look for? Prof Priya Soma-Pillay talks about everything pregnant women need to know.

In this podcast, Prof Priya Soma Pillay shares her insights on what it means to be pregnant during COVID 19.

Prof Soma-Pillay is the newly appointed head of Obstetrics and Maternal and Foetal Medicine at Steve Biko Academic Hospital and the University of Pretoria. Azania Mosaka interviewed her on how COVID-19 could impact pregnant women and their babies.

What can pregnant women do to lower their risk of COVID-19 infection?

“Pregnant women should practise the same personal hygiene principles as non-pregnant women, and that is frequent hand washing, using hand sanitiser, wearing masks and avoiding touching one’s face with your hands,” Prof Soma-Pillay says. “One should also avoid close contact with other people and practise social distancing.

“If a pregnant woman experiences any symptoms, she should isolate herself, wear a face mask and phone her local healthcare facility or the national COVID-19 helpline,” she adds.

Do pregnant women have a high risk of contracting the virus?

Prof Soma-Pillay describes the symptoms pregnant women may experience if they contract COVID-19.

“Data from America shows that about 14% of people will not have any symptoms even if they are carrying the infection. The majority of women will have mild flu-like symptoms consisting of a cough, fever, and a sore throat. A small proportion will have severe symptoms – shortness of breath and respiratory problems – and these are the women we are particularly worried about,” she says.

“Fortunately, our reproductive age group are women under the age of 40,” she adds. “Women at high risk are those who are pregnant above the age of 40 and those with co-morbid conditions like hypertension (high blood pressure) and diabetes.”

Are babies at risk?

Prof Soma-Pillay says there’s no evidence to suggest that babies are at risk of contracting the virus while they’re in their mother’s womb. “No viral particles have been identified in amniotic fluid, breast milk or cord blood, so there’s no evidence of what we call ‘vertical transmission’ or that the foetus can be infected while in utero.”

What symptoms should a pregnant woman look out for?

“Pregnancy can mimic mild disease because of the physiological changes during pregnancy. Women are sometimes short of breath but if she feels this is persisting despite rest, she should contact her healthcare practitioner,” Prof Soma-Pillay explains.

“Most pregnant women will have the typical cough, fever and sore throat,” she adds. “Some of the rarer symptoms are shortness of breath and even diarrhoea. What we’ve also picked up now is the loss of smell and taste. If you are unsure, it’s better to contact your doctor for advice.”

Should women go to hospital for antenatal care?

Prof Soma-Pillay says it’s very important that women continue their antenatal care at hospitals. “The Department of Health has made a list of non-emergency but essential services that need to continue, and antenatal care is one of them,” she says. “Other services on the list are contraceptive services, termination of pregnancy, postnatal care and gynaecological oncology.”

“So, although women may feel that they may be putting themselves at risk, all healthcare facilities have been advised to adapt their way of functioning,” she adds. These adaptations include making appointments so that there are only two or three people in a waiting room at a time.

What about midwife labour or home birth?

Prof Soma-Pillay says, “midwife-led care or home birth are not recommended for women who test positive for COVID-19 during their pregnancy. Midwife-led care or home births are generally reserved for women who have low-risk pregnancies. If they test negative for COVID-19, this can continue.”

She explains further, “every healthcare facility should have the ability to screen and test all individuals at every antenatal visit. If a pregnant woman tests positive for COVID-19, she now becomes a high-risk patient. She should then be managed by a specialist or at a facility that is designated for COVID-19 care.”

Can mothers receive visitors after giving birth?

“At this stage the recommendation by the Department of Health is that hospital visitors be limited,” Prof Soma-Pillay says. “We’ve seen a few hospitals in KwaZulu-Natal and Johannesburg that have become hotspots for COVID-19 infections. Just being in the hospital puts one at risk for both spreading the disease and contracting the infection.”

“At Steve Biko hospital, women are not allowed any visitors and partners are no longer allowed to be present at the birth. This is to try and limit and protect other patients and people entering the hospital.”

Bonding with your baby when you have COVID-19

Prof Soma-Pillay emphasises that babies cannot contract the virus from breast milk. “The virus has not been isolated in breast milk, so babies are not at risk of contracting the virus through breastfeeding. The recommendation is that if the mother and baby are both well, that breastfeeding continues under certain conditions.”

“Breastfeeding, bonding, and skin-to-skin contact have several advantages. Provided the mother practises hygiene principles – regular hand washing, sanitising, cleaning of the breast before and after breastfeeding– breastfeeding has more benefits than isolating the mother from the baby,” she explains.

Should women plan to get pregnant during the pandemic?

“The Department of Health is recommending that women postpone planned pregnancy to after the pandemic,” Prof Soma-Pillay says. “One of the reasons for this is to try and limit infection, both for the pregnant women while she’s pregnant but also to limit the burden on our healthcare facilities.”

“If possible, we encourage women to postpone pregnancies if they can,” she concludes.

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