by David Emvula

PREGNANCY is a special time full of joy and anticipation.

Unfortunately, for many expectant mothers, the Covid-19 pandemic has clouded this period with fear, anxiety and uncertainty.

Pregnant women do not appear more likely to contract Covid-19 infection when compared to the general population.

However, pregnancy puts you at higher risk of severe illness compared to women who are not pregnant. Pregnant women and have higher rates of intensive care unit (ICU) admission – particularly in the third trimester.

Emerging evidence suggests that pregnant women who have tested positive for Covid-19 at the time of birth had higher rates of stillbirth or a preterm birth, however, the actual increases remain low.

Firstly, antenatal care should be regarded as essential, and women are encouraged to attend, while observing social distancing and infection prevention measures, as recommended by the government.

If a woman has symptoms suggestive of Covid-19, she should go for testing.

If she has contracted the virus, she needs to consult her doctor.

This can be done telephonically to limit exposure. When you find out you are pregnant, contact your obstetrician as soon as you can.

Studies conducted before the first vaccines were approved for emergency use did not include pregnant women, but the benefits of vaccination for pregnant women outweigh the theoretical potential risk the vaccine may pose.

Considering the risk of severe Covid-19 in pregnancy, vaccination is highly recommended for all pregnant women and those planning pregnancy.

There are three potential mechanisms of maternal transfer of Covid-19 to the neonate, namely through the placenta, during birth, and after birth.

Transmission through the placenta appears less likely, but some case reports suggest this is possible.

Exposure to maternal infected secretions around the time of birth makes transmission possible.

After birth transmission can occur through an infected mother, family member, or healthcare worker.

Transmission through an infected mother is more likely via respiratory secretions and less likely via breast milk.

It is best during this time to isolate to avoid any risk and exposure to you and your baby.

It is recommended that breastfeeding women get a Covid-19 vaccine.

Breastfeeding can continue after vaccination and remains one of the best ways to protect your child against diseases and to help them stay healthy.

In conclusion, becoming pregnant during the pandemic is a matter of personal choice, however, it is wise to consider the impact this may have on your health.

In the absence of any effective treatment for Covid-19, vaccination is the only hope.

Discussion with your doctor could help you make an informed decision on which vaccine to take.

Importantly, claims linking Covid-19 vaccines to infertility are unfounded and have no scientific evidence supporting them.

Are pregnant women at higher risk of getting severely ill?

According to the World Health Organisation (WHO), pregnant women or recently pregnant women who are older, overweight, and have pre-existing medical conditions, such as hypertension and diabetes, seem to have an increased risk of developing severe Covid-19.

When pregnant women develop severe disease, they also seem to more often require care in intensive care units than non-pregnant women of reproductive age.

Due to changes in their bodies and immune systems, we know that pregnant women can be badly affected by some respiratory infections.

It is therefore important that they take precautions to protect themselves against Covid-19, and report possible symptoms to their healthcare provider.

Pregnant women should take the same precautions to avoid Covid-19 infection as other people.

You can help protect yourself by:

▩ Washing your hands frequently with an alcoholbased hand rub, or soap and water.

▩ Keeping space between yourself and others and avoiding crowded spaces.

▩ Practising respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately.

If you have a fever, cough or difficulty breathing, seek medical care early.

Call before going to a health facility, and follow the directions of your local health authority.

Pregnant women and women who have recently delivered should also attend their routine care appointments.

* Dr David Emvula is an obstetrician and gynaecologist at the OB-GYN practice.

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