Pregnancy in a Pandemic

Pandemic or no pandemic, the birth of a child is an epic, momentous occasion in any adult’s life. So before thinking about the uncertainties associated with covid-19, pregnancy and child-birth, take a moment to appreciate the beauty of life growing within. Know that you are not alone in this surreal experience. If you’re an expectant mom, the best thing to do right now is to take back a little bit of sense of control and control what you can. You can control what you listen to and what you watch and most importantly your lifestyle. Be kind to yourself, surround yourself with cheerful people who support you. There is much of anxiety associated with being pregnant during the lockdown, but don’t let that wash out the joy in expecting a child as well.

Do not fall prey to random information floating around on whatsapp and social media, instead gather authentic information from legitimate sources like the WHO, CDC, ICMR websites if needed. According to the World Health Organization [WHO] and Royal College of Obstetricians and Gynecologists [RCOG], there is no evidence that covid-19 puts pregnant women at higher risk of severe illness than any other healthy population. Experts believe that expecting mothers are as likely as the general audience to get infected by the Novel Coronavirus and so should take equal health measures to protect themselves.

Also there is no evidence to suggest an increased risk of miscarriage, which is in contrast to other viral infections, such as influenza known to cause more serious complications during pregnancy. Latest studies on COVID 19 suggest that early transmission from the mother to her foetus during pregnancy or birth is probable (vertical transmission). However, it is also important to stress on the fact that in all known cases of newborn babies who have developed CoronaVirus shortly after birth, the babies have been well. 

So simply put, according to the recent findings, it is considered unlikely that if you have the virus it would cause problems with your baby’s development, as none have been observed currently. In the event of being pregnant, it is extremely crucial to avoid it as your best strategy and to follow a few simple guidelines to keep CoronaVirus and any other infection at bay. 

• The most important thing is to ensure strict hand hygiene for yourself and your close family members as suggested by WHO
• As Social distancing is one of the keys to limit spread of the virus, avoid any gatherings. Recently in Maharashtra, restaurants, malls and other places of social gatherings were closed down to ensure social distancing is practised right. 
• Going out for walks is one of the few ways you can keep your body from feeling stiff during pregnancy, just remember to maintain a safe distance from people and do not touch anything on your walk.
• If you have a mild cold or cough, in all likelihood, your immunity may be compromised for that time and so limit any exposure to others. And meanwhile ensure you are well hydrated and rested to get back to your best pregnancy self.
• Avoid meetings with friends and family till the Coronavirus case status in your city is minimal. Remote technology options such as the internet, whatsapp calling and such social tools are great for keeping in touch with loved ones and keeping them up to date with your progress. 
• Focus on a healthy well nourished diet and lifestyle. Avoid reading any and every piece of information that comes your way as it might stress you out. Only trust your doctor.

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Even during the pandemic, it’s very important that if you have any concerns about yourself or your pregnancy write all of them down and contact your Obstetrician or midwife to discuss these. In this pandemic situation, your doctor may literally be the busiest person in your city right now and may not have time often to answer questions that are not emergencies. Hence save your time and thiers too by having all doubts jotted down, ready to ask them. Limit your visits to the hospital as much as possible as medical practitioners want expecting mothers to come over only when you are completely ready to deliver to avoid any chance of infection or exposure to COVID 19.

If you are towards the end of your pregnancy, having a birth plan in place for your delivery can help ease feelings of anxiety by giving you a better sense of control however be aware that due to the current situation, the birth plan may not always be as predictable depending on which part of India you live in. Make a list of essentials needed during labor and hospital stay, who to phone when the labour begins, who will provide support during labour and where. What will also help is keeping a hospital bag ready for the day your water breaks and you know you are on your way to welcoming the new life !

Once the baby is here, you may start establishing breastfeeding as a way to nurture and bond with your newborn. There is no evidence currently that proves that COVID 19 is passed on in breast milk. The bountiful benefits of breastfeeding and the upgrade to immunity it offers to babies no doubt overwhelms any potential risks of transmission of CoronaVirus through breastmilk. If your baby is a healthy full term baby, your doctor will ensure that after delivery, she will be in your arms for skin to skin bonding and nursing.

If you are at risk for CoronaVirus after delivery, the primary risk while breastfeeding is close physical contact between you and your baby. If you are suspected to have contracted the virus, your cough or sneeze may contain droplets which will lead to infecting the baby in turn. If infected or suspected with symptoms, consider wearing a face mask or precautionary barriers while handling your baby incase you suspect yourself with symptoms. You can also pump breastmilk and get a family member to feed the baby with your expressed breast milk.This is simply a precautionary measure while you rule out your infection.

Close observation of hygiene, as always, is important and particularly with family members residing in the house. Ideally home Visits from extended family and friends should be avoided and every one at home who is handling the baby should practice standard recommended hand hygiene. It is important that your baby is feeding well and gaining weight and if you have any concerns please contact your Pediatrician. Although it’s a difficult time, see the positive side of having this time to bond as a family. Enjoy the quietness of your family together for this time. It’s quite special to be able to bond with your baby alone, discover that new human being and enjoy that. 

Once restrictions are lifted please refrain from large family gatherings to celebrate your baby’s arrival until more is known about the spread of the virus in the community. Taking care of one’s mental health is equally important during this time. This pandemic will inevitably result in an increased amount of anxiety in the general population, and this is likely to be even more so for pregnant women as it represents an additional period of uncertainty. The impact of social isolation results in reduced support from wider family and friends, the potential of reduced household finances, major changes in ante-natal and other care with appointments being changed from face to face to telephone contact. Getting adequate rest and sleep is much more important if you are pregnant . Try to maintain a healthy diet. Eat nutritious food and engage in simple physical activity at home to relax, like stretching exercises, breathing exercises. Focus on taking care of yourself as much as you possibly can. Put your hands on your belly and enjoy being pregnant. Keep in touch, talk with family and friends often, this will help you feel less isolated. Try to avoid unhelpful coping strategies. Social media can be a great way to stay connected and gain information. However, for some it can also become overwhelming and worsen feelings of stress and anxiety. Consider whether you need to switch off for some time to maintain your wellbeing. And it is completely normal and important to attend to your own needs as a priority along with your newborn. After all, nurturing a new life as a new mother will be an exhilarating experience for sure and you got to be your best for that. 

This guest article is written by Dr.Yojitha, MD, a board certified Pediatrician working in the private health sector for the past 5 years. She is also a new mom passionate about reading and strongly believes in baby wearing, cloth diapering, baby-led weaning and a sustainable living for her family. You can find her here.