Launceston General Hospital COVID-19 in Pregnancy Information Sheet

What effect does coronavirus have on pregnant women? 

It appears pregnant women are no more likely to become infected by coronavirus than anyone else. However, pregnant women have altered immunity, and may become more unwell with infections than other people.  It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms. 

More severe symptoms such as pneumonia appear to be more common in older people, those with weakened immune systems, or long-term health conditions.  If you have diabetes, high blood pressure, obesity, or an underlying heart or lung condition you may be more unwell if you have coronavirus.

Women in the last trimester of pregnancy are more likely than others to become unwell if they contract the virus.  Women above 28 weeks’ gestation should be especially careful about social distancing and minimising contact with others.

We understand that pregnant women are anxious about their own health and that of their unborn baby. Helpful and up to date information can be found below:

• RANZCOG website
• Raising Children Network website

What can I do to reduce my risk of catching coronavirus? 

The most important things you can do are:

• getting one of the two available coronavirus vaccinations – Pfizer or Moderna (see below)
• washing your hands often with soap and warm, running water (or alcohol-base hand rub), especially after coughing, sneezing or blowing your nose, after coming from public places to your home or workplace, and before eating, drinking or touching your face
• frequently and thoroughly clean surfaces at home and at work, using either detergent or disinfectant
• keeping two large steps distant from other people if you have to go out and staying home as much as possible
• staying healthy by exercising regularly, getting lots of sleep, and eating a healthy diet will not stop you from catching coronavirus, but may make any illness less severe. It is also important to stop smoking – talk to your doctor or midwife.

For more detailed advice, visit the Tasmanian Coronavirus website       

Vaccinations

All pregnant women are encouraged to have one of the two available mRNA coronavirus vaccines – either Pfizer or Moderna. Vaccination at any stage of pregnancy appears safe and lowers the risk of the pregnant woman becoming very unwell with the virus, and also the risk of complications for the baby (such as preterm birth). Having the vaccine while pregnant will also provide some protection for your baby.

Women can protect themselves and their babies by making sure that they have the recommended immunisations for seasonal influenza (“flu”) and pertussis (whooping cough).

Influenza immunisations should be arranged as soon as they become available, whatever stage of pregnancy you are at.  Pertussis immunisations are recommended after 20 weeks gestation.

Will there be any changes to my antenatal care? 

We will continue to run a high-quality obstetric service during the COVID-19 pandemic, while at the same time making changes to reduce the risk of COVID-19 infection for patients and staff.

Some changes you might notice at the Launceston General Hospital include:

• shortening the duration of antenatal visits
• using telephone consultations where possible
• avoiding face to face antenatal classes
• restricting visitors: visitors may not be permitted whilst in hospital or attending antenatal clinic, however, your partner will be able to be present during labour and at the birth of your baby
• earlier discharge from hospital than would otherwise be planned with increased support from extended midwifery service (EMS) at home.

Throughout this time, your health, and the health of your baby remains our priority.

If you have any concerns, please contact the Maternity Unit on (03) 6777 8960.

What should I do if I think I may have coronavirus or been exposed? 

You should phone the Tasmanian Public Health Hotline on 1800 671 738 if you are pregnant and: 

• you think you might have coronavirus
  • symptoms include fever and cough, sore throat or shortness of breath
• you have been in close contact with someone with coronavirus.

How will I be tested for coronavirus? 

Testing is carried out at the Public Health or Community clinics. You may need to attend the hospital you are very unwell or have difficulty breathing. The test involves swabs being taken from your mouth and nose.  You may also be asked to cough up sputum, a mixture of saliva and mucus. 

Anyone who is tested for coronavirus must self-isolate (stay home) until they have a negative test result. Instructions for self-isolating are given below.

Why would I be asked to self-isolate? 

You may be advised to self-isolate because: 

• you have come into contact with someone who has coronavirus 
• you have symptoms suggestive of coronavirus and are waiting to be tested, or for your results 
• you have tested positive for coronavirus and need to recover at home.

What should I do if I’m asked to self-isolate? 

Pregnant women who have been told to self-isolate should stay indoors and avoid contact with others for 14 days or until advised by Public Health.  

The Public Health guide on self-isolation currently recommends people should:  

• not go to school, work or public areas 
• not use public transport 
• stay at home and not allow visitors  
• ventilate the rooms where they are by opening a window  
• separate themselves from other members of their households as far as possible using their own towels, crockery and utensils and eating at different times 
• use friends, family or delivery services to run errands but advise them to leave items outside.

You may wish to consider online fitness routines to keep active, such as pregnancy yoga or Pilates.

Can I still attend my antenatal appointments if I am in self-isolation? 

You should contact the Maternity Unit on (03) 6777 8962 to inform them that you are currently in self-isolation for possible/confirmed coronavirus and ask for advice on attending routine antenatal appointments.

Routine face-to-face antenatal appointments will be delayed until isolation ends.  If your appointment cannot wait, special arrangements will be made for you to be seen.  For example, you may be asked to attend at a different time, or in a different clinic.  

What do I do if I feel unwell or I’m worried about my baby during self-isolation? 

You should call the Maternity Unit on (03) 6777 8960 at any time if you have concerns about your pregnancy and think you might need to come to hospital (e.g. you think your waters have broken, labour pains start, or baby’s movements change).

For other concerns about the wellbeing of yourself or your baby during your self-isolation period, contact your midwife or the Maternity Unit.

It’s time to seek advice from a health professional if: 

• you feel consistently bad (eg sad or worried) for more than two weeks
• negative thoughts and feelings start to affect your ability to function normally
• you have signs of depression, eg you lose interest in doing things you usually enjoy, or often feel hopeless or unable to cope
• you feel anxious or worried most or all of the time
• you start having panic attacks or develop obsessive or compulsive behaviours.

What should I do if I test positive for coronavirus? 

If you test positive for coronavirus you should call the Maternity Unit on (03) 6777 8962 to make them aware of your diagnosis.  If you have no symptoms or mild symptoms you will be advised to recover at home and a member of the Public Health team will check on you by phone regularly.  If you have more severe symptoms, you might need to be treated in a hospital setting.  

If you feel your symptoms are worsening, or if you are not getting better, you should inform your Public Health contact, or contact the Maternity Unit on (03) 6777 8960 for advice.

You should inform the Maternity Unit, Ambulance Tasmania, and/or the Emergency Department that you have tested positive for coronavirus and follow their instructions.

How will my care be managed after I have recovered from coronavirus? 

An ultrasound scan may be arranged a few weeks after your recovery to check that your baby is well.  

If you have recovered from coronavirus and tested negative for the virus before you go into labour, where and how you give birth will not be affected by your previous illness.  

Will being in self-isolation for suspected or confirmed coronavirus affect where I give birth? 

If you are suspected or confirmed of having coronavirus, and labour starts, you should contact the Maternity Unit prior to presenting to hospital.  

During labour your baby’s heart rate will be continuously monitored to check how your baby is coping with labour. Your oxygen levels will also be monitored with a probe attached to your finger.  As continuous fetal monitoring can currently only take place in a hospital maternity unit where doctors and midwives are present, it is not recommended that you give birth at home. 

Will being in self-isolation for suspected or confirmed coronavirus affect how I give birth? 

There is currently no evidence to suggest you cannot give birth vaginally or that you would be safer having a caesarean birth, so your birth plan should be followed as closely as possible based on your wishes.  

However, if you are very unwell and need urgent delivery, a caesarean birth may be recommended. 

There is no evidence that women with suspected or confirmed coronavirus cannot have an epidural or spinal block.  However, the use of Nitrous Oxide (gas and air) or water immersion in the bath may increase the spread of the virus so your maternity team will discuss all the pain relief options available to you in labour.  

What happens if I go into labour during my self-isolation period? 

If you go into labour, you should call the Maternity Unit on (03) 6777 8960 for advice and tell them that you have suspected or confirmed coronavirus infection.  

If you are well, you will be encouraged to remain at home (self-isolating) in early labour as per standard practice.

When you and your maternity team decide you need to come to hospital:

• you should come in by private transport (your own car) if possible.
• you will be met at the hospital entrance and given a surgical face mask which will need to stay on until you are in a birthing room  
• your birth partner will be able to stay with you throughout your labour.

Can a newborn baby catch coronavirus, or could I pass coronavirus to my baby?

There is a small chance that the baby can catch the virus from his/her mother during pregnancy. There are no known cases of birth defects due to COVID-19 infection. Babies can become infected with coronavirus from their parents, or other infected family members after birth.  Babies who have been infected with coronavirus seem to have mild symptoms and to recover quickly. Most babies born to mothers with coronavirus remain well, but a small proportion (about 10%) develop a flu-like illness at 2-3 weeks of life.

If your baby develops breathing difficulties (e.g. fast breathing, cough), poor feeding, is pale and/or has a fever then you should seek medical attention.

Will I be able to stay with my baby/give skin-to-skin if I have suspected or confirmed coronavirus? 

Yes, if that is your choice.  As long as your baby is well and doesn’t need care in the neonatal unit, you will be kept together after you give birth.  We will give you advice on how to feed and care for your baby safely.

A discussion about the risks and benefits of staying with the baby should take place between you and your family and the doctors caring for your baby (paediatricians).  If you are positive for coronavirus and your baby requires care in the Neonatal ICU or Special Care Nursery, you will not be able to visit baby until you have completed any prescribed quarantine and tested negative.

Will I be able to breastfeed my baby? 

Yes.  At the moment there is no evidence that the virus can be carried in breastmilk, so it’s felt that the benefits of breastfeeding outweigh any potential risks of transmission of coronavirus through breastmilk.  The main risk of breastfeeding is the close contact between you and your baby, which might lead to the baby coming infected.

A discussion about the risks and benefits of breastfeeding should take place between you and your family and maternity team.  If you choose to breastfeed your baby, the following precautions are recommended: 

• wash your hands before touching your baby, breast pump or bottles 
• wear a face mask when within 1.5 m of baby and during breastfeeding
• follow recommendations for pump cleaning after each use 
• consider asking someone who is well to feed expressed milk to your baby.

If you choose to feed your baby with formula or expressed milk, it is recommended that you follow the sterilisation instructions carefully.  If you are expressing breast milk in hospital, a dedicated breast pump should be used.  

Can a newborn baby catch coronavirus, or could I pass coronavirus to my baby?

There is a small chance that the baby can catch the virus from his/her mother during pregnancy. There are no known cases of birth defects due to COVID-19 infection. Babies can become infected with coronavirus from their parents, or other infected family members after birth.  Babies who have been infected with coronavirus seem to have mild symptoms and to recover quickly. Most babies born to mothers with coronavirus remain well, but a small proportion (about 10%) develop a flu-like illness at 2-3 weeks of life.

If your baby develops breathing difficulties (e.g. fast breathing, cough), poor feeding, is pale and/or has a fever then you should seek medical attention.

If you have any Mental Health wellbeing concerns

Being stuck at home can lead to severe strain on family relationships and mental health, especially if there are other problems such as money worries. For help and advice on counselling services, contact the following services:

• Panda, 1300 726 306
• Relationships Australia
• MensLine Australia, 1300 364 277
• Beyond Blue, 1300 224 636
• 1800 Respect (Domestic Violence and Counselling), 1300 737 732
• Cope (Centre of Perinatal Excellence)