CONCEPTION AND PREGNANCY DURING COVID TIMES

Dr. Zareena Algiers Khalid. MD, FRCOG , Senior consultant, Dept of women’s health , Aster Medcity, Kochi

With the second wave of Covid-19 crisis fetching a wave of negative news, expectant mothers are left reeling with stress and anxiety, and wondering about the kind of world they are bringing their newborn in. Pregnancy is a very special period that a woman is blessed with, but it can be tough during a pandemic.

A Pregnant woman has similar risk like the rest of the healthy population to contract Covid 19. Roughly a pregnant woman of 3-4 months with Covid 19 may show no symptoms at all and most pregnant women who do have symptoms only have mild cold or flu like symptoms. However, a small number of pregnant women can become seriously ill with Covid 19 including loss of lives. Pregnant women are at an increased risk of becoming severely ill when compared to a non-pregnant woman especially after the 28th week of pregnancy. This category of pregnant women with Covid has been included in the moderate risk group of Covid infections. Severe illness is seen in women over the age of 35 years, obese women, associated diseases like Diabetes Mellitus and Hypertension. 

Studies so far have shown that Covid 19 infection in pregnancy is unlikely to cause miscarriages or fetal anomalies, though it has been linked to low birth weight, growth delays and preterm deliveries (before 37 weeks). Premature deliveries can occur due to the severe infection itself, most often it is due to early caesarean deliveries undertaken by the obstetrician to promote recovery of the sick mother. Another common matter of concern is whether the Covid infection will be transmitted from the mother to the baby during pregnancy or childbirth. Studies so far have not shown an in-utero transmission of the virus to the fetus. Routinely all such babies are tested for Covid infection after birth. If at all a newborn gets the Covid infection they have been found to remain well without any consequences. Regarding breast feeding in Covid positive mothers, World Health Organization (WHO) has recommended to encourage it as long as adequate precautions are taken like using hand hygiene and face mask. Covid virus has not been detected in breast milk. Despite this directive by the WHO, many institutions still isolate the baby from the mother and give expressed breast milk. Finally, it is a combined decision of the mother and the caregiver whether to breast feed or not. All these issues can also add stress in pregnancy which can be managed by following our guide for pregnant women mental Health during the covid-19 

Post pregnancy care

Hospitals and care providers have made adjustments in antenatal care to avoid the risk of getting exposed to Covid-19 by reducing the number of visits a pregnant woman makes to the hospital with extra support provided over telephone or telemedicine. Women undergoing fertility treatment and pregnant women should be encouraged to receive Covid-19 vaccination. Since Covid vaccine is not a live vaccine, there is no reason to delay pregnancy attempts because of the vaccine administration or to defer treatment until the second dose has been administered. Neither does the Covid vaccine increase the risk of infertility nor miscarriage. Whereas WHO recommended Covid vaccine to all pregnant women, the Indian government only recently approved Covid vaccination to be given any time during pregnancy and lactation. The benefits of vaccination outweigh the potential risk of Covid infection especially since the second wave of Covid 19 may hit the pregnant and lactating women more severely when compared to the first.

Needless to say, following social distancing, hand hygiene, using face mask, keeping well hydrated and mobile, staying active with regular exercise, and boosting immunity with nutrition can help to support a healthy pregnancy and reduce infections.