Giving birth in a pandemic: Answering questions about COVID-19 and pregnancy

TORONTO — Pregnant women across the country are facing the prospect of giving birth amid the COVID-19 pandemic. CTVNews.ca spoke with Dr. B Anthony Armson, the president of the Society of Obstetricians and Gynaecologists of Canada (SOGC), to answer questions pregnant women may have about the novel coronavirus.

Here is a summary of what the SOGC knows about the virus and how it may impact pregnancy and childbirth: (Note: Interview took place on March 25. Check the SOGC for latest statements on COVID-19 and pregnancy.)

Answers have been condensed for length.

Q: What are the risks of contracting COVID-19 in pregnancy?

Dr. Armson:

The limited data we have comes from China, where a few dozen pregnant women contracted COVID-19.

The bottom line is, based off this information, pregnant women who contract COVID-19 do not appear to have a worse prognosis, or worse illness or worse risk than non-pregnant individuals.

With pregnant women, there’s always a background concern that they may be at higher risk for respiratory infection. But that does not appear to be the case with COVID-19.

This is unlike SARS or MERS, other coronaviruses, where pregnant women did have a higher risk compared to non-pregnant women.

Q: Can COVID-19 be passed on from the mother to the unborn baby (called vertical transmission)?

Dr. Armson:

Based on the limited data we have, there does not appear to be a risk of vertical transmission or infection of COVID-19 from the mother to the baby in utero.

Also, for mothers who do have COVID-19, there does not appear to be evidence of a higher rate of miscarriage or birth defects.

There have been a few more recent reports of the possibility of pre-term birth. But it’s not clear from the reports whether the pre-term birth was a decision made by the doctor or was spontaneous.

Q: If both mother and baby are healthy, are there any special precautions parents should take to protect the newborn from contracting the virus?

Dr. Armson:

At this moment, the SOGC is not recommending isolation of the infant from the mother. And women who choose to breastfeed should be allowed to do so, as long as they continue to take the right infection-control precautions, such as proper hand-washing.

However, in this current time of physical distancing, it would be reasonable for new mothers, fathers and babies to limit contact with others.

Q: Maternity wards across the country have changed their visitor policies. How does this differ from before the COVID-19 pandemic?

Dr. Armson:

While every hospital had its own rules, before the pandemic, many hospitals would permit a small number of family members to support a woman throughout her labour.

Now, many maternity wards have reduced the number of support people allowed in the delivery room to one. That is consistent with the policy for women who require a C-section or a delivery involving forceps.

Editor’s note: Pregnant women should check with their respective hospital or birth centre to know what changes to the visitor policies have taken place.

Q: On March 24, a number of New York City hospitals enacted a policy that pregnant women cannot have any support person in the delivery room with them, meaning no partner, spouse or family member. Could this happen in Canadian hospitals?

Dr. Armson:

Obviously, New York City’s situation has become extreme. They’re taking every step they can to reduce the risk of transmission.

The SOGC would need to have reasonable evidence to take that kind of step, because depriving a mother of any support in labour has a lot of impact. It would require pretty good evidence to support that before the SOGC would recommend it.

Q: What would you say to reassure pregnant women in Canada during this uncertain time?

Dr. Armson​:

There’s incredible planning going on 24/7 to ensure (hospitals) are prepared and ready to provide safe care to mothers and their babies in the midst of this pandemic.

The SOGC is in constant communication with other obstetrical organizations and expert panels to make sure our recommendations are consistent.

Within every institution, there’s been a great deal of care taken to map out, step-by-step, how to get every mother and baby through their labour and delivery safely.

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