Giving Birth in the Time of Coronavirus
By Karin DeLucia,
Everything you need to know according to recent studies and guidelines.
The period surrounding child birth is usually characterized by a physiological wave of emotional states. Giving birth during an emergency health situation is certainly amplifies those emotions.
As Freelance Midwives working in this field, we want you to know we are empathetic and present for the families who are going through this experience at this delicate moment.
We want to provide information to guide and raise awareness, summarizing in simple words the results of the studies carried out from January 2020 to today on pregnancy, childbirth and breastfeeding during the coronavirus epidemic. The aim is to provide sufficient material and fact based knowledge to help you make the informed choices and find the best possible solutions to protect your health as well as others. Currently we health professionals are called to respect and follow (as always) the guidelines, to protect public health and our community. Hence, we offer a care path with a multidisciplinary case-by-case evaluation.
Although the available studies are recent and inconclusive, from the data that has emerged it has been shown that:
MOST PREGNANT WOMEN INFECTED WITH THE VIRUS EXPERIENCE SLIGHT OR MODERATE SYMPTOMS SIMILAR TO A FLU such as cough and fever. The most serious symptoms have been found mostly in elderly people or those with previous pathologies such as immunosuppression, diabetes, cancer, or chronic respiratory diseases. The symptoms, even if mild, should not be underestimated and it is important to always contact a general practitioner and follow the protocols for the prevention and management of this health emergency.
IT IS FUNDAMENTAL TO TAKE NORMAL PREVENTIVE ACTIONS TO REDUCE THE RISK OF CONTAGION. Respect isolation and / or quarantine, wash hands often with soap and water or alcohol-based gel, avoid contact with people suffering from acute respiratory infections, do not touch your face with your hands, when sneezing or coughing cover your mouth and nose with disposable tissues or with the crease of the elbow, use a mask if you suspect you are ill or if you are assisting sick people. In case of suspected symptoms, you should not go to the emergency room but call the general practitioner and follow his instructions.
CONTRACTING THE VIRUS IN THE THIRD TRIMESTER OF PREGNANCY HAS NOT SHOW ANY VERTICAL TRANSMISSION. That is, to date, no transmission of the virus from the mother was found IN r the baby in utero. The presence of the virus has NOT been found in the placenta, in the amniotic fluid or even in the baby’s blood taken from the umbilical cord.
SUSPECTED OR CONFIRMED CASES OF SARS-COV-2 DOES NOT INDICATE A NEED FOR AN ELECTIVE CAESARIAN.
BREASTFEEDING REMAINS THE PRIMARY AND BEST METHOD OF FEEDING. EVEN in cases where a mother has tested positive for SARS-Cov-2 she should still breastfeed while adhering to a higher set of hygiene and health standards such as vigorous and repetitive hand washing and wearing a mask. This is because breastfeeding has been shown to protect the baby’s health even if the mother is positive ( this was documented during the previous SARS and MERS epidemics). Coronavirus has not been detected in the milk of mothers who have tested positive, while it is possible to pass on the antibodies against the virus through breast milk. So it is essential to preserve the mother-infant relationship by starting and maintaining breastfeeding. When this is not possible due to certain clinical conditions or in compliance with the woman’s wishes, it is important to pump and collect breast milk with the aid of the breast pump, always following the hygiene conditions indicated above.
In conclusion, it is important to preserve the physiology of childbirth and birth as much as possible, with due care even in case of suspected or confirmed cases. Obviously in these cases it is advisable to go to hospital structures which are ready to face, manage and stem the infection as much as possible and to protect the health of the pregnant woman and the newborn.
For women giving birth with suspected or confirmed cases of SARS-Cov-2 who must go to the hospital, international guidelines recommend:
- Stay at home during the early phases of labor and to go to an health facility when in active labor.
- Use private transport or call an ambulance informing them that you are in isolation for possible contagion from SARS-Cov-2.
- Notify the hospital in advance of a suspected infection.
- FOR ALL OTHER WOMEN WHO ARE NOT AT RISK AND DO NOT DISPLAY SYMPTOMATOLOGY it is recommended to stay at home as much as possible to reduce the possibility of potential contagion and maintain your health. We freelance midwives recommend in this case, to consider the possibility of in home care.
We midwives are working to create support networks to guarantee safe and preventive obstetric assistance. Most of our consultations, activities, courses or visits are taking place online, reducing travel to the strict minimum. Home visits are carried out in extremely necessary cases and with adequate protective devices. We are trying to clinically support all healthy women with physiological pregnancies to the best of our ability, in order to preserve the health of mothers and babies, by reducing the need to access and/or stay in healthcare facilities which can potentially put you at risk of contagion. The goal is to preserve the physiology of birth for the protection of the health of mum and baby
These days we are offering:
- Assistance for in home labors and postpartum care for healthy women who go to the hospital to deliver and elect for early dismissal.
- Obstetric care for home birth if health requirements and clinical conditions allow
- Health evaluations for your pregnancy with in home obstetric visits
- Support for breastfeeding and newborn management
- In home blood samples and swabs
- Online consultations, midwifery assistance by phone or via Skype
- Online birth courses
- Online yoga courses for pregnancy
- Online support groups for new mothers and new parents
Now more than ever it is important to stay at home and we Midwives are there. We are doing what we can.
Andrà tutto bene!
Resources:
Sources:
https://app.ostetriche-bgcrlomimb.it/notizie/c/0/i/43505327/informazioni-su-coronavirus-covid19
https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1002/uog.22013
in collaboration with Midwives:
Gabriella Pacini, Sara Bettacchini , Patrizia Mazza, Giorgia Alazraki
Edits by:
Dr. Elisabetta Pandolfi
Karin DeLucia is a Midwife who lived and worked in New Zealand for two years, expanding upon her English and her midwifery skills. She has an Italian Language website www.ostetricakarindelucia.
