Coronavirus (COVID-19) information

Pregnant women do not appear to be more severely unwell than the rest of the population. However, as this is a new virus, how it may affect you is not yet clear.

It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms.

When you are pregnant you are more vulnerable to getting infections than a woman who is not pregnant. If you have an underlying condition, such as asthma or diabetes, you may be more unwell if you have coronavirus.

It is therefore important that you take precautions to protect yourself against COVID-19, and report possible symptoms (including fever, cough or difficulty breathing) to your healthcare provider.

If you develop more severe symptoms or if you are not getting better you should contact your maternity hospital Pregnancy Assessment Unit in the first instance.

As this is a very new virus we are just beginning to learn about it. There is also no evidence that the virus can pass to your baby while you are pregnant (this is called vertical transmission).

Expert opinion is that your baby is unlikely to be exposed during pregnancy. As we learn about the coronavirus infection we will update this information.

The most important thing to do is to wash your hands regularly and effectively as soon as you come from public places to your home or workplace.

There is useful advice on the https://monashhealth.org/

• Wash hands often with soap and running water, for at least 20 seconds. Dry with paper towel or hand dryer.
• Try not to touch your eyes, nose or mouth.
• Cover your nose and mouth with a tissue when you cough or sneeze. Then dispose of the used tissue immediately.
• Cough or sneeze into your upper sleeve or elbow if you don’t have a tissue.
• Keeping a space between yourselves and others.
• Stay at home if you feel sick. If you take medication make sure you have enough.
• Phone your doctor or the hotline – 1800 675 398 – if you need medical attention. They will tell you what to do.
• Continue healthy habits: exercise, drink water, and get plenty of sleep.
• Wearing a face mask is not necessary if you are well.
• Buy an alcohol-based hand sanitiser with over 60 per cent alcohol.

Social distancing measures are steps you can take to reduce the social interaction between people to help reduce the transmission of coronavirus (COVID-19). They are:

• Avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough.
• Avoid non-essential use of public transport, varying your travel times to avoid rush hour, when possible.
• Work from home, where possible.
• Avoid any large gatherings.
• Keep in touch with friends and family using remote technology such as phone, internet, and social media.
• Use telephone or online services to contact your GP or other essential services.

Everyone should be trying to follow these measures as much as is pragmatic.

Based on the evidence we have so far, pregnant women are still no more likely to contract coronavirus than the general population.

What we do know is that pregnancy in a small proportion of women can alter how your body handles severe viral infections. This is something that midwives and obstetricians have known for many years and are used to dealing with. As yet, there is no evidence that pregnant women who get this infection have a higher chance of serious complications than any other healthy individuals.

We advise all pregnant women to be very cautious and follow the advice above to reduce the risk of exposure to Coronavirus.

All pregnant women should follow government advice:

• Practice social distancing.
• Access fact sheets for patients from the Department of Health and Human Services

Pregnant women who can work from home should do so.

If you can’t work from home and you work in a public-facing role that can be modified appropriately to minimise your exposure, this should be considered and discussed with your occupational health team.

Ongoing pregnancy care and postnatal care when you have a new baby is essential to ensure the wellbeing of you and your baby.

If you have symptoms of possible coronavirus infection, you should contact your maternity hospital for further advice regarding appointments.

The following practical advice may be helpful:

• If you have a routine scan or visit due in the coming days, please contact your maternity unit for advice and a plan. You will still need to attend for a visit but the appointment may change.
• Some appointments may be conducted on the telephone or using Telehealth.
• If you are between appointments, please wait to hear from your maternity team.
• If you are attending more regularly in pregnancy, then your maternity team will be in touch with your plan for pregnancy.
• If you miss an appointment and haven’t heard from your maternity team, please contact them to rearrange the appointment.

Whatever your personal situation, please consider the following:

• If you have an urgent problem related to your pregnancy get in touch using the same emergency contact details you already have.
• If you have symptoms suggestive of coronavirus, contact your maternity services and they will arrange the right place and time to come for your visits. You should not attend a routine clinic.
• Have no more than one person with you at face to face appointments (and not a child under 16 years).
• There may be a need to reduce the number of pregnancy care visits. This will be communicated with you.
• Do not reduce your number of visits without communication first with your maternity team.

If you are pregnant and you have either:

• a high temperature
• a new, continuous cough.

You should stay at home for 7 days. Do not go to a GP surgery, pharmacy or hospital.

You should contact your maternity hospital to inform them that you have symptoms suggestive of coronavirus, particularly if you have any routine appointments in the next 7 days.

If you have concerns about the wellbeing of yourself or your unborn baby during your self-isolation period, contact your maternity care team. They will provide further advice, including whether you need to attend hospital.

The process for diagnosing coronavirus infection is changing rapidly. To be tested, you must have the symptoms AND meet the situation requirements.

For the latest information on testing criteria for coronavirus please visit the Monash Health Information about coronavirus disease (COVID-19) page.

If you test positive for coronavirus, you should contact your midwife or maternity care provider to make them aware of your diagnosis. If you have no symptoms, or mild symptoms, you will be advised to recover at home. If you have more severe symptoms, you may be treated in a hospital setting.

You may be advised to self-isolate because:

• You have symptoms of coronavirus, such as a high temperature or new, continuous cough.
• You have tested positive for coronavirus and you’ve been advised to recover at home.

Pregnant women who have been advised to self-isolate should stay indoors and avoid contact with others for 7 days. If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.

The guidance 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 household 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.

The Australian Government has general Coronavirus (COVID-19) isolation guidance on what to do if you’ve been asked to self-isolate at home or elsewhere.

You should contact your midwife, doctor or the hospital pregnancy care clinic to inform them that you are currently in self-isolation for possible/confirmed coronavirus and request advice on attending routine pregnancy care appointments.

Some appointments can be undertaken by telephone or telehealth.

It is likely that routine appointments will be delayed until isolation ends. If your midwife or doctor advises that your appointment cannot wait, the necessary 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, to protect other patients.

If you have confirmed coronavirus infection, as a precautionary approach, an ultrasound scan will be arranged 14 days after your recovery, to check that your baby is well. (This will depend on how many weeks pregnant you are and when other routine ultrasounds are due). This 14 day period may be reduced as more information on how infected people are as they recover becomes available.

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.

If you have concerns about the wellbeing of yourself or your unborn baby during your self-isolation period, contact the Pregnancy Assessment Unit at the hospital where you are booked. They will provide further advice, including whether you need to attend hospital.

If attendance at the hospital is advised, pregnant women are requested to travel by private transport, and alert the Emergency Department reception once on the premises, prior to entering the hospital.

Women with suspected or confirmed coronavirus are advised to attend a maternity hospital for birth, so that their baby can be monitored using continuous electronic fetal monitoring, and maternal oxygen levels can also be monitored.

We will keep this advice continually updated as new evidence emerges.

There is currently no evidence to suggest you cannot give birth vaginally or that you would be any safer having a caesarean birth if you have suspected or confirmed coronavirus.  However, if your respiratory condition (breathing) suggests that birth is urgently needed, a caesarean birth may be recommended.

It is recommended that you do not have a waterbirth if you have suspected or coronavirus, as the virus can sometimes be found in faeces. It may also be more difficult for clinical staff to use adequate protection equipment during a water birth.

There is no evidence that women with suspected or confirmed coronavirus cannot have an epidural or a spinal block.

If you go into labour, you should call your maternity unit for advice, and inform them that you have suspected or confirmed coronavirus infection.

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

Your maternity team have been advised on ways to ensure that you and your baby receive safe, quality care, respecting your birth plan as closely as possible.

When you and your maternity team decide you need to attend the maternity unit, general recommendations about hospital attendance will apply:

• You will be advised to attend hospital via private transport where possible.
• You will be met at the Emergency Department entrance and provided with a surgical face mask, which will need to stay on until you are isolated in a suitable room.
• Coronavirus testing will be arranged.
• Your birth partner (one) will be able to stay with you throughout. Other visitors are unable to attend.

The current diagnostic testing advice for COVID-19 in the baby is only indicated if the mother is confirmed as being positive and the baby has symptoms of cold or flu.

Yes, if that is your choice. Provided your baby is well and doesn’t require care in the neonatal unit, you will be kept together after you have given birth.

A discussion about the risks and benefits should take place between you and your family and the doctors caring for your baby (neonatologists) to individualise care for your baby.

This guidance may change as knowledge evolves.

Yes. At the moment there is no evidence that the virus can be carried in breastmilk, so it’s felt that the well-recognised benefits of breastfeeding outweigh any potential chance of transmission of coronavirus through breastmilk.

The main risk of breastfeeding is close contact between you and your baby, as you may share infective airborne droplets, leading to infection of the baby after birth.

A discussion about the risks and benefits of breastfeeding should take place between you and your family and your maternity team. This guidance may change as knowledge evolves.

If you choose to breastfeed your baby, the following precautions are recommended:

• Wash your hands before touching your baby, breast pump or bottles.
• Try to avoid coughing or sneezing on your baby while feeding at the breast.
• Consider wearing a face mask while breastfeeding, if available.
• Follow recommendations for pump cleaning after each use.
• Consider asking someone who is well to feed your expressed breast milk to your baby.
• Routinely clean and disinfect surfaces you have touched.

If you choose to feed your baby with formula or expressed milk, it is recommend that you follow strict adherence to sterilisation guidelines. If you are expressing breast milk in hospital, a dedicated breast pump should be used.

• Royal College of Obstetricians & Gynaecologists
• World Health Organisation (WHO) | Guidance on COVID-19 for pregnant women