Coronavirus: everything pregnant women need to know now

Sars-CoV-2, a new variant of the corona virus, has been spreading worldwide since the end of 2019. The disease that causes the virus is called Covid-19. In contrast to the flu viruses, which recur every year, we lack a so-called basic immunity with this new pathogen. This means that nobody has immune protection and everyone who comes into contact with the virus gets infected. In addition, there are no drugs or vaccines to protect vulnerable groups. So many are worried. We answer the most important questions for pregnant women.

How dangerous is a coronavirus infection during pregnancy?

Since the virus is so new, there are hardly any studies on how the virus affects pregnancy and the unborn child. According to the German Board and College of Obstetrics and Gynecology (GBCOG), there is currently no international evidence that pregnant women are more at risk from the novel coronavirus (SARS-CoV-2) than the general population. It is expected that the vast majority of pregnant women will have only mild or moderate symptoms, similar to those of a cold or flu. There is no evidence of an increased risk of miscarriage.

Likewise, according to the GBCOG, there is no evidence that the virus can be transmitted to the baby during pregnancy. It is therefore considered unlikely that the virus will cause abnormalities in the fetus. So far, only 20 pregnancies in which the newborn was not ill have been reported internationally, all mothers live in China. To be on the safe side, your baby would be tested for the corona virus after birth.

This is how you protect yourself from infection with the corona virus

• Keep as far away from other people as possible when coughing or sneezing.
• Avoid contact with other people if you notice symptoms of a cold or a fever.
• Sneeze into the crook of your arm or into a handkerchief – never in your hand, as you will touch doorknobs and other objects through which the virus is spread.
• Avoid touching public transport grab rails, elevator buttons, etc. with your fingers.
• Avoid touching when greeting other people.
• Wash your hands regularly and thoroughly. That means: with soap and water for at least 20 seconds.
• Do not put your hands on mucous membranes on your face, i.e. your eyes, nose and mouth.
• Disinfectants are not necessary if these hygiene measures are observed and if you do not have a previous illness.
• If you have not yet been vaccinated against the flu (influenza), it is best to do so. This way you are at least as well armed as possible against a viral disease.
• If you are healthy, mouth and nose protection does not reduce the risk of infection. This only makes sense if you are ill with COVID-19.

You can also find out more about hygiene measures on the website fectionsschutz.de of the Federal Center for Health Education.

Important travel advice when you are pregnant

In principle, according to the German Board and College of Obstetrics and Gynecology, you should keep your distance from fellow passengers to avoid transmission – this of course also applies in everyday life when you are traveling on trains, buses or other public transport. For travel within Germany, it is advised to follow the advice of the Federal Ministry of Health , which is updated regularly. It is also useful, GBCOG said, to make sure your travel insurance covers the birth and care of your baby before you travel. This is important in case your return journey is delayed and you have to give birth abroad. The risk when traveling abroad is no higher for pregnant women than for other travellers. Here it is worth taking a look at the page of theFederal Foreign Office with travel warnings for certain areas .

What to do if you have had contact with a person who has tested positive for COVID-19?

In this case, the recommendation of the German Board and College of Obstetrics and Gynecology is to contact your treating gynecologist by phone. There you will be informed about all further measures. You can also contact the medical on-call service on 116117.

The first symptoms of COVID-19 are a sore throat, cough, runny nose and fever.
Diarrhea can also occur. In severe cases, breathing problems or pneumonia can occur. If you notice these symptoms in yourself or your child, it does not automatically mean that you have contracted the new corona virus. The well-known cold viruses are also in high season at the moment.

What to do if you have tested positive for the coronavirus?

In this case, too, the GBCOG recommends calling the gynecologist first to draw attention to the diagnosis. If you have no symptoms or only slight symptoms and there are no risk factors for complications in you or other people in the household (e.g. chronic underlying diseases), you can recover at home under the supervision of a doctor treating you. If you have more severe symptoms, you may be treated in a hospital.

When is isolation necessary?

For this case, the German Board and College of Obstetrics and Gynecology has published guidelines, which we are sharing with you here. Isolation is recommended when:

• You have been in contact with someone who has a coronavirus infection.
• You have visited a specific area or country where there are COVID-19 cases or which has been designated as a risk area.
• You have symptoms that indicate infection with the coronavirus and you are either waiting to be tested or to get your results.
• You have tested positive for the coronavirus and have been advised to recover at home.

The isolation may only be lifted if you have been fever-free for 48 hours and you have not noticed any symptoms of corona disease for 24 hours. In addition, two SARS-CoV-2 PCR tests carried out 24 hours apart must be negative.

What to do when asked to self-isolate

If you are pregnant and have been advised to self-isolate, GBCOG says you should stay indoors and avoid contact with other people for 14 days.

That means:

• You are not allowed to go to work or school or other public areas.
• You are not allowed to use public transport.
• Air the rooms you are in regularly.
• Separate yourself from other people in your household as much as possible. Use your own towels, dishes and utensils and eat at different times than the rest of the family.
• If possible, let friends or family run errands or use the delivery service. The handover should take place without direct contact, for example leave the things in front of the door.

Can prenatal appointments be kept?

Inform your gynecologist that you are currently in self-isolation for a possible or confirmed coronavirus infection. Routine check-ups can usually be postponed until isolation ends without harm to you or your child. If an appointment cannot wait, the German Board and College of Obstetrics and Gynecology will announce that the necessary precautions will be taken so that you can keep the appointment.

If you are worried about your baby during self-isolation or if you feel unwell, it is best to contact your gynecologist as well. “Where hospital admission is recommended there, pregnant women are asked to travel by private transport or arrange hospital transport and to telephone the clinic before entering the hospital,” according to the GBCOG.

Impact of suspected or confirmed infection with COVID-19 on childbirth

The GBCOG advises: “As a precautionary measure, pregnant women with suspected or confirmed coronavirus infection during labor are advised to attend a delivery clinic where the baby can be continuously monitored electronically and oxygen levels can be checked hourly.” A home birth or a birth in a birth center is not recommended. In any case, inform the maternity ward you have chosen in advance.

A suspected or confirmed coronavirus infection has no influence on the birth process. A caesarean section may only be necessary if a respiratory disease requires an immediate delivery. A PDA can be performed as usual.

Can you stay with your baby after the birth?

You can stay with your baby as long as your baby is fine and does not need to be cared for in the neonatal ward. You should discuss the advantages and disadvantages with your partner, your family and the doctors treating you.

Are you allowed to breastfeed your baby?

According to the GBCOG, there is nothing wrong with breastfeeding your baby: “There is currently no evidence that the virus can be transmitted through breast milk. Therefore, it is believed that the recognized benefits of breastfeeding outweigh the potential risks of transmission of the coronavirus. Infected mothers or suspected cases should prevent transmission of the virus through droplet infection when breastfeeding by taking hygiene measures such as thorough hand washing before and after contact with the child and by wearing a face mask.

You should follow these precautions when breastfeeding:

• Wash your hands thoroughly before touching your baby, breast pump or bottle.
• Wear a face mask.
• Thoroughly clean the breast pump after each use.
• Follow the sterilization guidelines very strictly with bottle feeding.
• Use a special breast pump if you express milk in the hospital.

Will the coronavirus continue to spread?

The Robert Koch Institute states that the pathogen can be expected to spread worldwide. Further chains of infection and outbreaks in Germany must also be expected. However, the risk to the population in Germany is rated as moderate. In order to stay up to date, you will find all relevant information about COVID-19 (Coronavirus SARS-CoV-2) here on the Robert Koch Institute’s homepage . The Federal Ministry of Health also publishes daily updated information on the corona virus. Doctors and researchers are currently working on a vaccine. According to Christian Drosten, it will take at least a year and a half before this is ready and on the market.

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