EDITORS’ NOTE: The news and advice about coronavirus is changing quickly. The information in this story is accurate as of the publishing date.
With the coronavirus spreading around the world and halting the regular routines of daily life as we know it, a big question that has emerged: Should women delay getting pregnant because of COVID-19?
When it comes to those needing fertility intervention, many have no choice but to put their hopes on hold. Over the past week, fertility clinics across Canada have temporarily discontinued treatments, while statements have been issued by reproductive medical associations across North America and Europe to postpone pregnancies, citing a lack of healthcare resources and information about how coronavirus affects early pregnancy.
But what about women who still can and will conceive on their own? Jokes aside about a “coronavirus baby-boom” due to couples being cooped up together, is it a bad idea to follow through with trying for a baby during a pandemic that no one knows how long will last?
The answer isn’t a simple yes or no. Here are the factors you should consider when making this life-changing personal decision.
Are pregnant women at higher risk of coronavirus?
Based on what we know now, pregnant women are at no higher risk of contracting coronavirus, says Vanessa Poliquin, an obstetrician and reproductive diseases specialist at University of Manitoba in Winnipeg. And if they do get COVID-19, she says they have no increased likelihood of bad outcomes, such as needing to be hospitalized or ventilated, compared with their non-pregnant counterparts of the same age.
Poliquin, one of the experts working on new guidelines for dealing with COVID-19 during pregnancy for Canada’s Society of Obstetricians and Gynaecologists, adds: “Medically speaking, we have no signals that this is harmful for pregnancy.”
What’s more, an analysis of nine infected pregnant women who delivered at Zhongnan Hospital of Wuhan University in China earlier this year, didn’t detect the virus in cord blood, amniotic fluid or breast milk—meaning at this point, researchers don’t think there is vertical transmission from mom to baby in utero—which might further ease worries about being pregnant right now.
While most data on COVID-19 and pregnancy is in the third trimester only, Poliquin says the lack of warnings about signs in early pregnancy is hopeful. “This has been going on now for about three months and there are nearly 400,000 people in the world infected, so conceivably there’s going to be a portion of women in their first trimester that have been infected and so far we’re seeing no signals of an increased rate of miscarriage or first-trimester complications.”
How will the quality of prenatal care differ during the coronavirus outbreak?
There is no doubt that care for pregnant women would look different in the era of coronavirus. We’re hearing about hospitals across the country putting restrictions on visitors (not allowing extra relatives or doulas for example), limited birthing teams wearing full-on protective gear and some prenatal clinics and appointments moving to a virtual platform. And it’s still unclear about how the longer-term strain on health services will affect routine ultrasounds or even allowing partners in the delivery room.
But rest assured that if you do get pregnant, obstetrical care will remain a priority, says Poliquin. “There is usually nothing about pregnancy that is elective. It remains a non-elective urgent piece of our healthcare puzzle and at most centres, there’s a lot of prioritization going on to keeping those obstetrical-care services afloat.”
Home births versus hospital births during coronavirus
If you have a low-risk pregnancy and access to a midwife, you may want to consider having a home birth to minimize any additional risks of contracting the virus. However, home births are obviously not for everyone, notes Poliquin. “It’s got to be a global assessment that’s individualized. For somebody who is a low-risk delivery who potentially has had a baby before without complications…you might do as well at home with a midwife,” she says. But there are still many situations where a hospital birth is preferable. “At [HSC Women’s Hospital in Winnipeg] in Manitoba, for instance, we have had no COVID-19, and this remains a very safe place to deliver a baby.”
What about the extra psychological and emotional stress of being pregnant right now?
It’s important to ask yourself how a pregnancy (or even having a newborn) would look for you right now amid the fallout of the outbreak.
Caitlin Beukema, a clinical social worker and psychotherapist in Toronto who specializes in reproductive and maternal mental health, says she’s been getting a lot of frantic questions about this decision, and in each case, women should take the time to reflect on what a pregnancy or baby would mean for their family right now and how they would fit into their world. “Everyone is facing more uncertainty and anxiety right now, and with this virus especially, we may see a rise in perinatal mood and anxiety disorders. Think about how you would manage some of those anxieties.”
Perhaps there is never a “right” time to have a baby, but Beukema says you should decide how important the timing is for you. Would you be OK with altering your ideal birth plan if you go ahead? What supports you can lean on, at least virtually, and would that be enough? Has your financial situation changed?
“With pregnancy, timing is obviously critical. If someone is in their late 30s and feeling this is their time, perhaps for them it’s worth it,” says Beukema. “If they feel confident they can socially distance and stay healthy, perhaps it’s something they want to go ahead and do.”
If you do get pregnant, Beukema suggests drawing on a list of people you can call on. One of her clinics will be offering group support programs for new moms where they can meet face-to-face with their babies online, and she expects a lot of services including lactation support, will be moving to digital platforms as well.
If you’re still thinking about getting pregnant now, how should you decide?
“This is not just a medical question; we’re seeing the financial system being affected, people’s jobs being affected, and just like at any other point in time, the decision to get pregnant is a multi-factorial problem that people need to consider their individual situations. But there’s no medical reason that I can see tell women that they should avoid getting pregnant right now,” says Poliquin.
“Each woman has to look at why it’s important for her to get pregnant now,” she adds. “I don’t think there’s any blanket right or wrong.”
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