While there is no need to panic about this - there is no evidence to suggest that COVID-19 causes problems with baby’s development or causes miscarriage, and the majority of pregnant women who catch Covid-19 make a full recovery and go on to have healthy babies - it does mean that you can expect some changes in your antenatal care and experience of pregnancy during the pandemic.
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If you are expecting a baby and are worried about how your pregnancy and birth might be different during the pandemic, or want to know what happens if you or your partner catches COVID, here is everything you need to know…
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Luckily most antenatal care providers have gone online, and can give you all the same personalized information through your computer screen. See https://gulfnews.com/parenting/pregnancy-baby/uae-covid-19virtual-antenatal-and-postnatal-support-for-pregnant-women-and-new-parents-1.1587277688499 for a list of providers
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Although in the UAE pregnant women often have very frequent antenatal visits with their obstetrician, it's no problem to scale them down (the international standard is around 8-10 visits through the course of your pregnancy), and doctors will do their best to combine investigations, scans and appointments in order to minimize hospital visits.
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While the number of visits may be reduced, there are some visits at certain weeks of pregnancy (eg 3 months and 5 months) that are important and it’s very important you attend these. If you have a high-risk pregnancy your doctor will advise if you need to see them more frequently. The scans should be done by operators who are certified and experienced in obstetric ultrasound.
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“This will allow a first assessment of your symptoms and offer advice as whether it is better just to stay at home, visit an outpatient clinic or go to the hospital,” says Dr George Michailidis of Genesis clinic in Dubai. Not all problems are the same and it is important to discuss with a medical professional in order to decide the best action needed. “Pregnant mothers should have direct access to their caring team as on occasions avoidance of visits and hospitals may delay management of potentially serious pregnancy complications,” adds Dr George.
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“We understand that for expats the husband's or birth partner's support is extremely important to pregnant women,” says Dr Manali Dande, Specialist Gynaecologist at Medcare. It is also important for the doctor to discuss the progress of pregnancy and/ or any complications which develop and the plan of delivery with the couple, rather than only with pregnant woman, so they can make an informed choice. “With everyone following the protocols with respect to COVID-19, there should not be any increased concern regarding with respect to COVID- 19,” adds Dr Manali.
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A socially distanced baby shower with a few select friends in the garden at home is the best bet, or a video chat event with your friends and family.
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“As a pregnant woman who is Covid-positive is considered in the ‘high risk category’, as per WHO guidelines, she will be admitted to the hospital once the test is positive,” says Dr Shiva Harikrishnan, consultant Ob/Gyn at Medcare Women & Children Hospital. While in some countries pregnant women are only self-isolated if they have a Covid-positive result and no symptoms, Dr Shiva says that is not usually the case here. “According to the UAE National guidelines once the pregnant woman is positive, even if she is asymptomatic, she needs to be kept in the hospital until two negative test results are there.”
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"If the husband or the partner is tested positive, they need to follow quarantine rules and try to keep away from the pregnant woman until it is safe," says Dr Shiva Harikrishnan, consultant Ob/Gyn at Medcare Women & Children Hospital.
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Wandering around a hospital greatly heightens your virus-exposure risk, so pack enough food and drink and entertainment option to minimize the number of times anyone has to leave and re-enter the room as much as possible.
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Unfortunately water births are not currently an option at UAE hospitals during the pandemic, but you should still be able to use water as a method of natural pain relief by using your bath at home before you go to the hospital, and you may be allowed to use the shower in your labour room.
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It’s worth double checking the policy at your chosen hospital, and ask what the policy is for birth partners at a natural birth, an elective C-section and in the case of an emergency C-section, as they may vary. For instance, at Mediclinic Parkview hospital your partner is allowed to accompany you during a c-section as long as you have regional anesthesia, but “If you are going to sleep for your C-section (not a usual practice) then your partner will wait for your outside the operating theatre” says Dr Jennifer Kasirsky, Consultant Obstetrician & Gynaecologist, Mediclinic Parkview Hospital.
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Dr Jennifer Kasirsky, Consultant Obstetrician & Gynaecologist, Mediclinic Parkview Hospital says: “The World Health Organisation and other healthcare agencies deem delivery as a high-risk procedure for spread of COVID-19 and we need to take full precautions to protect our staff.”
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“However, we know that this is quite cumbersome and are committed to your safety and comfort. We will require that your husband or birth partner wear a mask when our staff is in the room with you,” says Dr Jennifer of Mediclinic Parkview.
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There's no reason why you can't have an epidural or spinal block, even if you are Covid-positive, but it's best to check your chosen hospital's individual policy on gas and air (aka Entonox) directly.
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“Birth photographers are not normally allowed now, and most units will not allow small children to visit,” says Dr George Michailidis of Genesis clinic in Dubai. "You should check with your hospital regarding visiting policies as they are subject to change at short notice as a response to the COVID-19 pandemic evolves.”
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"Covid-positive pregnant women are cared for in an isolated and dedicated maternity area within the maternity unit," says Dr Usha Sethi, specialist gynaecologist, Aster Clinic, Tecom. "The maternity team follows infection control measures to lower the spread of infection. Continuous baby monitoring and mother’s assessment is done during labour."
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"There is currently no evidence to suggest that you cannot give birth vaginally or that you would be safer having a caesarean birth if you have suspected or confirmed coronavirus, unless the woman’s respiratory condition demands urgent delivery," says Dr Usha Sethi, specialist gynaecologist, Aster Clinic, Tecom. "Until now there has been no evidence of perinatal transmission of Covid infection to the baby while passing through the birth canal, hence caesarean delivery is reserved only for obstetric indications," adds Dr Shiva Harikrishnan, consultant Ob/Gyn at Medcare Women & Children Hospital.
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Dr Usha Sethi, specialist gynaecologist, Aster Clinic, Tecom adds: “A small number of babies have been diagnosed with Coronavirus shortly after birth, but it is not certain whether transmission was before or soon after birth. Maternity teams maintain strict infection-control measures at the time of birth. All babies born to COVID-19 positive mothers are tested for Covid, have appropriate close monitoring and early involvement of neonatal care where necessary. Given the current limited evidence, the recommendations are that women and healthy infants who do not otherwise require neonatal care are kept together in the immediate postpartum period."
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Dr Usha Sethi, specialist gynaecologist, Aster Clinic, Tecom, says: “With limited studies so far, there is no evidence showing that the virus can be carried or passed on in breastmilk. The well-recognised benefits of breastfeeding and the protection it offers to babies outweigh any potential risks of the transmission of coronavirus through breastmilk."
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You should still write a birth preferences list to communicate to your medical team what your preferences are, you are still able to use relaxation techniques such as Hypnobirthing, and you can still bring your own items from home to make you feel relaxed.
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