Pregnancy, Birth, and COVID-19
Pregnancy can be a confusing time no matter when it happens to you. There's a lot to learn about development, birth, and baby care. But what happens when you're giving birth during a pandemic? What if you or your partner test positive for COVID-19? How do you properly prepare if you're self isolating? And who really wants to go to a hospital right now?!?
Certified birth doula Lindsey Bowns CD(DONA) [ adora birth + wellness, Calgary ] recorded this live Q+A for you, referencing evidence-based information from the World Health Organizations, the CDC, and Alberta Health Services.
Doula Services are still available!
adora birth + wellness offers doula support using a mixture of virtual services, physically distanced support, and safe, protected hands-on care so you can feel confident giving birth in these anxious and uncertain times.
Pregnancy, Birth + COVID-19:
Your Questions, Answered.
UPDATED AS OF JANUARY 30, 2021
NOTE: As a certified birth doula in the Alberta Health Region, this information is based on Alberta Health Services (AHS) guidelines, which are informed by the World Health Organization and the Centre for Disease Control. The information may not be the same in your region, but it will have been based around the same research and knowledge about COVID-19. Talk to your doctor if you are unsure.
Remember also that our knowledge about COVID-19 isn’t perfect; it’s a very new virus, so data is being collected and analyzed as we go.
Am I more likely to contract COVID-19 while pregnant?
In short, NO. Pregnant women do not appear more likely to contract the infection.
However, when you are pregnant, you may already be experiencing a variety of symptoms that make you feel unwell: nausea which can cause dehydration, exhaustion, shortness of breath. Once you compound a viral illness on top of that, it is understandable that contracting COVID-19 could make you feel quite unwell.
What if my partner gets sick?
If your partner gets sick you should have them perform a self-assessment and then contact your health region to organize testing if recommended. If they test positive, the health region will provide instructions for them to quarantine.
This may be hard on you because pregnancy can be physically demanding, in addition to possibly still working from home or taking care of older children. If your partner is required to self-isolate away from you, in-home personal care and childcare services (eg: babysitter, housekeeper, postpartum doula) ARE allowed under the current guidelines, and having the support of an additional caregiver may help you cope. There’s no reason this caregiver can’t be related to you (eg: your mom, sister), as long as they are taking the same level of precautions that a hired professional would - masking, hand hygiene, sanitizing any supplies, etc.
I'm supposed to have a prenatal appointment but I'm nervous to go. What can I do?
Let me assure you that your care team is working very hard to make sure that this virus is not transmitted within their office. They don’t want you to get sick, and they don’t want to get sick either.
Call your doctor’s office or ultrasound clinic and ask them what precautions they are taking for in-office visits. Generally speaking, they have removed waiting rooms from your experience: you will be asked to wait in your car and proceed directly into a private room when there is one available. Also only the pregnant individual will be allowed inside; no extra support people, no dads/partners and no kids. Again, if you don’t have childcare available for your other children, this is where a designated cohort family/person may be beneficial.
Extra sanitization and hand washing is likely taking place on-site, and staff will be wearing personal protection such as masks, and will not be coming to work if they are sick, have travelled, or have been exposed to anyone who has.
You should not skip prenatal appointments; there is risk in doing this, just as there is risk in leaving you home. The name of the game here is to minimize risk all around.
Your care provider’s office should be contacting you directly to either confirm upcoming in-person visits or explain if/how they will be moved to telehealth visits.
I'm scheduled to give birth at the hospital but I'd rather have a home birth now.
I can understand that home seems like the safest place to be right now, definitely. However, the hospital is still a very safe place to give birth too.
In Alberta, obstetricians (OBs) do not attend home births; your care would have to be provided by a midwife in order to have a home birth. OBs and midwives are both resources covered under AHS; a midwife doesn’t cost extra money, it’s just a care option that you have.
If you are currently under the care of an OB, you may not be able to transfer your care to a midwife. Generally speaking midwives’ schedules are full once you’re 4-10 weeks pregnant; if you’re any further than that, you can apply for midwifery care, but it isn’t likely that you will find a practice with remaining availability for your due date.
If you are currently under the care of a midwife and were considering a hospital birth, but would like to pivot to a birth at home or at a birth centre such as Arbor Birth Centre in Calgary, this is a conversation to have with your midwife.
If you are early enough in your pregnancy that you have not been assigned an OB yet, you do still have the option of applying for midwifery care. This can be done online, and there is some availability for due dates September or later.
I heard that all home births are cancelled.
This is not true in Alberta; home births are continuing as scheduled unless members of the household are ill.
I'm scheduled for a home birth but I/my partner/someone in our household is sick.
If you/your family are sick or self-isolating, your care will be required to transfer to an OB and your birth plan will pivot to a hospital birth.
I want to limit my time at the hospital.
Completely understandable, and AHS wants that too.
In order to labor comfortably and efficiently at home, you can use the help of a doula who can provide in-person or virtual services and training for you and your partner.
You can research techniques online/YouTube.
You can take online childbirth education that will teach you some comfort measures.
After an uncomplicated vaginal delivery, AHS will work to discharge you within as little as 6 hours.
How will covid-19 change my experience at the hospital? Should I pack anything different?
Once you enter the hospital you will be screened before admission. This is NOT a COVID-19 swab. It is a questionnaire and a temperature check. If mom is experiencing any symptoms, she will immediately be swabbed and treated as positive until proven otherwise.
Some things to note about the hospital right now:
- Laughing gas (entonox) was not available at some Calgary hospitals earlier in the pandemic, but IS available again as of May 11, 2020 as a pain relief measure.
- Bring your own food: the communal kitchens normally used by patients are closed.
- You will have to wear a mask upon entry to the hospital, and your support person will have to wear a mask the entirety of their visit. You may be able to remove your mask during labor, dependent on instructions from your nurse.
Can I have a doula at my birth?
According to Alberta Health Services current policy (last updated January 26, 2021) you are entitled to ONE support person of your choosing (professional or otherwise) IF they pass screening. An additional support person - such as a professional doula - is eligible for approval depending on your location, care team, and birthing circumstances. You may contact your primary care provider (doctor or midwife), as well as Alberta Health Services Patient Relations at 1-855-550-2555 in advance of your birth to receive updates on the newest policy changes, and advocate for your right to the birth support of your choice if necessary.
What if my partner is sick when it's time to give birth?
Dads: DON’T GET SICK.
If your partner is not able to pass initial screening they will NOT be allowed in.
If you’re like many other Calgarians who aren’t actually “from here,” there’s a good chance your parents don’t live here. You can’t just call your mom to come with you instead. Or maybe your parents or your sister DO live here, but are part of your “cohort family” and are taking care of your existing kids.
And…because you’re pregnant, you’re probably somewhere between 25-40 years old…making your parents somewhere between 45-75 years old…they are in the most vulnerable population. They are being infected the most, they often have pre-existing conditions…they probably shouldn’t be coming to the hospital.
So…what are you going to do?
You’re going to call a doula. This isn’t meant to be a sales pitch. You don’t have to call me. You can call any doula that’s listed as a member of the Calgary Doula Association, and you’ll be well taken care of.
Yes…a doula costs money, BUT…we come with tools like information…physical tools like birth balls and massage rollers…. We probably haven’t left the city, let alone the country in months or years because we can’t – we’re always on call for a birth. We have already been self-isolating as a precaution in case we are called upon by our existing clients. And when our phone rings…we will answer. Always. Because our phones are always on, we’re always on call for someone. We are as “safe” a person as you’re going to find in your time of need.
If you’re due in the next 8 weeks or less, I would consider designating 1-2 people as part of your backup plan. If dad is sick, I will call this person. And if they are sick too, I will call this person. If your backup plan might involve a doula, I recommend going to the Calgary Doula Association website, researching individuals who look/sound like they might be a good fit for you, and keeping their information close at hand in case you need it.
What if I'm sick before I go into labor?
If you’re sick before you go into labor, perform a self-assessment and contact your health region for testing if recommended. This will enable your care team to take appropriate precautions with your pregnancy and labor the minute you arrive at the hospital.
What if I'm sick when I go into labor?
If you’re sick when you go into labor but haven’t been tested, you will be screened when you arrive at the hospital. If you fail the screening, you will be swabbed for COVID-19 and treated as if the test is positive until the results are back.
This means you will be required to wear a mask and will be in a private room all the time – no waiting/triage rooms and no shared postpartum rooms. Constant electronic fetal monitoring will probably be used (a probe will be attached directly to baby’s scalp; this is completely painless for you and baby both).
Will I have to have a C-section if i have COVID-19?
No, being sick would not be a reason to require you to have a c-section.
However, being sick may affect you physically, and it also may affect how baby tolerates labor. If it is determined that baby is not tolerating labor well (HR dropping or spiking), a c-section will be recommended (and this true anytime, but especially if the mother is positive for COVID-19).
I won't be able to do skin to skin if i am COVID-19 positive.
Skin to skin is still recommended right now, even if the mother is positive for COVID-19.
My baby will get taken away If I am COVID-19 positive.
Separation of mother and baby is NOT recommended. Unless the mother or baby is critically ill (as in, in ICU/NICU), skin to skin would still take place and your baby will not be removed from your care, even if you are positive for COVID-19.
As per Alberta Health Services COVID-19 Neonatal Management Pathway, contact & droplet precautions will be taken (mother will practice hand hygeine and wear a mask while breastfeeding), mother/tamily if positive for COVID-19 cannot visit NICU if applicable. AHS will endeavor to early discharge mother and baby if mother is well enough to care for baby. You should also aim for 2 meter separation when not providing direct care for baby.
The only reason mother and baby would be separated is if baby is admitted to the NICU and mother is COVID-19 positive (infected persons are not allowed access to the NICU due to the fragile nature of the babies admitted there), or if mother or baby have significant symptoms and are not managing well (serious respiratory infection, difficulty breathing, symptomatic to the extent that mother is unable to care for baby).
I won't be able to breastfeed if I am COVID-19 positive.
Breastfeeding is still recommended, even if mother is positive for COVID-19. There is no evidence of transmission of the virus through breastmilk. When breastfeeding, you will be required to perform good hand hygiene immediately before and after holding baby, and if you are positive for COVID-19 you will be required to wear a mask while nursing. The only reason breastfeeding would not be possible is if mother or baby are too ill to participate.
I hosted a complete Q&A on breastfeeding and COVID-19 earlier this week with a board certified lactation consultant. You can watch the replay and download a 1-page fact sheet here.
Can I have visitors at the hospital?
No. As of January 26, 2021, no visitors are allowed at the hospital. You may have ONE Designated Support Person for the duration of your stay (and this person must be consistent / cannot be substituted). Exceptions may be made for a professional caregiver such as a doula, or in surrogate or adoptive parent situations.
What happens when we go home?
You will be requested to make a trip to see the Public Health Nurse within 48 hours of your hospital discharge. If you are under the care of a midwife, you will not visit Public Health; your midwifery care team will perform in-home visits to conduct newborn wellness checks instead.
What about visitors at home?
If you are healthy upon delivery:
Newborn babies are susceptible to all kinds of “big germs” – we need to worry not only about COVID-19, but also colds, flu, whooping cough. So safety measures should be taking place, coronavirus or not.
The current provincial guideline is a ban on social visits. Caregiver visits are allowed, when the caregiver is taking outlined precautions such as masking, handwashing, and sanitization of equipment.
I know it’s a monumentous time and it’s really hard to tell people that they can’t see you or see baby.
To deal with visitors, here are some things you can consider:
- Not in the house, facetime/video chat only.
- Visit from outside the house. You and baby can be at a window and you can talk on speakerphone. This is an option if someone wants to stop by to bring you diapers, grocery delivery, a home cooked meal, etc.
Lindsey Bowns is a professional Calgary doula. adora birth + wellness provides DONA International certified birth doula services, working alongside your local midwife or OB, in hospital or at home.