Episode 11: So you have COVID and you're pregnant (Jan 2022)
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Episode 11 Content and Overview
In episode 11 of the Pregnancy and Childbirth podcast, Dr Greg Jenkins, obstetrician and gynaecologist, talks about what happens if you catch COVID-19 whilst you're pregnant. Dr Greg provides advice specific to where we are in the pandemic at the present time, so it's important to note that this podcast was recorded in mid January 2022 and in Sydney where Dr Greg is based.
Listen to this episode to learn about:
What to do if you catch COVID-19 during pregnancy
Effects of COVID-19 illness on vaccinated and unvaccinated pregnant women
What symptoms you are likely to experience and how to manage them
What happens if you're in late pregnancy and your waters break? Or you go into labour before you've been able to deisolate?
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Transcription
00:00:00
Hi, I'm Greg Jenkins, obstetrician. Welcome to my podcast. Today we're going to talk about what happens if you catch COVID whilst you're pregnant. The advice I'm going to give is specific to where we are in the pandemic at the present time, so it's important to note that this podcast is being recorded in mid January 2022 and in Sydney where I'm based. We're in the midst of a rather large outbreak of Omicron COVID.
00:00:32
At the outset, I should mention that this advice is of a very general nature only, and it assumes that you are basically a healthy person with a healthy pregnancy. If you have any pre-existing medical problems or any significant issues during your pregnancy, it's very important that you seek immediate advice from your pregnancy care provider if you're diagnosed with COVID. That's because the advice I'm going to provide here may not be particularly applicable to you.
00:01:03
Now for every pregnant woman who catches COVID during pregnancy, they should make early contact with their pregnancy health care provider so that they can obtain a specific advice to their particular needs.
00:01:16
Now if you catch COVID during pregnancy, it matters whether you're a vaccinated or unvaccinated person. We're seeing significantly milder illness in vaccinated pregnant women are with unvaccinated women a bit more likely to experience a more significant illness. And we're seeing a very small number of unvaccinated women admitted to hospital with very severe, and in some cases critical illness, requiring intensive care support.
00:01:45
So I would just reiterate the advice from one of my earlier podcasts around vaccination, if you haven't accessed COVID vaccination up to this point, I would strongly encourage you to do so at the earliest opportunity.
00:02:00
This is also useful opportunity to reflect on the public health advice, so follow whatever public health orders happen to be in place, but we do know that masks significantly reduce the transmission of COVID. So when you're in a crowded public indoor areas, it's very helpful to be wearing a mask, to maintain social distancing wherever possible, and to practice good hand hygiene, and of course if you have symptoms then isolate at home until your symptoms have resolved and get a COVID test, of course.
00:02:40
It's very possible that you've done all those things extremely well, and that you're a double vaccinated person, but now you find yourself having contracted COVID. So what does that mean? Well, the first thing to say is that you're very unlikely to experience a significant illness, and by a significant illness I mean an illness that's significant enough for you to require care in hospital.
00:03:03
The symptoms can be quite bothersome and you may well feel quite unwell for a few days. Most women will experience a sore throat, often described as a scratchy throat, a cough for a couple of days, maybe a sense of chest tightness, fatigue, fevers, and generalised muscle aches and pains, and headaches would be the most common symptoms that we're seeing during COVID illness.
00:03:33
The respiratory symptoms, the sore throat, and a cough and the chest tightness usually pass fairly quickly, and most commonly only last a few days. Some people with COVID will experience significant nausea and vomiting, and if you're a woman in early pregnancy who catches COVID, if you're in early pregnancy and you're already experiencing our troublesome early pregnancy, nausea and vomiting, it's possible that COVID might make this worse.
00:04:02
If you reach a point where you're not able to keep all fluids down, without vomiting, then this would be a trigger for you to go to hospital at your local emergency department to seek medical advice, as you may require, intravenous fluids and medication to help manage the nausea and vomiting.
00:04:22
In terms of the other, more common symptoms, cough medicines are fine to help manage the cough, although sometimes are limited benefit, but they are safe medications in pregnancy. We would recommend regular Panadol as this will help with any fever and will help with the generalised muscle aches and pains and the headaches which often accompany COVID.
00:04:44
It's important to keep up your fluids, so make sure that you're drinking plenty and taking on adequate nutrition, so even if you're feeling sick, please try to eat well during your period of illness.
00:04:57
Now, in terms of the baby, if you're above 25 weeks gestation we'd be expecting her baby to be moving actively every day, and that continues during the period of your COVID illness. So you should continue to notice your baby moving actively every day.
00:05:14
If you find that there's a significant reduction in your baby's movements or an absence of movement, then it's important that you contact the birth unit at the hospital where you’re booked in to have your baby or make contact with your pregnancy care provider so that they can arrange for an assessment of your baby’s well being or further explore the change in movements that you have noticed.
00:05:39
I should stress that the likelihood of your COVID illness causing a significant problem for your babies well being is very unlikely, but monitoring foetal movements and during a period of illness is a very important thing to do.
00:05:54
Now as I said most women are not going to be unwell enough to need to seek care in hospital. Vaccinated women tend to have a shorter and more mild cause of illness than unvaccinated women, but you should be aware of the things that would lead to a need for you to present to hospital.
00:06:13
So if you are becoming increasingly short of breath such that you would have trouble walking up a flight of stairs uninterrupted or speaking in a long sentence without taking a break to catch your breath, then this will be a trigger for hospital presentation and you should call an ambulance.
00:06:31
Sometimes COVID can cause very high fevers, and if you have persistent fevers above 38.5 degrees Celsius, if you have a thermometer at home to measure your temperature, and if those fevers don't reduce with Panadol or paracetamol, then you should contact either the birth unit at the hospital where you were booked or your pregnancy care provider, because again, this may be a reason to present to hospital for review.
00:07:00
So what about deisolation? So the criteria around deisolation are the same for pregnant women as for the rest of the population. So if you're a fully vaccinated person, provided you have become asymptomatic for 24 hours by day seven of your illness, then you are allowed to deisolate.
00:07:22
So the criteria that we are using around duration of illness is the onset of symptoms, which will usually be a sore throat or cough or a positive COVID test, whichever of those things happened first.
00:07:39
So the first day of your symptoms or the day you get a COVID test will become day one of your illness, and if you reach day 7 and you have no respiratory symptoms for the 24 hours preceding day 7, you can then deisolated. And by respiratory symptoms we mean a persistent cough, a sore throat, runny nose or a fever. And you may find that you still have some persisting tiredness and lethargy, so that the tiredness can persist for a while, and we may have quite significant muscle aches and pains and headaches as well.
00:08:14
Now those symptoms are ok and they can last for a while and you can still deisolate in the presence of those symptoms, provided you don't have any respiratory symptoms.
00:08:27
Now, if you're an unvaccinated person and you need to isolate for 14 days. If you are a vaccinated person and you get to day 7 and you still have a cough and sore throat and a runny nose, you need to isolate for a further 3 days and you can't deisolate until day 10.
00:08:45
Now, what happens if you're in late pregnancy and your waters break? Or you go into labour before you've been able to deisolate? Now not all hospitals are able to look after COVID positive woman during labour and birth. Now this is something that's changing fairly quickly so keep abreast of what's going on with your local hospital, and your pregnancy care provider will be able to provide you with the latest information around this.
00:09:13
Most women with COVID are remaining quite well as we have discussed and having COVD during the time of labour and birth shouldn't impact significantly on the care that you receive during your labour and birth and shouldn't impact on the birth itself, but it might result in a change in the hospital where you need to give birth and of course all of the staff looking after you will be wearing PPE, so they'll be wearing eye protection, a gown, gloves and a special type of mask during the care that you receive during your labour and birth.
00:09:56
Now in many hospitals it's possible for your partner to still be with you as a support person during labour and birth, but this is going to vary from hospital to hospital. And it will depend on whether your partner is COVID positive and whether or not they have significant symptoms. So again, this is something you can explore with both the birth unit at the hospital and your pregnancy care provider.
00:10:21
We would expect that as a well, COVID positive woman, who gives birth to a healthy term baby that your baby will remain with you during your hospital stay and you would be encouraged to breastfeed and have close contact with your baby just as would normally occur.
00:10:41
Finally, we are seeing lots of pregnant women are being diagnosed with COVID, and in the vast majority of cases we're seeing most of those women have a mild illness not requiring hospitalisation, being cared for safely in the community, and being deisolated fairly quickly, and continuing on with their pregnancies in a normal way.
00:11:03
I hope you found this podcast informative. Just one final reminder if you are an unvaccinated person, please consider getting a COVID vaccination as soon as you are able. Many thanks for listening. Bye for now.
