Information on COVID-19
for Pregnant Women
Know, Prepare, Protect
Know, Prepare, ProtectInformation on COVID-19 for pregnant women
What is the novel coronavirus?
Coronaviruses are a large family of viruses that cause illness ranging from the common cold to more severe diseases. The novel coronavirus is a new strain, not previously identified in humans. COVID-19 is the infectious disease caused by the latest discovered coronavirus (SARS-CoV-2).
How does the virus spread?
People can catch COVID-19 from others who have the virus through inhaling small droplets from people with COVID-19 who cough or sneeze or through touching contaminated surfaces and then touching their mouth, nose or eye.
Therefore mask wearing and regular handwashing are still very important in preventing infection.
What are the symptoms?
Many people who become infected experience mild illness and recover, but it can be more severe for others. The symptoms include a combination of:
- Fever
- Cough
- Difficulty breathing
- Muscle pain
- Tiredness
- Loss of taste/smell
If you are diagnosed with COVID-19 when pregnant, please inform your maternity hospital of this as you will be watched more closely than other pregnant women and are likely to receive additional scans and visits.
Most healthy pregnant women who test positive will stay at home to recover; and need to keep an eye on their symptoms and contact their maternity hospital if the symptoms get worse. Paracetamol is a safe medication in pregnancy for mild symptoms such as fever or mild discomfort/pain.
Mothers who get very sick and need to be in the hospital are at higher risk of going into early labour and will be watched closely for this. The best way to prevent serious problems is to provide urgent care if the illness worsens.
All mothers who have had COVID-19 will be asked to monitor fetal movements and to contact the hospital if they have any concerns to arrange urgent review.
Useful links
https://www2.hse.ie/conditions/coronavirus-and-pregnancy.html
https://hse.drsteevenslibrary.ie/Covid19V2/maternity/women/infants
https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/casedefinitions/
What to do if you are pregnant? How can you prepare yourself?
- Educate yourself on COVID-19 from trusted sources.
- Discuss your concerns about COVID-19 with your antenatal care provider.
- Continue to attend antenatal appointments where scheduled.
- The National Immunisation Advisory Committee (NIAC) recommends that pregnant women should be offered the COVID-19 vaccination between 14-36 weeks’ gestation following an individual benefit/risk discussion with their obstetric caregiver. See below for more information on receiving the vaccine through your hospital.
- Keep physically active to ensure good physical condition.
- Have over-the-counter medicines and medical supplies (e.g. tissues, thermometer) to treat fever.
- If taking any prescription medicines, refill them and/or get them delivered to you.
- Activate your social network.
- Contact family, friends, neighbours or community healthcare workers in advance and make joint plans on what to do when COVID-19 is spreading in your community or if you become ill.
- Follow instructions from national authorities on how to prepare for emergencies.
- Continue to practice general hygiene.
Useful links
https://www.rcpi.ie/covid19/clinical-guidance-for-doctors/
https://www.rcm.org.uk/advice-for-pregnant-women/
https://www.rcpch.ac.uk/resources/covid-19-guidance-neonatal-settings
Frequently Asked Questions
Listed below is a few frequently asked questions by patients. For a list of useful resources for expectant mothers please see the question ‘ What antenatal support will I receive?’
What do I do if I have a COVID-19 related query or concern?
If you have any COVID-19 related query or concern, – then please contact the numbers below. They will direct your call to a member of staff who can discuss your options with you.
CUMH: 021 492 0500
UHW Labour Ward 051 842770
STGH Labour Ward 052 6177099
UHK Labour Ward on 066 7184324
Is it safe to continue antenatal check-ups?
We understand that you may be fearful about going to appointments while recommendations are in place such as such as staying home and practicing physical distancing. However, we still advise you to attend antenatal appointments where scheduled.
Our hospitals have taken steps to make it as safe as possible, such as screening, social distancing in waiting rooms and availability of hand sanitisers.
If you have any specific concerns, please call your hospital.
What antenatal support will I receive?
As antenatal classes have been cancelled in hospitals during COVID-19, each maternity hospital or unit in Ireland South are providing a selection of live online antenatal classes for expectant mothers.
- Cork University Maternity Hospital website contains a wide variety of online resources relevant for all expectant parents, including videos and useful downloads as well as a list of live online classes:
https://irelandsouthwid.cumh.hse.ie/maternity-care/online-parentcraft-education/ - UHK have a range of useful videos for all expectant mothers, including labour, antenatal and breastfeeding and al list of useful contact numbers:
http://uhk.ie/maternity/ - UHW are offering antenatal classes live online. Please contact your midwife in the Outpatients Department (OPD) on 051 848 000.
- STGH are also offering mothers live parent craft classes online. Please contact the following number for more details: 086 043 1660.
What should I do if I have or am at risk of COVID-19 and I need to come to the hospital?
Do not hesitate to contact the hospital if you are unwell, we are well-equipped to help you if you have COVID-19 and will be happy to assess and treat you.
If you are advised to attend the hospital because you are ill, please contact the reception before arrival. Please do not travel by public transport. If it is not possible to travel by private car, please discuss with the hospital. You will be requested to wear a mask if you have symptoms.
When you arrive, you will be asked about your symptoms. You will them be directed through the patient care pathway for that particular hospital.
I’m feeling incredibly anxious about giving birth. What should I do to cope?
Many women are anxious about giving birth and the current situation can make things more stressful. Having a plan in place for your birth can help. We recommend sitting down with your partner to discuss the birth and draw up a birth plan. This can include details on who to phone when the labour begins, and who is to be your birthing partner when you give birth. Please feel free to discuss this plan with staff when you attend antenatal appointments and we are happy to address any concerns you may have.
Please be reassured that our midwives are there to support you and will do their best to make the experience of giving birth as positive as they can and will guide you through each step. Please focus on taking care of yourself as much as you possibly can. Eat and drink well, and try to enjoy being pregnant as it is a special time.
Note that mental health problems are very common, up to 1 in 5 women will develop a perinatal mental health difficulty in pregnancy and after delivery. If you have concerns, your GP or midwife/obstetrician can refer you to Specialist Perinatal Mental Health Services that are available in CUMH, UHW or STGH. Further information can be found on the links below.
https://irelandsouthwid.cumh.hse.ie/maternity-care/perinatal-mental-health/
https://www.hse.ie/eng/services/list/4/mental-health-services/specialist-perinatal-mental-health/
If I have COVID-19, will I have to have a caesarean section?
It is recommended to have a hospital birth where the baby can be watched closely and where caesarean section is available if needed. There are no reasons at the moment to choose a caesarean section instead of a vaginal delivery when a mother has COVID-19, unless the mother is very ill or another reason exists.
Can my birth partner come in with me when I give birth?
Your birth partner can join you when you are in strong, active labour and go to the delivery suite. They can stay with you until soon after the birth, – and then, they are kindly asked to go home. They will, of course, come back to collect you and your baby when you are being discharged from hospital. If you are having a caesarean birth, please speak to your hospital and they will advise you on when birthing partner can join you.
Useful advice for birth partners attending births can be found on the following link:
https://www.rcm.org.uk/labour-and-childbirth/
Please note that restrictions on access for partners and support persons are now easing. Ireland South Women & Infants Directorate are cautiously and steadily re-opening visiting in all four maternity hospitals in our network – CUMH and the maternity units of UHK, UHW and STGH.
What support will I receive during induction/early labour?
We understand you may be concerned that your partner can’t be with you during the early stages of labour or induction. Our doctors and midwives are committed to providing you with excellent support in all stages of labour. You will have a midwife in the induction room at all times, you will be kept informed and you will be supported throughout.
When you are in the strong, active stage of labour your support person will be contacted and asked to come in for further support.
What breastfeeding supports are available?
Breastfeeding support services are up and running in our hospitals as usual. The midwives on the ward are your primary supports for breastfeeding. They are here to support you on your breastfeeding journey whether you’re a first-time mum or not.
We also have lactation consultants available who visit mothers in the wards to provide additional help where needed. Many also run live online breastfeeding classes on a regular basis. You can call them on the numbers below and if they are not available, they will always call you back.
CUMH breastfeeding: 087 662 3874
UHW breastfeeding: 051 842 757
STGH breastfeeding: 086 043 1660
UHK breastfeeding: 066 718 4318
You can also get great support online from breastfeeding.ie or mychild.ie and can speak to a breastfeeding expert live online. In addition the WHO website provides information on COVID-19 and breastfeeding.
Patient’s perspective – what to expect?
Useful stories published in Irish newspapers:
19 April 2020: Pregnancy and COVID-19
29 May 2020: Wellbeing: Minding maternal mental health
1 June 2020: Giving birth in Ireland during COVID-19
5 May 2021: Professional and personal lives collide in pandemic pregnancy
How can you protect yourself and others?
Clean your hands often. Wash your hands with soap and water or, if not available, use an alcohol-based hand sanitizer:
- Before eating, after using the toilet;
- After blowing your nose, coughing or sneezing;
- After having been in public places;
- After having touched surfaces in public places;
- After having touched other people.
Avoid touching your face, nose and eyes.
Avoid meetings, events and other social gatherings in areas with ongoing community transmission.
- Practice social distancing if COVID-19 is spreading in your community:
Avoid crowds, especially in confined and poorly ventilated spaces. - Do your grocery shopping at off-peak hours.
- Avoid using public transport during rush hours.
- Exercise outdoors instead of indoor settings.
- Work from home where possible.
Pregnant women should be offered mRNA COVID-19 vaccination between 14-36 completed weeks gestation following an individual benefit/risk discussion with their obstetric caregiver.
The wearing of facemasks in public is recommended by the HSE where it is difficult to practice social distancing. As advice on this is changing regularly, please visit the HSE page on face coverings for more information.
We are still learning about COVID-19.
We don’t yet know how it affects all pregnant women and their babies.
Should I receive the COVID-19 vaccine if I am pregnant?
The guidance on COVID-19 vaccines in pregnant women has changed. It is now recommended that pregnant women should be offered an mRNA COVID-19 vaccine between 14-36 weeks gestation following an individual benefit/risk discussion.
The COVID-19 vaccine for pregnant women is now available in all hospitals in Ireland South Women & Infants Directorate. CUMH and the maternity units in UHK, UHW and STGH are currently operationalising access with women in more advanced pregnancy being prioritised. All pregnant women between 14-36 wks gestation will be contacted directly in due course.
We encourage you to visit the COVID-19 Vaccine Decision Aid to help you to make an informed decision about the COVID-19 vaccine before, during or after pregnancy. To view the aid, please visit:
https://rcpi-live-cdn.s3.amazonaws.com/wp-content/uploads/2021/05/IMPS-IOG-COVID19-Decision-aid-V3_050521_.pdf
- CUMH: If you are pregnant and attending CUMH and are interested in receiving the Covid-19 vaccine, please note that the team will contact you. The calls have already started with those at 36 weeks’ gestation first and we are working our way down. Please bear with us. If you have any further queries you can also talk to your obstetrician or midwife at any of your hospital appointments.
- STGH/UHK/UHW: If you are pregnant and attending the maternity units in Tipperary, Kerry or Waterford hospitals and are interested in receiving the Covid-19 vaccine, please note that a member of the team will contact you. All pregnant women between 14-36 wks gestation will be contacted, with those in more advanced pregnancy being prioritised.
Useful Resources:
- COVID-19 Vaccine Decision Aid for Pregnant Women. Available here.
- NIAC Recommendations for COVID-19 Vaccination in Pregnancy. Available here.
- Questions and Answers for Pregnant or Breastfeeding Women About COVID-19 Vaccination (Updated May 2021). Available here.
- COVID-19 Vaccination Scenarios in Pregnancy. Available here.
Are pregnant women a high risk group?
Unfortunately, the latest evidence does suggest that pregnant women are a high-risk group. Pregnant women do not appear more likely to contract COVID-19 than the general population, but pregnancy is an independent risk factor for COVID-19 disease severity.
The latest research suggests that there is a risk that pregnant women can suffer more severely from COVID-19. Pregnant women with COVID-19 may be more likely to be admitted to hospital, to need help with breathing and to need care in an intensive care unit. There may also be an increased rate of premature labour and stillbirth.
Therefore, if you have COVID-19 and feel unwell, please contact the hospital for assessment
If you are having difficulty breathing contact the emergency services 999/112.
(RCPI, COVID-19 infection Guidance for Maternity Services May 2021)
What are the risks of stillbirth with COVID-19?
A very small number of stillbirths are linked to a condition called COVID placentitis. COVID placentitis is an inflammation of the placenta which has occurred in the first few weeks following infection with SARS-CoV-2. This inflammation prevents the placenta from functioning well and oxygen and nutrients are not passed as easily to baby,
The women who were identified as having COVID placentitis presented with reduced fetal movements in the weeks following COVID-19 infection, which in some cases was very mild. COVID placentitis seems to be more common with the B117 variant.
It is very important that you contact your maternity unit or hospital immediately if you notice your baby is not moving as much as usual. We will then arrange for you to come in for assessment.
Do not hesitate to represent if you are still concerned about baby’s movements, even if initial assessment was reassuring,
Is it dangerous for me if I get COVID-19 when pregnant?
The majority of young healthy pregnant women who contract COVID-19 do not develop serious illness and will recover well. However, a small percentage of pregnant women can become critically ill due to the changes that occur in pregnancy.
Pregnant women with other health problems may be considered more vulnerable to COVID-19 infection. For example, lung problems high blood pressure, pre-existing diabetes, gestational diabetes, cardiac disease, or HIV.
As mentioned already, pregnant women are at higher risk of developing severe COVID-19, needing hospital care or ICU care. They are also at increased risk of developing pre-eclampsia.
It is therefore important to let your GP and hospital know if you test positive to ensure that antenatal care can be arranged with surveillance as necessary.
Is it dangerous for my baby if I get COVID-19 when pregnant?
Women who contract COVID-19 will of course be concerned about the effect of this virus on their baby,
There is currently not enough evidence to directly link COVID-19 to first or second-trimester pregnancy loss.
Large studies from around the world have not seen a rise in stillbirths during the pandemic. However, as mentioned previously, there is a link between COVID placentitis and stillbirth. This is particularly associated with the B117 variant.
Therefore, if you have COVID-19 or have recently had COVID-19 and have concerns regarding your baby’s movements, please contact the hospital.
There is not enough evidence at present to rule out a link between COVID-19 and growth restriction. Therefore, if you have had COVID-19 extra scans may be required to confirm baby is growing well.
There is a link between COVID-19 and preterm birth and thus women who are unwell with COVID-19 may need additional monitoring.
Very few infections have been reported in the newborns of women with COVID-19 and the outcomes for these babies have been very good.
Can I breastfeed if I have COVID-19?
It is not yet clear whether COVID-19 can be transferred via breast milk. Other coronaviruses are destroyed by pasteurisation but there is no evidence to inform whether COVID-19 (if present) would be similarly destroyed. Small studies to date have not identified the virus in breast milk.
(RCPI, COVID-19 infection Guidance for Maternity Services May 2021)
The World Health Organisation recommends that women with COVID-19 can breastfeed if they wish to do so, but must be really careful to wash your hands and to use a facemask while feeding.
Another option is to pump or express the breastmilk by hand and have someone who is not sick feed it to the baby. If you pump or hand express your milk, make sure you wash your hands before doing so.
For more information on breastfeeding and COVID-19, visit the WHO website.
We are still learning about COVID-19.
We don’t yet know how it affects all pregnant women and their babies.
Are pregnant women a high risk group?
Unfortunately, the latest evidence does suggest that pregnant women are a high-risk group. Pregnant women do not appear more likely to contract COVID-19 than the general population, but pregnancy is an independent risk factor for COVID-19 disease severity.
The latest research suggests that there is a risk that pregnant women can suffer more severely from COVID-19. Pregnant women with COVID-19 may be more likely to be admitted to hospital, to need help with breathing and to need care in an intensive care unit. There may also be an increased rate of premature labour and stillbirth.
Therefore, if you have COVID-19 and feel unwell, please contact the hospital for assessment
If you are having difficulty breathing contact the emergency services 999/112.
(RCPI, COVID-19 infection Guidance for Maternity Services May 2021)
Should I receive the COVID-19 vaccine if I am pregnant?
The guidance on COVID-19 vaccines in pregnant women has changed. It is now recommended that pregnant women should be offered an mRNA COVID-19 vaccine between 14-36 weeks gestation following an individual benefit/risk discussion.
The COVID-19 vaccine for pregnant women is now available in all hospitals in Ireland South Women & Infants Directorate. CUMH and the maternity units in UHK, UHW and STGH are currently operationalising access with women in more advanced pregnancy being prioritised. All pregnant women between 14-36 wks gestation will be contacted directly in due course.
We encourage you to visit the COVID-19 Vaccine Decision Aid to help you to make an informed decision about the COVID-19 vaccine before, during or after pregnancy. To view the aid, please visit:
https://rcpi-live-cdn.s3.amazonaws.com/wp-content/uploads/2021/05/IMPS-IOG-COVID19-Decision-aid-V3_050521_.pdf
- CUMH: If you are pregnant and attending CUMH, you will be contacted by the team with a view to scheduling your vaccine. Please note that women in more advanced pregnancy are being prioritised.
What are the risks of stillbirth with COVID-19?
A very small number of stillbirths are linked to a condition called COVID placentitis. COVID placentitis is an inflammation of the placenta which has occurred in the first few weeks following infection with SARS-CoV-2. This inflammation prevents the placenta from functioning well and oxygen and nutrients are not passed as easily to baby,
The women who were identified as having COVID placentitis presented with reduced fetal movements in the weeks following COVID-19 infection, which in some cases was very mild. COVID placentitis seems to be more common with the B117 variant.
It is very important that you contact your maternity unit or hospital immediately if you notice your baby is not moving as much as usual. We will then arrange for you to come in for assessment.
Do not hesitate to represent if you are still concerned about baby’s movements, even if initial assessment was reassuring,
Is it dangerous for me if I get COVID-19 when pregnant?
The majority of young healthy pregnant women who contract COVID-19 do not develop serious illness and will recover well. However, a small percentage of pregnant women can become critically ill due to the changes that occur in pregnancy.
Pregnant women with other health problems may be considered more vulnerable to COVID-19 infection. For example, lung problems high blood pressure, pre-existing diabetes, gestational diabetes, cardiac disease, or HIV.
As mentioned already, pregnant women are at higher risk of developing severe COVID-19, needing hospital care or ICU care. They are also at increased risk of developing pre-eclampsia.
It is therefore important to let your GP and hospital know if you test positive to ensure that antenatal care can be arranged with surveillance as necessary.
Is it dangerous for my baby if I get COVID-19 when pregnant?
Women who contract COVID-19 will of course be concerned about the effect of this virus on their baby,
There is currently not enough evidence to directly link COVID-19 to first or second-trimester pregnancy loss.
Large studies from around the world have not seen a rise in stillbirths during the pandemic. However, as mentioned previously, there is a link between COVID placentitis and stillbirth. This is particularly associated with the B117 variant.
Therefore, if you have COVID-19 or have recently had COVID-19 and have concerns regarding your baby’s movements, please contact the hospital.
There is not enough evidence at present to rule out a link between COVID-19 and growth restriction. Therefore, if you have had COVID-19 extra scans may be required to confirm baby is growing well.
There is a link between COVID-19 and preterm birth and thus women who are unwell with COVID-19 may need additional monitoring.
Very few infections have been reported in the newborns of women with COVID-19 and the outcomes for these babies have been very good.
Can I breastfeed if I have COVID-19?
It is not yet clear whether COVID-19 can be transferred via breast milk. Other coronaviruses are destroyed by pasteurisation but there is no evidence to inform whether COVID-19 (if present) would be similarly destroyed. Small studies to date have not identified the virus in breast milk.
(RCPI, COVID-19 infection Guidance for Maternity Services May 2021)
The World Health Organisation recommends that women with COVID-19 can breastfeed if they wish to do so, but must be really careful to wash your hands and to use a facemask while feeding.
Another option is to pump or express the breastmilk by hand and have someone who is not sick feed it to the baby. If you pump or hand express your milk, make sure you wash your hands before doing so.
For more information on breastfeeding and COVID-19, visit the WHO website.
HSE
COVID-19 and pregnancy:
https://www2.hse.ie/conditions/coronavirus-and-pregnancy.html
HSE 24-hour COVID-19 care line:
