Many pregnant women are wondering if they will be able to give birth accompanied by their partner, and if, after the birth of the baby, in case of positivity, they will still be able to breastfeed and practice rooming-in.
These are questions that are not only legitimate but very important in view of the birth event that unfortunately will occur in the era of a pandemic.
The situation we are experiencing is worrying but at the same time chaotic. Too many voices out of the chorus and a lot of confusion.
In this chaos of words, opinions and ideas, there is a document that should make it clear for everyone.
This is the report of the Higher Institute of Health, dated May 2020 entitled: “Interim indications for pregnancy, childbirth, breastfeeding and care of the very young of 0-2 years in response to the COVID-19 emergency “
We advise you to read it in its entirety. It is based on the scientific evidence collected up to that moment and on national and international guidelines and guidelines that address the issue of assistance to women during pregnancy, childbirth and the postnatal period.
We have reported here some key points that deserve attention.
Covid19 infection in pregnancy, transmission and complications
- Although the evidence is still scarce, vertical transmission SARS-CoV-2 virus cannot be ruled out. To date it is considered a rare but possible eventis.
- Pregnant women do not appear to be at greater risk than non-pregnant women for severe COVID-19 infection requiring hospitalization.
- There is currently no evidence of an increased risk of miscarriage in relation to maternal COVID-19 infection.
- There is currently no evidence of teratogenic effects on the fetus.
- The evidence supporting an increased risk of fetal underdevelopment is not conclusive.
- The pregnancies of women infected with SARS-CoV-2 appear to be associated with a higher frequency of preterm delivery.
COVID19 positive women during labor and delivery
- Epidural analgesia is not contraindicated in cases of SARS-CoV-2 infection and should be recommended to reduce the use of general anesthesia in case an emergency / emergency caesarean section is required.
- Induction of labor requires evaluations on an individual basis, taking into account the possible risks and benefits.
- In women with a favorable clinical picture, if there is no fetal compromise, there are no indications for accelerating labor.
- COVID-19 positivity does not in itself constitute an indication for caesarean section of election, the current indications for vaginal or surgical delivery remain valid
- The mode of delivery must not be affected by the presence of COVID-19, unless the woman’s respiratory conditions require her to deliver urgently.
- The choice of the mode of delivery it must be discussed with the woman, taking into account her preferences and any obstetric and anesthetic indications.
- Water birth should be avoided due to the potential risk of transmission through faeces and because PPE (Personal Protective Equipment) are not waterproof.
- The decision of the position to be taken during childbirth is subject to the same assessments as in the ordinary period, not linked to the COVID-19 emergency, taking into account the choices of the woman.
- Early umbilical cord clamping (within one minute) does not appear to benefit the infant.
- Late cord clamping (1-3 minutes) is indicated for the known health benefits for the newborn.
Presence of a carer during childbirth
- To women the presence of a person of one’s choice must be GUARANTEED throughout the duration of labor, delivery and during hospitalization in support of a better documented birth experience.
- A single person, asymptomatic, can remain next to the woman during labor and delivery, except in the case of general anesthesia.
- When a woman enters maternity service she should be asked whether she or the person of her choice have had signs and symptoms suggestive of COVID-19 (fever, persistent cough, nasal congestion and discharge, difficulty breathing, sore throat, wheezing or sneezing) within the previous 7 days. If so, the person of her choice cannot access the service and the woman can choose another trusted, asymptomatic person.
Skin-to-skin contact with the newborn for mothers Positive to COVID19
- Skin-to-skin contact is NOT contraindicated because its health benefits for the newborn, including early breastfeeding, outweigh the potential risks of transmission and COVID-19 related disease.
- During skin-to-skin contact and the first breastfeed, prevention measures are recommended for COVID-19 positivity.
- Mothers and babies should be empowered to stay together and practice skin-to-skin contact and rooming-in day and night, especially after childbirth and during the initiation of breastfeeding.
- Management of mother and baby must allow the mother to breastfeed as often and for as long as she wishes.
- The separation of the mother from the child must be evaluated case-by-case, based on the clinical conditions of both, the desire of the woman and in consideration of the effects that such separation would have on their well-being and on breastfeeding.
The whole document here: ” Interim indications for pregnancy, childbirth, breastfeeding and care of the very young of 0-2 years in response to the COVID-19 emergency “