In mid-May, during the most heightened stages of the pandemic and when the full lockdown restrictions were still in place, pregnant women were advised by specialists in the UK to try, as far as possible, to restrict contact with other people not from their household. This advice is still recommended and, as restrictions are now easing, many pregnant women will want to know the risks to their health and wellbeing as the world begins to return to something resembling normality.
While there is still much that doctors cannot be certain about yet, in relation to how coronavirus and COVID-19 affects pregnant women and their babies, what healthcare specialists have deduced is that there appears to be no “huge risks”. Christopher Lees, professor of obstetrics at Imperial College London said that if coronavirus was a significant risk for pregnant women, then healthcare professionals would have witnessed it already.
Some of the earliest research into coronavirus and pregnancy found that out of 427 pregnant women with COVID-19 who were admitted to UK hospitals, most were in their third trimester. This led to special advice for women who are more than six months’ (28 weeks) pregnant to be particularly aware of social distancing and increased hygiene measures.
The data, from the UK Obstetric Surveillance System (UKOSS), found that older pregnant women, those from ethnic minority groups and those who were overweight, were more likely to be admitted to hospital having contracted COVID-19.
There were also reports in the press that some women who had contracted COVID-19 were delivering their babies pre-term. Dr Ed Mullins from Queen Charlotte’s and Chelsea Hospital, London said that it was possible that signs of fetal distress may have precipitated early delivery, or perhaps to enable the mother to be treated more appropriately for low oxygen levels.
Prof Marian Knight, professor of maternal and child population health from the University of Oxford, said premature labour is sometimes associated with acute illnesses which cause fever in the mother, but it is most likely that delivery would be the result of early Caesarean rather than premature labour starting spontaneously.
On 16 March 2020, the Chief Medical Officer, as a precaution, announced that all pregnant women would be classed as a vulnerable group.
As lockdown measures are now being reduced, more and more pregnant women may be required to return to work. The guidance remains clear that if a pregnant woman can work from home, she should. However, if a pregnant woman is unable to do her job at home and where the role is public-facing, employers must modify the woman’s working conditions appropriately to minimise exposure to the public and, consequently, the possible risk of contact with coronavirus.
On 21 March 2020, occupational health advice for pregnant women was published by the government (updated 26 March) stating that women in their first or second trimesters (under 28 weeks’ pregnant) who had no underlying health conditions should uphold recommended social distancing at work, as well as using other precautions such as personal protective equipment (PPE) where necessary.
On 21 April, the guidance was further updated to clarify that the responsibility for risk assessment and provision of PPE lies with the employer and that women who are under 28 weeks’ pregnant should only continue working, or return to work, if a risk assessment supports this. Women who are in their third trimester (more than 28 weeks pregnant) remain in a vulnerable group.
Despite understandable fears about coronavirus, it is important that pregnant women maintain their antenatal checks and contact their healthcare team if they have any concerns about their health or that of their baby.
The Royal College of Obstetricians and Gynaecologists has produced guidance on coronavirus infection and pregnancy, including specific advice on antenatal care and occupational health guidance for women who work in a public facing role.
The overarching advice remains that if you have a medical emergency you should contact the emergency services.