Risks to the pregnant mother
The virus affects pregnant women in a similar manner to non-pregnant women. There is currently no evidence that pregnant women are more likely to get seriously ill from COVID-19 infection compared to their non-pregnant counterparts. Worldwide, the majority of mothers have recovered well with a small proportion requiring oxygen supplementation and more specialised Intensive Care Unit (ICU) care.
Pregnant women with a greater risk of complications are those who are older, obese or have medical conditions like diabetes and hypertension. If a mother does become very ill as a result of COVID-19 infection, it is possible for the illness to cause a miscarriage or cause labour to start prematurely. In some situations where the mother is very unwell, the baby may need to be delivered to help with the mother’s heart and lung functions, possibly at a premature gestation.
Risks to the fetus/baby
There is a small possibility of the virus passing from the mother to the baby in the womb or upon birth (vertical transmission). However, studies across the world have shown the risk of vertical transmission to be low, and most infected babies recover well. To date, in Singapore, none of the babies born to COVID-19 infected mothers have had the infection.
There is currently no evidence that COVID-19 infection in pregnancy leads to a higher risk of babies developing abnormalities. COVID-19 infection does not affect the baby’s risk of having a genetic or chromosomal abnormality such as Down syndrome.
Having a baby – the delivery process
The current evidence shows that the risk of neonatal COVID-19 infection is not higher with vaginal deliveries compared to Caesarean deliveries. Hence, COVID-19 infection is not a specific reason for requiring a caesarean delivery, unless there are other circumstances that necessitate it.
After the delivery
Based on the existing scientific evidence, babies do not seem to have an increased risk for COVID-19 infection. The risk of neonatal infection also does not seem to be greater even when the baby remains with the mother after delivery or if the baby is breast-fed. If the usual safety precautions are undertaken, for example, through wearing a mask and maintaining good hand hygiene at all times, Mothers with COVID-19 do not routinely need to be separated from their babies and breastfeeding can continue.
Thinking of having a baby
A common question is whether one should delay pregnancy till after the COVID-19 pandemic has passed.
As described above, the current evidence shows that pregnant women are not at higher risk of acquiring COVID-19 infection compared to non-pregnant individuals, and that babies are not at higher risk of developing abnormalities even if the mother is infected during pregnancy.
Fertility is time-sensitive and diminishes with age, especially after the age of 35. As it is uncertain at this point in time when the pandemic will be over, waiting indefinitely may reduce one’s chances of pregnancy due to increasing age. Do be reassured that it is safe to engage in antenatal care in clinics and hospitals because of all the precautions that are being undertaken in the form of strict screening and preventative policies such as safe distancing.