Pregnancy, childbirth and caring for a newborn during the COVID-19 pandemic

Vaccination for COVID-19

Pregnant people are at increased risk for severe outcomes of COVID-19. Evidence shows that mRNA COVID-19 vaccines have no safety concerns during pregnancy or breastfeeding. The National Advisory Committee on Immunization recommends that people who are planning a pregnancy, pregnant or breastfeeding get a:

• complete series with an mRNA vaccine
• booster dose when eligible

There's no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems.

Pregnancy

Being pregnant during the COVID-19 pandemic can be stressful. It's natural to worry about the effects of the virus on your pregnancy and your unborn baby.

The latest scientific evidence shows that COVID-19 doesn't impact all pregnancies the same way. There are a number of important factors to consider, including:

• your risk of exposure to COVID-19
• pre-existing conditions that may further increase your risk of severe disease or outcomes if you get COVID-19 while pregnant

It's important to talk to your health care provider. If you do get COVID-19 while you're pregnant, you may have an increased risk of more severe disease or outcomes, including the need for intensive care.

It's important to continue regular prenatal visits during COVID-19, even if they're virtual appointments.

Pre-existing conditions

If you have a pre-existing condition, you may also be at risk of more severe disease or outcomes. These conditions include:

• obesity
• diabetes
• high blood pressure
• advanced age during pregnancy

If you have a pre-existing condition and are pregnant, you can reduce your risk of getting sick with COVID-19.

Protect yourself and others

During pregnancy, it remains important to use multiple individual public health measures at once, regardless of your vaccination status, such as:

• getting an mRNA vaccine
• wearing a mask
• minimizing non-essential in-person interactions with people from outside your immediate household
• avoiding closed spaces (with poor ventilation) and crowded places with people from outside of your immediate household
• practising frequent hand hygiene.

This layered approach is the best way to protect yourself and others from getting COVID-19.

Consider asking your doctor, obstetrician or midwife for telephone or videoconference appointments, if possible. Doing so can help you to avoid in-person interactions with others.

Childbirth

Giving birth during the COVID-19 pandemic can be stressful. Talk to your health care provider about how COVID-19 may affect your birth plan and your family after birth.

Learn about the COVID-19 policies regarding support and visitors.

If you plan to give birth at home, talk to your midwife about:

• precautions to make sure your home environment is safe
• whether home births are still an option in your province or territory

You may be planning to give birth at home. If so, talk to your midwife about precautions to make sure your home environment is as safe as possible.

If you have COVID-19, talk to your health care provider about how this may affect giving birth. With proper precautions, breastfeeding, skin-to-skin and rooming-in are recommended at birth.

Baby care

Once a baby is born, they can get COVID-19 from other people, so it's important to limit their contact with others.

To protect yourself and your baby, you should continue to follow recommended individual public health measures, such as:

• wearing a mask
• improving ventilation
• maximizing physical distance from others
• cleaning your hands

We recommend breastfeeding when possible. It has many health benefits and offers the most protection against infection and illness throughout infancy and childhood. Breastmilk isn't known to transmit COVID-19.

However, evidence suggests that people who have received an mRNA COVID-19 vaccine have antibodies in their breastmilk. These could help protect the baby. Breastfeeding provides important nutrition for your baby.

If you have symptoms or have tested positive for COVID-19

General precautions

If you have or think you have COVID-19, you must isolate yourself at home and away from others as quickly as possible. You can still hold your baby skin-to-skin and stay in the same room as them, especially when bonding and breastfeeding.

You should take precautions to avoid spreading the virus to your baby.

• Wear a respirator in shared spaces, including when you're in the same room as your baby.
  • If unavailable, wear a well-fitted medical mask.
  • If neither are available, you should properly wear a well-constructed and well-fitting non-medical mask.
• Keep your space well ventilated.
• Wash your hands frequently with soap and water for at least 20 seconds, especially before touching your baby.
• Clean and disinfect surfaces and objects that you or others frequently touch.
• If sleeping in the same room as your baby, maximize the physical distance between you and your baby.

Precautions during feeding

When feeding your baby:

• put a clean towel on your nursing pillow (if you use one) each time you use it
• clean any breast pump equipment carefully before and after each use by:
  • washing the pump and containers after every use with dishwashing liquid and warm water
  • rinsing with hot water for 10 to 15 seconds
• don't share bottles or breast pumps

You may be too ill to breastfeed or provide routine baby care. If so, ask a healthy adult to feed and care for your baby. Ideally, the baby's caregiver would be someone who is part of your immediate household. As there may be COVID-19 in the home, the baby's caregiver should:

• avoid being in a shared space (such as the same room) or having in-person interactions with you
  • if this isn't possible, they should:
    • make sure interactions are as few, as brief, and occur from the greatest physical distance possible
    • wear a respirator, or if unavailable, a well-fitted medical mask
    • if neither are available, you should properly wear a well-constructed and well-fitting non-medical mask
    • improve ventilation in the space
• avoid direct physical contact with you
  • if direct physical contact is expected, they should wear a respirator
    • if unavailable, a well-fitted medical mask
• clean their hands frequently

Visitors after your baby is born

After your baby is born, friends and family may want to visit and meet your baby. Visitors should be limited to reduce the risk of possible exposure to COVID-19. This can be very difficult, but it's important to keep your family safe.

Consider celebrating the birth of your baby by having virtual visits and using online tools.

If you do plan to have in-person visits, continue to follow:

• the advice of your local public health authority on gathering size limits
• recommended public health measures

Ensure in-person visits occur in lower-risk settings, such as outdoors or in a well-ventilated indoor space. Ask visitors to:

• stay home if they're sick
• wear a well-constructed and well-fitting non-medical mask
• maximize physical distance from you and your baby
• clean their hands frequently when visiting

Continue to follow individual public health measures regardless of your vaccination status. This will help prevent the spread of COVID-19. These measures are most effective when layered together and used alongside vaccination.

Mental health

Having a baby is a big change for families. Feeling a range of emotions is normal and expected. You know yourself and your baby best. If you think you may need extra help and support, it's important to reach out.

If you or a loved one are experiencing feelings that concern you, seeking help early can help you to feel better sooner. Parenting during COVID-19 can be especially challenging, but there are many resources available.

We encourage parents to talk about their mental health with:

• family
• friends
• community supports
• their health care provider

For more information

Visit:

• Canada.ca/coronavirus
• www.pregnancyinfo.ca

Contact:

• 1-833-784-4397