The coronavirus (COVID-19) that is spreading globally will become more prevalent in the weeks and months ahead in all areas of Canada and the U.S..
To date, there is very limited data on the risk to pregnant women. When comparing to other viral respiratory infections, such as SARS and even seasonal influenza (flu), pregnant women are thought of as a higher risk group for severe illness, morbidity and mortality when compared to nonpregnant women of the same age. There is one published case series (n=9) from China with no apparent adverse clinical outcomes for the pregnancies; placental examination, amniotic fluid and umblical cord blood samples and newborn throat swabs could not confirm transmission to the babies. Vertical transmission or transmission at the time of labour is unknown. There is no evidence of transmission via breast milk.
The virus is primarily spread through respiratory droplets from close contact with infected persons. Typically what happens is that an infected person coughs and droplets land on surfaces that are then touched by a non-infected person. That person then touches their face (mouth, nose, eyes) and self inoculates themselves thus the importance of hand washing.
Coronavirus infection symptoms:
- fever (pregnant women should take acetaminophen)
- respiratory symptoms (cough/sneezing, shortness of breath, difficulty breathing)
- muscle aches
- sore throat
Symptoms may take up to 14 days to appear after exposure to the virus.
Everyone, including pregnant women, should take the usual actions to prevent infection; washing hands with soap and water is best but alcohol-based hand sanitizer use can also be helpful. And avoid people who are sick. Use of a surgical face mask WILL NOT prevent you from contracting the virus; those who are infected should consider wearing a face mask to limit droplet spread. Of note, the Surgeon General for the U.S. has asked people to stop buying medical face masks because of the concern of limiting supply for hospitals and health facilities.
When SARS was active, many hospitals implemented a restricted visitor policy. This will likely take place at your local hospital with only direct support personnel allowed in to the hospital for labour and the postpartum to help reduce risk of spread of the virus to the hospital and to patients and staff; typically this would be limited to a single support person. Health Care Providers will be asked to follow hospital specific infection control guidelines when seeing potentially infected patients in clinics and/or on Labour and Delivery. If you suspect you’re infected, you should call ahead to your local Labour & Delivery unit and when entering the hospital put on a facemask and wash your hands to help reduce chance of transmission.
To reduce the chance of newborns acquiring the virus, do not let anyone kiss the baby (especially on the face or hands) and anyone handling the baby should thoroughly wash their hands with soap and water (for at least 20 seconds) first.
In addition to coronavirus, it is still flu season. If you have not already had your seasonal flu vaccine, it is recommended that you get it as soon as possible. Pharmacies and primary care providers still have this in stock. The flu vaccine is safe in pregnancy and also offers benefits for your baby. Evidence shows that for women who received the flu vaccine in pregnancy, there was a significant reduction in flu-like illness in their children in the first 6 months of life.
Feeding your Baby:
The limited data suggests that COVID19 is not passed through breast milk. Regardless, if you have been diagnosed with COVID19 or are suspected of having COVID19, you should do the following:
- Always thoroughly wash your hands before touching the baby (feeding, changing diapers, playing with the baby, etc.)
- Wear a face mask to prevent droplet transmission
If you are pumping/collecting breastmilk, ensure that your sterilize the bottles and pump after each use. If you are formula feeding, ensure that you have at least a 14 day supply of formula and any supplies needed to sterilize the equipment.
There is a suggestion from the Centres for Disease Control (CDC) that temporary separation of baby and an infected mother should be considered. If this was to occur, pumping and an alternate person bottle feeding the breastmilk should still occur in order to maintain milk supply.
Update: March 15th, 2020
A case of a newborn being diagnosed with COVID19 was reported in the news in England. It appears that the mother was symptomatic before delivery but that she was not diagnosed (did not have a positive screening test) until after delivery. It’s unknown if the baby acquired the infection during pregnancy, delivery or shortly after delivery. Given the limited data published, it’s most likely that it didn’t occur during the actual pregnancy but certainly could have occurred during the delivery or immediately after.
For any woman who has diagnosed COVID19 or is being investigated, a discussion should occur regarding immediate temporary separation of mother and baby after cord cutting. Similarly, skin-to-skin contact may not be recommended for women with diagnosed or suspected COVID19.
Update March 16th, 2020
How do you know if you need to be tested for COVID-19?
If you think you have COVID-19 symptoms or have been in close contact with someone who has it, use the self-assessment tool linked below to help determine if you need to seek further care.
Where can you be tested for COVID-19?
In our KFL&A community a COVID-19 Assessment Centre is now open at Hotel Dieu Hospital (HDH) site of Kingston Health Sciences Centre. It is set up to assess returning travellers, as well as community residents, who are experiencing symptoms of COVID-19, including fever, cough, or difficulty breathing.
Located at HDH, the COVID-19 Assessment Centre will operate 7 days a week between the hours of 1:00 to 8:00 p.m. Patients will enter HDH by a separate, well-marked entrance directly across from the Chown Memorial Parking Garage. Large signage will direct people to the correct door, which is just west of the main entrance.
If you are in another community and believe you need to access testing call your local public health unit, primary care provider (for example, family doctor) or Telehealth Ontario at 1-866-797-0000 to determine the most appropriate place to go.
Update March 17th
The following video was developed by the World Health Organization and released back on January 30th. It provides excellent background information on COVID-19.
Since the release of this video a global pandemic has been declared.
Daily updates on COVID-19 in Canada are available at:
Update March 18th
There is a lot of information circulating about COVID-19. Make sure you are getting you information from a reputable source. The below video provides an excellent update on what we know about COVID-19 to date.
Update March 20th
A new analysis of 38 pregnant women with COVID-19 and their newborn infants was recently published online in the Archives of Pathology and Laboratory Medicine. This analysis is reassuring, showing no vertical transmission of the virus from mom to baby while pregnant. Further information on this analysis will hopefully be available soon. A link to the abstract of this analysis can be found below.
Update March 26th
The COVID-19 pandemic has brought many things to a halt -- but not delivery rooms.
Listen to Dr. Smith's interview on CBC's All in Day by clicking the link below. He tells us what precautions are being taken, and what parents-to-be need to know.
As more scientific data presents itself, we will continue to provide updates on any concerns or recommendations.
For more information on COVID-19 and pregnancy please refer to the following resources:
Society of Obstetricians and Gynaecologists of Canada - Updated Committee Opinion
COVID-19 in Pregnancy
Coronavirus (COVID-19) Infection in Pregnancy
Information for healthcare professionals
Version 1: Published Monday 9 March, 2020
For updates on Coronavirus (COVID-19) in Canada visit the following Public Health Agency of Canada website:
For local updates and information in KFL&A visit: