Covid-19 Vaccinations in pregnancy 

Key messages: 

From the Royal College of Obstetricians and Gynaecologists (RCOG) 

• COVID-19 vaccines are recommended in pregnancy. Vaccination is the best way to protect against the known risks of COVID-19 in pregnancy for both women and babies, including admission of the woman to intensive care and premature birth of the baby. 

• Women may wish to discuss the benefits and risks of having the vaccine with their healthcare professional and reach a joint decision based on individual circumstances. However, as for the non-pregnant population, pregnant women can receive a COVID-19 vaccine even if they have not had a discussion with a healthcare professional. 

• You should not stop breastfeeding in order to be vaccinated against COVID-19. 

• Women trying to become pregnant do not need to avoid pregnancy after vaccination and there is no evidence to suggest that COVID-19 vaccines will affect fertility. 

• Having a COVID-19 vaccine will not remove the requirement for employers to carry out a risk assessment for pregnant employees. 

COVID-19 information for all women and birthing people currently booked with us for care 

Testing 

In line with current UK guidance, we are now offering COVID-19 screening (testing) to all women who are admitted to our maternity unit with an overnight stay 

If you are booked for an elective procedure i.e. elective caesarean section or induction of labour you will be offered a COVID screening swab at your pre-assessment appointment or on admission for your induction of labour. 

A screening test will be offered on admission to the hospital, day 3 and day 5 whilst you are an inpatient. 

Why are we doing screening tests? 

A screening test is offered, to support the safety of the Maternity Services for all our women and babies and that they can be cared for in the safest environment. We can also ensure you are given the most appropriate advice regarding self-isolation. 

We know that some people who have COVID-19 do not develop or show any signs or symptoms. Offering screening to everyone who is admitted to hospital will help us keep our patients and staff as safe as we can. 

What does the test involve? 

The screening test is a simple swab. The test is a sample and is needed from two areas; one from inside your nose and one from the back of your throat. The test should not be painful but may be felt as uncomfortable. 

The swab is then sent to the laboratory for testing and the results should be available within 48-72 hours. 

Will my birth partner be offered the test? 

The hospital is unable to provide testing for birthing partners at this current time. All birthing partners will be asked to wear face coverings, wash their hands-on arrival and maintain social distancing whilst in the hospital.  If your birthing partner declines to follow the national guidance of wearing a face covering and maintaining social distancing, they will not be able accompany you. 

 If your birthing partner has symptoms of Covid 19 or has a positive test for Covid 19 they will not be able to come into hospital and they will need to self-isolate. In addition, if your birthing partner is during a period of self-isolation, they cannot attend the hospital.  You should then choose an alternative birthing partner who has not tested positive for Covid 19 and has not been in contact with someone who has Covid 19. 

How long will my test results take? 

Usually within 48-72 hours. One of the maternity team will contact you if the swab test is positive for COVID-19 and give you appropriate advice. 

Pregnant women and new mums should continue to follow strict social distancing. 

Am I required to take the test? 

The test is recommended but it remains your choice whether to take the test or not. 

What if I decline the test? 

You will always be welcome. We are actively encouraging all women to continue to attend for their antenatal, labour and postnatal care for the wellbeing of themselves and their babies. Your care will not change if you do not have any COVID-19 symptoms. 

How do I receive my test results? 

If you are an inpatient, one of maternity team looking after you will inform you of your result. If you are at home, a maternity team member will contact you by telephone if your result is positive, or send you a letter if your result is negative. You will also be given advice on any further plans if needed. 

What will happen if my swab test result is positive and I am pregnant? 

If you are still an inpatient and your swab test result is positive we will move you into an isolation room or bay where we can look after you. You will be asked to wear a mask and will have a separate toilet and bathroom. Designated staff will be caring for you wearing the appropriate personal protective equipment (PPE). 

If you have been discharged from the hospital during your pregnancy and your swab test result is positive you will be contacted by one of the maternity team to discuss any possible changes to your planned antenatal care. 

If you have had Covid 19 and have a repeat test within 90 days you may have a positive result because fragments of the inactive virus can be detected long after the person is no longer infectious. 

How will my birth plan change if I have a positive swab test result? 

We are following national guidance on how to keep you and your baby safe (Royal College of Obstetricians and Gynaecologists). We will ensure you get the best care and respect your birth choices. 

If you have symptoms or tested positive for COVID-19 and go into labour, you will be advised to give birth on the Labour Ward, which is an Obstetric Led unit. This is so the team can monitor you and your baby more closely. 

Your birth partner providing they do not have any signs or symptoms of COVID-19 or a temperature themselves – will still be able to be with you during your labour and birth. 

Will I be tested if I am planning to have a homebirth? 

Not at this current time – we are following national guidance, which recommends offering a screening test to anyone admitted to hospital for an overnight stay only. 

What if I test positive after I have had my baby? 

If your baby is well, they will be able to stay with you, however if your baby becomes unwell with 

COVID-19 symptoms they will require to be admitted to the Special Care Baby Unit (SCBU) or Neonatal Intensive Care Unit (NICU) for special care. 

If you test positive and your baby is already being cared for in SCBU/NICU you will not be able to visit until a you have undertaken a period of 10 days self-isolation; either 10 days after the onset of illness or/and receipt of positive test result – even if you have no symptoms.  We will attempt to avoid separation of you and your baby where absolutely possible. 

If I have tested positive for COVID-19 can I still breastfeed? 

There is currently no clinical evidence to suggest that the virus can be transmitted through breastmilk. The benefits of breastfeeding outweigh any risks of transmission of the virus through breastmilk or by being in close contact with your baby. If you are COVID-19 positive take precautions to limit the spread of COVID-19 to your baby by: 

• Washing hands thoroughly before and after contact with your baby. 

• Routinely cleaning and disinfecting surfaces. 

• Cleaning any feeding equipment, including breast pumps, bottles and teats thoroughly before and after use. 

• Avoid coughing or sneezing near your baby and by wearing a face mask or face covering. 

• Taking care to avoid falling asleep with your baby. 

What are the chances of my baby testing positive if I test positive? 

As this is a new virus, there is limited evidence about caring for women with coronavirus infection when they have just given birth. A small number of babies have been diagnosed with coronavirus shortly after birth, so there is a chance that infection may have occurred in the womb, but it is not certain whether transmission was before or soon after birth. 

Your maternity team will maintain strict infection control measures at the time of your birth and will closely monitor your baby. 

Will I or my baby need to stay in hospital if we test positive? 

The evidence to date suggests that although babies can develop COVID-19, very few babies develop severe symptoms. 

All available evidence suggests that generally pregnant women are at no greater risk of becoming infected with COVID-19 and/or becoming seriously unwell than other healthy adults if they develop COVID-19. Although, pregnant women from Black, Asian and Ethnic minority backgrounds are more likely to experience more severe symptoms and/or complications, and therefore should seek professional advice and assistance quickly if they become symptomatic and unwell. 

The majority of pregnant women who become infected with COVID-19 may experience only mild or moderate cold/flu- like symptoms, cough and fever, shortness of breath, headache and loss of sense of smell /taste. 

If you have no symptoms or your symptoms are mild, and you and your baby are otherwise fit for discharge from the hospital you will be able to return home and will be advised to self-isolate for 10 days. 

How is the hospital protecting us from COVID-19? 

We are taking steps to keep everyone as safe as possible. All people coming to the hospital- patients, visitors and staff are all expected to wear face masks. There is also restricted visiting. 

Patients who test positive for COVID-19 are cared for away from others who are not COVID-19 positive and we use appropriate PPE when providing direct care to you. 

We are advising all staff, patients and families to undertake regular strict hand washing.