If this disease worries everyone, it is even more the case when we are expecting a baby! The questions you are asking yourself about Covid-19 and the answers from Prof. Cyril Huissoud, obstetrician-gynecologist and deputy head of the maternity ward of the Croix-Rousse hospital in Lyon.

Are we more at risk of catching Covid-19 when we are pregnant?

The question is legitimate since, during pregnancy, the immune defenses are partially inhibited so that they do not turn against the fetus. But from what could be observed during the first wave of the epidemic, pregnant women were relatively little infected . Probably because they were particularly scrupulous in the application of barrier gestures . It is strongly recommended that pregnant women be vaccinated against the flu so as not to run the risk of co-infection with Covid. And because the flu can be a source of severe complications.

In the event of contamination, is a pregnant woman more at risk of developing a severe form of Covid-19?

With the hindsight of a few months available, it now appears that a pregnant woman has only a very slight increased risk of developing a severe form of Covid compared to a woman of the same age who is not pregnant. 

However, the risks of severe forms increase for pregnant women who are overweight, obese, suffering from diabetes, respiratory and cardiovascular pathologies. Exactly as in the general population.

If significant respiratory complications occur, it is most often 7 to 11 days after the onset of symptoms. In pregnant women, they can also take the form of thrombosis such as pulmonary embolism, with an even greater frequency than in the general population.


If a pregnant woman tests positive, how is she cared for?

If she has no symptoms or mild symptoms, no special treatment is required. No impact is to be feared during the course of the pregnancy. 

If she has a high fever, cough, headache, and muscle aches - like with the flu - she is weak, but this does not put her at particular risk of miscarriage or premature birth.

If in the days following the first symptoms his condition worsens, hospitalization may be necessary. Anticoagulant treatment - without any danger for the baby - may be given to prevent thrombosis. She may also receive corticosteroids - again without any danger for the baby - in order to avoid a deterioration of the respiratory state. And if necessary, we will provide him with an oxygen supply.

In the event of significant respiratory deterioration, it may be necessary to deliver the baby earlier than expected in order to improve the mother's condition: once the baby is born, she can breathe more easily, the lungs no longer being compressed. through the uterus.

Does Covid-19 pose a risk to the fetus?

According to international literature, it seems that cases of transmission of the virus from mother to baby during pregnancy are extremely rare. And with very little consequence for the baby when this happens: no case of fetal malformation has been reported.

If the mother suffers from oxygen desaturation, the fetus is only very rarely affected: it is able to capture enough oxygen to cover its needs.

In a few cases of severe Covid in the mother, abnormal heart rhythms have been observed in the baby: this may have led to the decision to have him born quickly by cesarean section.

Is it compulsory to wear a mask during childbirth?

According to the recommendations of the CNGOF (National College of French Gynecologists and Obstetricians), wearing a surgical mask is desirable during childbirth, both for women and for caregivers, so that everyone can protect each other from possible contamination.

If at the time of expulsion a woman struggles to bear the mask because she feels embarrassed to catch her breath, the team can offer her a more comfortable visor. The projections of droplets that it may emit during the expulsive efforts will thus be largely stopped. 

And if the woman really does not support the mask or the visor, the team may eventually allow her to wear nothing during the expulsion. If they have them - which is not the case everywhere! - caregivers can then wear more filtering FFP2 masks to protect themselves.

Even if wearing a mask is not very pleasant at such a time, you should know that it does not prevent pushing properly: the number of cesarean sections and instrumental extractions did not increase during the first epidemic wave.


Can we breastfeed if we are sick with Covid-19?

There is no contraindication to breastfeeding her baby for a woman sick with Covid, of course, if her condition allows it.

Hand washing before breastfeeding should be done even more carefully. And it is recommended to wear a mask so as not to contaminate your baby.