Squared Up Into The Pregnancy Phase In The Times Of Covid-19? Here’s Everything You Need To Know!

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The coronavirus pandemic has brought the world to an abrupt halt. It has muddled people with unresolved questions that have left them with a vague picture of COVID 19 in terms of its many causes and effects. The one section that seems to be especially ambiguous in these trying times is the ‘pregnant women’. Pregnancy is a phase where a woman can feel multiple emotions. With Coronavirus coming into the picture, a lot of to-be-mothers are left daunted with uncertainties and fairly so! But here is a thing-Optimism is the opium for all those hullabaloos popping up in the mind. In these times of open-ended possibilities, we talked to a Dr. Manisha Singh (MBBS, DGO, DNB – Obstetrics & Gynecology) at Fortis Hospital, to converge and make sense of all that is disjunct with respect to ‘Coronavirus and Pregnancy’.

Precautions! What to do?

Coronavirus is a subject that is still being widely studied by the researchers. This in itself makes it obvious that it is in the best interest of all people, especially pregnant women to stay indoors and maintain isolation because there may not be an immediate and sure shot solution for COVID 19 infected pregnant women. “When pregnant women get even normal fever, it is always recommended to get a detailed consultation.”, says Dr. Manisha Singh, a senior gynecologist at Fortis hospital. Coronavirus has been spreading all over the world like wildfire. In these times, it is imperative to follow the guidelines provided by the World Health Organisations because everyone irrespective of their existing physical conditions is indiscriminately susceptible to the Coronavirus. “So far we have not dealt with a pregnant woman with COVID 19 but with all that is going on, if a woman gets a high temperature, she must without much ado consult a doctor.” However, WHO on their FAQ section does not mention pregnant women in the high-risk category. In addition, Dr. Singh says that pregnant women should keep in mind to be very honest about their partner’s travel history to the doctors besides keeping general precautions.

Can the Coronavirus be transmitted from mother to baby?

With scant availability of data, the recommendations coming in from various reports across the world are contradictory. Dr. Manisha says that while studies are still evolving, so far it does not precisely indicate that newborns can contract the virus from their mothers. However, she continues, it is a good idea to isolate the baby from the mother as soon as they are born. Her advice aligns with a number of worldwide reports including China and the US. According to the WHO, so far no sample of the virus has been found in amniotic fluid or breast milk. It is still a matter of contention if the COVID 19 can be passed on to the babies from the mothers.

Can pregnant women with Coronavirus breastfeed?

The World Health Organisation says, ‘YES’. Since the virus sample has so far not been found in breast milk, women depending on their wish may/may not opt to breastfeed. Dr. Manisha reiterates that coronavirus is still an open-ended subject and we can never be sure what we learn about it tomorrow so it is important for mothers to be mindful at all times. WHO gives a nod to breastfeeding on conditions such as utmost care for respiratory hygiene, washing hands before and after touching the baby and regularly cleaning the surface that may have come in contact with the infected mother.

In addition, if the mothers feel too weak to be able to breastfeed, they can resort to ‘expressing milk’, ‘Relactation’ and ‘Donor milk’ as alternate options.

Delivery of the baby- C-Section or Normal

In the case of confirmed or suspected COVID-19 cases, WHO advises that normal delivery is the best way to go about it. However, the Caesarean section should be considered only if medically necessary or justified. Moreover, the report also states that the “mode of birth should be individualized and based on women’s preferences alongside obstetric indication.”

Has the COVID 19 lockdown affected pregnant women’s visits and timely consultations?

Dr. Manisha says, “We have definitely limited the patient’s visits to the hospital but we are available for them 24*7 over the call. We keep a tab on their health by constantly staying in touch. However, if there ever arises a need to see a doctor even for a mild fever, we are always around and hospitals are always open.” It is advisable to take adequate precautions while visiting a hospital such as masks, sanitizers, etc.

The psychological effect of coronavirus lockdown on pregnant women

The coronavirus lockdown phase is quite a testing time for everyone in general. Therefore it is quite understandable that pregnancy, which is already an emotionally charged phase in a woman’s life may in a lot of ways affect their mental space. Dr. Manisha suggests that during these times of emotional turmoil, women should always keep in touch with their closest confidante and share everything without any fear of judgment. It is important to talk to someone and feel free to be able to speak up. Most importantly, talk to the doctors, they are always listening and they can always be trusted. A wise person once said, “No question is a silly question, especially during pregnancy.” In addition, physical exercises like walking and yoga coupled with a few minutes of meditation every day can release all that oxytocin and make one feel happier and refreshed.

In conclusion, pregnancy is a beautiful time in the lives of all women and no matter what the circumstances are, it can always be made special with people who matter. Love flavored with some excitement and covered by precautions can surely help one get through this phase of pregnancy with ease. On an optimistic note, while you square up to official WHO guidelines, don’t forget to stop and embrace each moment that is going to bring you a lifetime of joy, happiness and uncontained aspirations for the future.

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Varsha Jain, a space gynecologist and visiting researcher at the Center of Human & Aerospace Physiological Sciences, King’s College London, explains in her research how it is like for female astronauts to experience a menstrual cycle in space. While the human body goes through numerous changes in space, Varsha was surprised to learn that female menstrual cycles don’t change though.

“Studies have shown that women can have periods as normally in space as they do on Earth. What’s more, menstrual blood flow isn’t actually affected by the weightlessness we experience in space, so it doesn’t float back in – the body knows it needs to get rid of it”.

Women and their periods in space were once used as an argument that women shouldn’t be astronauts. When Sally Ride became the first American woman in space in 1983, tampons and sanitary napkins were never part of that process. But since then women have been living and working in space for decades now, and with no issues. That’s also because all available data on periods in space pertain to short-duration missions.

The Challenges

While periods may not hinder an astronaut’s ability, it may not be a very pleasant thing to deal with in space. Also, when astronauts undertake longer missions, how many tampons or pads a woman can carry onboard can be a huge problem given the issue of weight and cargo space that these may occupy. Carrying a three-year supply of birth control pills onboard doesn’t sound practical either.

With limited resources and water supplies, menstruating may not be a very pleasant experience. Also, not all waste disposal systems in space are designed to handle menstrual blood, as the toilet system is connected to the water reclamation system (which recycles urine into drinking water), solid waste is distributed in a cylindrical container which is then exposed to vacuum to dry the waste. Unwanted liquid waste is vented to space, hence menstrual cups may not serve the purpose not to forget the constraints for its insertion and removal. For the longest time, NASA has been inviting new ideas to facilitate recycling in space.

So what are the other options?

With these issues, most female astronauts turn to the oral contraceptives or hormone pills which may help them skip or suppress their period.

According to Varsha’s research, “The oral progesterone pill is the most popular option. The second option is an IUD (intrauterine device), which is inserted into the uterus by a doctor and can safely last for three to five years. Subdermal implants are another option, and are safe to use for up to three years. Last is the Depo-Provera, a hormone injection similar to progesterone. It must be administered once every 12 weeks, and can be safely used for two to three years.”

According to Florida’s Gynaecologist, Dr. Kristin Jackson, the best methods for suppression are either the pill or the IUD.

“It’s completely safe for women to skip their periods. Every woman is different, but some methods are more reliable than others.” However, the most reliable methods aren’t always the safest as she points out with the depo shot.

Varsha agrees. “Studies of women in the military have shown that many would like to suppress their menstrual flow during deployment, so it’s not a stretch to assume astronauts want to do the same”.