What does childbirth look like when the mother is infected with the coronavirus?
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A few days ago, Ewa wrote to the editor, who was in home isolation in her ninth month of pregnancy due to a positive test result for the presence of coronavirus. Ewa was very afraid of giving birth in the same hospital, especially isolation from the newborn baby. Now she spoke again. She gave birth to a healthy child, whom she, however, has not yet hugged …

  1. The story of Ewa, whose results of COVID-19 tests prevented a normal birth, found its continuation
  2. Freshly baked mums in the wards of single-name hospitals face many problems: they cannot hug a newborn or breastfeed
  3. The guidelines of the Ministry of Health apply in hospitals, which are primarily intended to protect medical personnel against infection, but also to minimize the risk of infecting other patients and newborns.

Childbirth during the coronavirus pandemic. Eve’s story continues

Ewa sent a letter to the editors of MedTvoiLokony – you can read it HERE.

When she was pregnant, Ewa stayed in isolation for a month. Although the symptoms of the infection completely resolved after a few days, she was not released from quarantine due to inconclusive test results.

She was tested several times, but never two consecutive swabs were negative. The vision of traditional childbirth was receding. She knew that if she gave birth in a single-name hospital, the baby would be born by caesarean section and would be isolated from her, because these were the guidelines. Unfortunately, her fears were confirmed.

Ewa writes:

I did not manage to get the double result. On Tuesday, I had two swabs: one at the drive thru point, the other at the hospital, because I checked in at the SOR. One was positive, the other negative. On Thursday, unfortunately, I started giving birth and I had a cesarean, the second test was positive and I am still separated from the baby who also had two tests and was lying alone in the incubator, but is healthy and can be hugged by midwives. I had another test just today and we’ll see what’s next. I gather strength after surgery and try to fight for lactation. I do not wish this stress to anyone. The recommendations of the neonatal unit are not respected in order to assess the risk of benefits for the mother and the child. I know from the doctor that women abroad with a plus, but without symptoms of infection, are with their children, because there is no virus in milk, and nothing is more valuable than skin-to-skin contact after childbirth, which was not given to me. My husband picked up a second negative result this morning. Perhaps if the child had waited a few days, it would be normal, or if the tests had been just plausible. For me now, the result of the test is to be or not to be, and it really feels like a lottery.

Childbirth does not have to end in a cesarean

Similar stories to the one described by Ewa are happening all over the country. After cesarean, the child is taken from the mother, there is no question of breastfeeding. Asymptomatic patients can talk about the greatest bad luck.

– During the admission in regional hospitals, we perform a screening test for patients – says Dr. Grzegorz Paleczek, obstetrician gynecologist in an interview with Medonet. – It is known that its credibility is low, but if it shows IgM and IgG antibodies, we have two options. Either the patient gives birth and the delivery is performed in special sanitary conditions in accordance with the recommendations, ie overalls, masks, etc. Or we transport her to a hospital designated for a given province, dealing with similar cases. If her condition allows it, she goes in a covid ambulance.

– Since the system is inefficient, it must be taken into account that making a call, for example, to a health service center, may take several hours – notes Dr. Paleczek. – Ambulances can also be at junctions. I had a patient who had to spend 8 hours with us because she came in on Sunday night. The test showed she had antibodies, but she had no symptoms. All this time she sat in solitary confinement with the midwife who saw her in full protective gear. As far as I know, after being transported to the designated hospital, another smear was also positive and the patient gave birth to a healthy child.

A number of interpellations regarding such patients were addressed to the Ministry of Health by the Rodzić po Human Foundation. In its explanations, the ministry refers primarily to the recommendations of the WHO.

But, for example, in the case of cesarean delivery in women infected with COVID-19, the ministry does not indicate it as the only method of delivery. It allows childbirth to be conducted in the ways of nature.

– For years we have fought the scourge of imperial sections – says Dr. Grzegorz Paleczek. “And now, when my mother learns that during a pandemic it is better to do them in order to stay in hospital shorter, all our work is wasted.

Breastfeeding by infected with coronavirus

Regarding breastfeeding by mothers diagnosed with COVID-19, the WHO recommendations in Poland have been adopted in full: “Infants born to mothers suspected, possibly infected or with a confirmed diagnosis of COVID-19 should be fed according to standard recommendations while taking the necessary precautions. to prevent and control the spread of infection ».

WHO specifies the concept of special precautions: they are to be single rooms, separate nurses, etc.

In a letter to the Rodzić po Human Foundation, the Ministry writes directly that: «so far in our country, the system of limiting the spread of infection in maternity wards from mothers, both under observation and with confirmed infection, faces great difficulties and evokes a lot of emotions. The lack of an adequate number of safeguards creates unnecessary tensions among the nursing and medical staff ”.

The recommendations of the American Center for Disease Control and Prevention (CDC) were also adopted in Poland, which admits that the data on the impact of COVID-19 on pregnant women and children are scarce. However, I recommend that babies born to women who tested positive were temporarily isolated from their mother. In addition, baby’s milk is to be expressed according to epidemiological rules, and can be fed from a bottle by another person. The CDC also recommended restricting visits.

Separating a newborn baby from his mother in the first days of his life is a terrible idea – believes Dr. Paleczek. – The child should have contact with her, she should be placed on the breast, fed, because it has a tremendous impact on the development of both his immunity and his personality. The first days are the most important. Before our eyes, many years of work for pro-maternal attitudes are just lost.

Isolation of the mother in case of suspicion or infection with the coronavirus is necessary

Therefore, the priority is to stop the spread of the coronavirus by limiting the mother’s contact not only with the newborn, but also with the environment in general.

An additional argument is the fact that a newborn with COVID-19 will require longer hospitalization, it will also pose a threat to other newborns and staff who should be as little exposed to the infection as possible.

In a situation where the sick mother would breastfeed, the staff would have to contact her very often (8-12 times a day) to latch the baby to the breast. Also, attempts by the staff to pass on the mother’s milk to the newborn result in more such contacts.

In turn, contamination of personnel can lead to staff shortages and, consequently, a decrease in the quality of neonatal treatment. This may contribute to increasing the number of newborn deaths due to other problems, such as prematurity.

The Ministry of Health therefore recommends isolating the baby from the mother, while allowing her to express milk to maintain lactation. After confirming that the risk of mother-to-child transmission of the infection has ceased (a double negative test in the infected and a single negative test in a suspected COVID-19 infection), natural feeding is possible.

Have you been sick with COVID-19? Were you in quarantine? Share your story with us – we look forward to hearing from you: [email protected]

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  3. I am 33 years old and pregnant, which is at risk [LETTER TO MEDTvoiLokony]

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