COVID-19 and pregnancy update

1. Any pregnant woman/person who develops an influenza-like illness should be evaluated for COVID-19 as per routine screening. The severity of symptoms for all patients should be assessed to determine if hospitalization is appropriate.
   
   
2. If an individual develops symptoms consistent with COVID-19, they should be tested in accordance with the current testing criteria. Pregnant women/people are eligible for testing as diagnosis of COVID-19 impacts their care. 
   
   
3. If an individual develops COVID-19 at any time in pregnancy, the following are recommended:
   
• A third trimester growth ultrasound is recommended for individuals who have been admitted to hospital due to complications of a COVID-19 infection in their pregnancy.
• In-person care, once outside of period of infectivity (unless clinically indicated to see sooner), to facilitate clinical assessment for growth restriction and continued careful monitoring for maternal and fetal well-being.
• Electronic Fetal Monitoring (EFM) during labour is only recommended for individuals who have been admitted to hospital due to complications of a COVID-19 infection in their pregnancy.
• Placenta to be sent to pathology in any case where the pregnant individual required hospitalization or ICU admission for COVID-19 infection. Placentas are routinely sent for evaluation in the context of preterm birth, fetal growth restriction, stillbirth or other adverse outcomes; however, please flag the COVID-19 infection on the placental requisition if the individual had COVID-19 in pregnancy.
• Generally, pregnancy is not a contraindication for most therapeutics for COVID-19, and therefore should be considered, where appropriate, to reduce morbidity and mortality. Therapeutics in pregnancy are covered on the Treatments page.
  
  
4. A diagnosis of COVID-19 should not result in a delay in delivery, including elective caesarean section. Delivery should continue as indicated under appropriate precautions regardless of an active infection. 
   
   
5. The Province of BC does not require any vaccine spacing between COVID-19 vaccinations and other vaccinations (e.g. Tdap, Flu). Time-sensitive interventions such as the administration of anti-D immunoglobulin and blood products should not be delayed due to recent COVID-19 vaccination and can be given simultaneously.
   
   
6. The Reproductive Infectious Diseases Service at BC Women’s Hospital is available for phone consultation for health care providers of pregnant women/people with documented or suspected COVID-19 in pregnancy if clarification is required for their care (604-875-2161).
   

General guidance documents

COVID-19 vaccines

• COVID-19 vaccine planning guide for people who are pregnant or breastfeeding
  

More resources

• Clinical guidance for newborns

Providing Culturally Safe care during COVID-19

Cultural Humility, Cultural Safety and Trauma-Informed Care help to create an equitable and respectful health care environment and these approaches are key to improving health services for Indigenous people.

Perinatal Health, Cultural Safety in COVID-19 provides guidance on

• Why Cultural Safety, Cultural Humility and Trauma-Informed Care are important during COVID-19
• Providing  Culturally Safe care during COVID-19
• Special considerations for serving rural and remote communities
• Family planning
• Prenatal care
• Labour and delivery
• Postpartum care