Recommendations for antepartum and intrapartum care for patients.
: June 20, 2023
- 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.
- 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.
- 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
- 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.
- 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.
- 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).
The Society of Obstetricians and Gynecologists of Canada (SOGC) also has information about COVID-19 in pregnancy
on their website.
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