COVID-19 is affecting the way we live our lives. Mothers out there may be asking themselves regarding the impacts on their pregnancy during this time of crisis. Thus, Motherhood is collaborating with GetDoc for AskMeDoctor, a weekly Q&A programme to answer all your questions. We welcome Dr.Timothy, an Obstetrician & Gynaecologist currently based in Tung Shin Hospital and Sunway Medical Centre Velocity to guide expecting mommies on how you can protect yourself and your baby during COVID-19 pandemic. Q1: Is this the right time for family planning? Dr. Timothy: If you have underlying medical conditions, such as diabetes, blood pressure, any heart or lungs condition, then you might want to delay your pregnancy. This is because we know that these medical problems do play a part in how severe you may get, if you contract the infection. They play a vital part in determining the survival rate of the patients because we know that patients who have the underlying medical condition as I have mentioned before, don\u2019t do very well when they get infected. So, compounded with the fact that you are pregnant, therefore there will be changes to your body, together with the underlying health conditions aforementioned, we advise that you may want to delay your pregnancy. Q2: Is it easier for pregnant moms to get infected by COVID-19? Dr. Timothy: COVID-19 do not choose who they will infect, so like everybody else who is susceptible, pregnant women have the same chance of getting infected. But from the data that we have seen, mainly from China which is the epicenter of the disease. We noticed that pregnant women are not more likely to get COVID-19as compared to their non-pregnant counterpart. This means that basically, the risk of getting COVID-19 for a pregnant woman is the same as for a non-pregnant woman. Q3: Can COVID-19 get passed from pregnant mom to unborn baby? Dr. Timothy: As for the transmission of COVID-19 from pregnant mother to unborn baby, we have very limited data on the topic. The data mainly from China, shows that there is very little risk of vertical transmission, as most of the babies born from mothers infected by COVID-19 were free from the disease. However, there is a recent report as recent as 26th March 2020 that there is a case of probable vertical transmission. Q4: Should pregnant moms avoid check ups during this period? Dr. Timothy: That would depend on what kind of test that you are going for. Because there are many important tests that you need to carry out throughout the pregnancy to ensure the health of the mother and the well being of the baby. There are certain tests that are carried out only during a certain period of your pregnancy. So, if you miss this critical period, you might not be able to do these tests. Therefore, you may not know if it may implicate your pregnancy in the future. It is best that while planning for your antenatal follow up, you would need to discuss with your obstetrician the necessary tests that need to be done during this period, and tailor your appointments accordingly. You may want to delay the interval but you still need to make sure that you are not missing any of the important tests or examinations during your pregnancy period. Because we don\u2019t want any complication to happen, both to the mother and to the baby. Q5: Can sanitizer be used on babies to protect them from viruses? Dr. Timothy: I will not advise that you apply hand sanitizer on the baby but you can actually maintain good hygiene for the baby by cleaning the baby regularly, bathing the baby. We do know that the COVID-19 is sensitive to normal soap as it can actually destroy the virus just by washing your hands with the normal soap. The baby skin is sensitive, we do not want to apply any hand sanitizers on the babies and sometimes babies may put their hands in their mouths. We don\u2019t want that to cause harm to the baby. Q6: If a mom gets infected by COVID-19 after delivery, is it okay that she continues to breastfeed her baby? Dr. Timothy: In certain countries, they had actually updated the guideline recently. Like the UK they have advocated that transmission to the baby through the breastmilk is minimum because they found that there were no viruses present in the breast milk. However, we have to take this news cautiously because we have very limited data. So, we would need to follow up on all the cases that are ongoing in every part of the world and see from time to time whether it is feasible or not to allow the breast feeding of an infected mother. Q7: Will the baby survive from Covid-19? Dr. Timothy: According to the Lancet Medical Journal, they calculated the mortality rate or the death rate based on the WHO data as of 1st of March 2020. The mortality rate in China was about 5%, while the mortality rate elsewhere is about 15%. This is for the general population and not only for babies but they did find that the younger people, the younger adult and children, generally do recover quite well. Q8: How does the hospital and us ensure that the baby is well protected from COVID-19 while still warded? Dr. Timothy: Most hospitals have taken great steps in preventing this, as you know nowadays if you want to enter hospitals you need to be screened thoroughly. All visitors, patients who present to the entrance of the hospital will need to be checked for their temperature to see if they have any fever. They will also need to fill up a questionnaire, which consists of a few questions regarding COVID-19 symptoms, their travel history and recent contacts. As for the hospital\u2019s environment nowadays we do practise the thorough cleaning of the hospital areas, including the labour wards. The nurseries are being cleaned at a more frequent interval, all the surfaces and instruments are being sanitized. The cleaning and sterilising of the equipment have been on-going even before this pandemic because we do not only want to prevent COVID-19 but we also want to prevent any other infections to the patients. Q9: Does breastfeeding help in this situation? Dr. Timothy: Actually, we have been advocating breastfeeding even before this pandemic. WHO actually promotes breastfeeding to all others because we do know that breastfeeding promotes the baby's immunity. It is one of the best foods for the baby. I would say that if you are breastfeeding, do continue with your breastfeeding but of course you need to make sure that you practise good personal hygiene and good hand hygiene as well before you breastfeed. Q10: Is the father allowed in the delivery room during this period? Dr. Timothy: So, the decision on the mode of delivery will depend on your local guideline. If you are COVID-19 positive, generally you will be in isolation and family members are not allowed to visit as well as the partner. This is to avoid contact and transmission of the COVID-19. Most hospitals allow the partner, the father to be around in the delivery room. So, if the mother is negative, then there should not be any issue. But most of the hospitals now have limited the number of visitors who can visit patients in the hospitals and the baby in the hospital. Based on the Ministry of health advisory, I think they have limited only one visitor per patient and the visitor should not be from the high risk group. For example, the children below the age of 12 and the senior citizens that are over the age of 65. Dr. Timothy's Advices for Pregnant Mothers The most important thing is how we can prevent the transmission. The only way to prevent transmission is through social distancing, which means we need to stay away from potential patients. We need to also practise good personal hygiene and good hand hygiene. Do keep yourself updated because this data might change from time to time. The advisory or the guidelines are being updated constantly because this is a new disease we are facing. We have no experience in managing this disease, we have vaccines, no medication for this disease. So, it would take some time for guidelines to be updated as, whatever guideline or advisory that has been given now may change from time to time. https:\/\/www.youtube.com\/watch?v9Rk8eVxMPC8 Well that is all from this week\u2019s Q&A session with 'Ask Me Doctor'. For the upcoming episode, our expert will answer pregnant moms' questions regarding Young VS Late Pregnancies. Stay tuned with us on our Facebook and Instagram page. Meanwhile, remember to keep your social distance (if you REALLY have to go outside), wash your hands regularly and keep yourself updated with the latest information from a reliable source.