If you are think you have been exposed to COVID-19 and want to be tested, go to this website for testing centres.

NEW: IF YOU ARE ACUTELY ILL with SHORTNESS OF BREATH or other symptoms, go to ER (even if PREGNANT) if it is not a pregnancy-related problem.

Updated vaccination information is at the bottom of this page. To book a vaccine, call 1-833-943-3900 or 1-888-999-6488 or BOOK online.

Pregnant Ontarians are eligible under “Highest Risk” category. Vaccination and boosters are HIGHLY RECOMMENDED and safe.

INFORMATION about your Clinic Visit during COVID-19 Pandemic

Please do not come to the clinic if you are showing any signs of possible COVID-19 infection including fever, sore throat, cough, muscle pain, runny nose, shortness of breath, loss of taste or smell OR if you have been in contact with someone that is suspected of having COVID-19.  No visitors are permitted to accompany you to clinic except in exceptional circumstances.  Screening will occur in each setting. Masks must be worn.

Please reduce the spread of COVID-19 by washing your hands or using hand sanitizer, staying 2 metres apart, and using a mask without a valve.

Gynecology

Appointments have returned to being in person. Follow up visits may be in video or phone for extenuating circumstances. Procedures require an in-person visit.

Coping with endometriosis during COVID-19.

Prenatal visits

Prenatal care is essential and continued through the pandemic.

For emergencies, please go to Family Birthing Centre at St. Joseph's Health Centre, Toronto..

SURGERY

Patients should wait at least 7 weeks after a COVID infection to have surgery, to reduce complications. Reasons for cancellation include ANY illness, or if you have eaten in the day of the procedure.

HAVING YOUR BABY DURING COVID-19

St Joseph’s Health Centre, Toronto has one of the best birthing policies in order to protect you, your baby, family, healthcare workers, and other patients.

The Family Birthing Centre, labour and delivery unit, is a protected area with restricted locked access, separate from the rest of the hospital and employees.  Pregnant women and their chosen support person will labour and deliver in private rooms. Postpartum room assignment will depend on availability and your preferences/insurance coverage. Strict safety procedures and precautions are in place to ensure safety of all staff and families. Visitor policy depends on seasonal rates of infection.

Note that hospital policies and information will evolve as the pandemic cases change. Currently, please attend triage on your own (partner may wait in car or lobby).  Please let your MD know if you would like to have your partner or support people on the phone with you during your discussion. Dec 2021: 1 vaccinated support person can remain with you. Aug 2021 to present: 2 support people are permitted per day. Vaccinated individuals have in-and-out privileges.

If and once you are admitted to hospital, your partner and/or support person of your choice. Please bring enough food/drink for them during your entire labour/delivery/postpartum stay (eg. 3 days).  There is a lovely lounge with microwave, fridge, seating area, and TV but there may be restrictions to leave your room (so bring temperature-stable foods or your own coolers, kettle etc). Exceptional care continues during the pandemic but you will be given a mask to wear when healthcare workers are in your room. No other hospital visitors are permitted for everyone’s safety.

If you are feeling anxious about being pregnant during the pandemic, you are not alone. During the pandemic, anxiety and depression have increased from 1 of 5 to 3 out of 5 pregnant women.

The following RESOURCES are excellent:

Pandemic Pregnancy Guide @pandemicpregnancyguide (Instagram) @PandemicPreg (Twitter)

Perinatal psychiatrist Dr. Pooja Lakshmin’s guide on Pregnancy and COVID-19

FAQ: Data is evolving as we learn more. Please ask your doctor for most up-to-date info. Canadian numbers are lower but we are taking full precautions for everyone’s safety, as we enter our 4th wave (Sept 2021).

BORN Ontario Information and Statistics (64,000 pregnant Ontarians vaccinated by September, 2021).

US pregnancy and COVID stats from CDC.

Up-To-Date COVID 19 and pregnancy

Is there an increased risk of miscarriage if I get sick with COVID-19?

No, with the limited research we have, COVID-19 does not appear to increase miscarriages or malformations, which is in keeping with other corona-virus related illnesses like SARS and MERS.  However, high fever in first trimester is associated with birth defects.

If I get sick with COVID-19 during pregnancy, can I pass it to the baby?

Passage of the virus from mom to fetus may depend on how sick mom is at the time (viral load), when the illness occurs (which trimester) vs. recovered, and whether mom is sick at the time of delivery. Unfortunately, we do not have enough data yet. There have been some case reports of probable vertical transmission. On the other hand, vaccination passes antibody protection to the baby, not virus. Vaccination is recommended.

Am I more likely to get COVID-19 because I am pregnant?

No, pregnant women are not more likely to get COVID. Take precautions as above and remember that people can be asymptomatic. Limit unnecessary interactions especially in the third trimester.

Are pregnant women with COVID at higher risks for complications?

Yes. While initial data didn’t show that pregnant women were sicker, we are seeing new data (July 2020) that pregnant women with COVID do get sicker. They may end up needing intensive care or ventilation (breathing tube).  If moms get very sick, this can also lead to complications like preterm birth, C-section, low birth weight (Jan 2021), ie mom is so sick that baby may need to be delivered early. This situation is similar to what we have known about the seasonal flu, and that is why yearly flu vaccines are recommended and safe at any trimester of pregnancy. Those with pre-existing medical conditions (breathing disorders, diabetes, heart disease, obesity) may have more severe illness. It is also important to remember though, that pregnant women also just as likely as other adults to recover from the illness, and that 89% of pregnant women are not hospitalized. Monthly ultrasound follow up is recommended. Prevention from infection is key. As of April 18, 2021, more pregnant women (as with general case numbers over 5000 per day in Ontario) are increasing and needing intensive care. AVOID ALL UNNECESSARY SOCIAL CONTACTS. Ensure family members are doing the same, being careful about distancing, masking, showering after work, and getting vaccinated as soon as possible.

What can I do if someone in my household is COVID positive?

Isolate ASAP. If able to use separate living, bathroom, kitchen spaces, please do so. Sanitize recently used surfaces and wash hands, wear masks.

Should I have a baby shower?

It is best to avoid any gatherings outside your immediate family or bubble. Many soon-to-be parents have changed their plans to virtual showers.

Is it safe to go to the hospital?

Please know that nearly all labour and delivery units in Canada are completely separate from the rest of the hospital and usually require special access to enter and exit.  Delivering in a Canadian hospital is safe and in an emergency, you have all of the expertise right there, instead of delays in a transfer to hospital from home that might mean an unwanted outcome. 

No one else, no other nurses or doctors in the hospital can give the specialized care that labour and delivery staff can. Patients with severe COVID, or staff from elsewhere in the hospital that care for patients with COVID, do not interact with healthy patients in the Labour & Delivery.  For pregnancy emergencies over 20 weeks, you go to Labour and Delivery TRIAGE. For COVID-related symptoms, go to Emergency Room. Give yourself extra time to get to the hospital. Some hospitals now require a COVID swab on admission.

Are there any changes in the labour and delivery process due to COVID?

There are no major changes in terms of pain management or mode of delivery.

Laughing gas may be aerosolizing so its use has been removed to prevent spread of COVID in case any users are infected.  Our anaesthesiologists (pain docs) continue to provide epidurals for excellent pain relief. Different hospitals may also provide shower/water therapy, birthing balls, massage, and continue to encourage music and entertainment to pass the time.

The same skills, art, and decision-making is used by OBGYNs regarding best and safest way to delivery your baby – whether vaginal, vacuum, forceps, C-section. We’re just wearing more PPE (personal protective equipment). We remain the same supportive people behind the masks although you can’t see our smiles. 

What do I do after the birth?

Most parents isolate for the first couple weeks getting used to routines with a new baby. I, myself didn’t want anyone seeing me in my state for a month. It’s a big adjustment! Parental leave can be lonely so in that way, it’s been hard for new parents but we are lucky with the technology we have for people to use video calling with friends, family, and even healthcare providers. This is helpful for your mental health. Many choose to isolate for 2 weeks after delivery in or out of a pandemic. Consideration should be paid to parental health and exposures (work), baby’s lack of immune system, and grandparents being older and more vulnerable to COVID complications. Vaccination (immune protection) helps relieve some of these stresses.

There are no major changes to breastfeeding or formula feeding. Use good hand and breast hygiene. If Covid positive, wear a mask.  There is no COVID virus in breastmilk. Some viral RNA has been found but not active virus. Some antibodies have been found in breastmilk but whether this offers protective effect for the baby has not yet been studied. Breastfeeding is safe. Vaccination in pregnancy also provides COVID antibodies to protect your baby!

If babies or children get COVID, they tend to have a mild illness but can transmit infection to others.

Are there any benefits to having a baby in a pandemic?  There has to be a bright side?

Not having to worry what you look like – be comfortable in your own clothes (or only the top half at Zoom meetings!). Not needing to buy maternity work clothes.

Being able to feel ill, throw up at home, frequent urination, trips to the bathroom

Sleeping more, naps especially in the exhausting first trimester when you feel like you hit a wall.

No commutes to work.

No unwanted comments, guests, people touching your belly, bump size, or baby.

Shorter prenatal visit waiting in the doctor’s office.

Spending more time with partners and other children before the baby comes.

RESEARCH STUDIES - findings here.

University of Calgary survey study on mental and physical wellbeing during a pandemic pregnancy.

McMaster University Survey study on Canadian moms and stress during pregnancy and birth in time of COVID-19.

If you have been vaccinated and are pregnant or nursing, you can join the Canadian registry here.

What are the latest professional guidelines about COVID-19 Vaccine? (updated May 30, 2021)

Updated Ontario COVID-19 vaccine information.

Pregnant women and people with medical conditions, high risk conditions now eligible to be vaccinated starting April 2021. Check here for Ontario vaccine rollout.

VACCINATION for Pregnant and Lactating Canadians is now recommended. (NACI, May 2021)

Even though pregnant people were not included in initial vaccine trials, over 139,000 pregnant and nursing individuals have since been vaccinated in the new year in the USA (CDC’s Vsafe Pregnancy Registry) and there have been no pregnancy or infant complications above baseline (non-vaccinated) rates (preterm labour, small babies, high blood pressure, diabetes, miscarriage, stillbirth, anomalies, neonatal death). There are reports of antibodies to COVID-19 found in baby’s blood after delivery, from mom’s vaccination during pregnancy, which offers protection to babies. This is why the whooping cough vaccine is safely given to moms in the third trimester (to pass immunity to babies). Safety and efficacy of mRNA vaccine can be summarized here (NEJM). Longer term data is unavailable.

Society of Obstetricians and Gynaecologists of Canada. The SOGC supports vaccinations of pregnant women with any (mRNA) COVID vaccine. These guidelines include statements on vaccination and pregnant workers and individuals.

Q&A on COVID-19 vaccine in pregnancy and lactation from mothertobaby.org.

SOGC, NACI, ACOG, support access and informed choice by those who are pregnant or lactating to receive the vaccine. The vaccine confers 95% protection from COVID-19 infection, meaning 5/100 may still get infected. Those in high risk situations (pre-existing medical conditions, work risks) may benefit highly from the vaccine. It is estimated that vaccination of 70% of the population is needed for herd immunity in order to decrease community infection rates. Please talk to your doctor about your individual circumstances.