COVID-19 and Pregnancy
Last Updated: 2021-09-22
Below you will find information about COVID-19 that is specific to those visiting for prenatal appointments, expectant mothers scheduled to give birth at Mount Sinai, postpartum patients or those who have an infant in the NICU.
What should I do if I think I may have COVID-19 or have been exposed to the virus?
- Visit the Ontario Ministry of Health website and complete the self-assessment tool prior to calling Telehealth Ontario or visiting your Local COVID-19 Assessment Centre.
- Local COVID-19 Assessment Centres are intended to educate & provide medical guidance. Find more information about these centres here.
- Toronto Public Health Hotline should be contacted for questions about COVID-19
Hours: 8:30 a.m. to 8 p.m.
Email: [email protected]
- Telehealth Ontario should be contacted if you are experiencing any COVID-19 symptoms
How will I be tested and what should I do if I test positive for COVID-19?
A COVID-19 test will be done and if you are positive, you will receive further direction from your local public health unit. If you test positive for COVID-19, contact your physician or midwife so they are aware of your diagnosis. Follow the advice of Public Health or your health care provider.
What effect does COVID-19 have on pregnant women?
As the situation with COVID-19 continues to evolve, we know to date:
- COVID-19 infection can occur in pregnant individuals. While the majority of pregnant individuals who acquire COVID-19 will experience a mild respiratory illness, in wave 3 of COVID-19, approximately 20 per cent of pregnant individuals will develop a moderate to severe form of the disease including pneumonia, respiratory distress requiring hospitalization and possible respiratory failure needing admission to the intensive care unit.
- COVID-19 infection in any patient can be life threatening illness – pregnant individuals are at risk.
- COVID-19 infection in pregnancy has been linked with increased rates of preterm birth, low birth weight babies, stillbirth, blood pressure problems and chance of Caesarean section.
How can I reduce my risk of getting COVID-19?
- Wash your hands often with soap and water for at least 20 seconds and dry with a paper towel or reusable dry and clean towel.
- Use alcohol-based hand sanitizer as an alternative.
- Avoid touching your eyes, nose and mouth with dirty hands.
- Cough or sneeze into your elbow.
- Maintain physical distancing and wear a mask when in public spaces, especially if you are unable to maintain a 2 metres (6 feet) distance from others.
- Strongly consider the COVID-19 vaccine.
COVID-19 Vaccination and Pregnancy, Pregnancy Planning and Postpartum
Pregnant individuals and individuals planning pregnancy are recommended to take the COVID-19 vaccine.
- Pregnancy, pregnancy planning or fertility treatment are NOT considered an exemption from COVID-19 vaccination. Contraindication to the COVID-19 vaccine (medical reason to not take the vaccine) would be a documented allergic reaction to PEG (the liquid portion of the vaccine) or a documented allergic reaction or documented myositis reaction to the first dose of the COVID-19 vaccine.
- The mRNA COVID-19 vaccines (e.g. Pfizer and Moderna vaccines) contain a biologic message that when injected into the muscle where it is absorbed will trigger your immune system to produce antibodies. These antibodies will bind the coronavirus preventing you from getting sick and also spreading the virus to other individuals. If you do acquire a COVID-19 infection despite the vaccine, the infection and symptoms will be mild.
- The vaccine DOES NOT enter your blood steam or cross the placenta to the baby. The baby is NOT exposed to the vaccine.
The COVID-19 vaccine has been administered to more than 150,000 pregnant individuals in the United States, a registry has tracked their pregnancies and determined no harmful effects for moms and babies.
Antibodies from the vaccine have been detected in breastmilk and thus may be protective for baby against COVID-19 infection. We see similar effects from other vaccines in pregnancy (Tdap, flu) and one of the many advantages of breastfeeding is the immunity shared with baby through breast milk.
For more information on the COVID-19 vaccine, visit Having a Baby at Mount Sinai.
Mount Sinai Hospital patients can also register for a free, video conference, interactive teaching session.
Hospital Visitor Guidelines
If I am scheduled to give birth at Mount Sinai, can I have a support person/partner during labour?
Women’s and Infants’ views birth as a major life event and our essential care partner policy is as follows:
24-hour access for ONE essential care partner is permitted.
Labour and Delivery
24-hour access for TWO essential care partners is permitted for patients experiencing a vaginal birth, with doula included as one of the essential care partners.
At all times, essential care partners must:
- NOT be symptomatic or COVID-19 positive
- Remain in the patient’s room
- Maintain physical distancing
- Wear a mask
The second essential care partner:
- May be asked to leave the Labour and Delivery room for certain procedures
- Cannot stay if the patient requires a ceasarean section
- Is not permitted to accompany the patient to the Mother Baby Unit postpartum
Mother Baby Unit
24-hour access for ONE essential care partner is permitted.
Patients can identify ONE additional essential care partner alternate, but the essential care partners must not visit at the same time.
Essential care partners are not permitted to remove their mask to eat or drink at any time.
Please ask your care team for further guidance and bring anything you may need during your stay (reading materials, additional clothes, phone charger, etc.)
What is the current visiting policy at Mount Sinai’s Women’s and Infants’ Program?
Please note that our visiting policies are subject to change at any time. We will endeavour to keep you informed and your health care team will take good care of you and your baby.
- All visitors are required to wear a mask at all times when in the hospital.
- Visitors under 12 years of age are not permitted at this time
- Essential care partners (support person/visitor) will be asked to stay at the bedside and follow all infection control precautions.
Patients admitted in the Antenatal Unit for less than seven days are able to have TWO essential care partners per day.
Patients admitted in the Antenatal Unit for more than seven days are able to have TWO essential care partners per day and identify TWO additional essential care partner alternates.
Only ONE essential care partner is permitted at a time.
If you are moved from your inpatient room for an ultrasound, your essential care partner will need to remain in your room until you return.
NICU patients are permitted TWO designated essential care partners (parents) at a time.
Patients can identify FOUR alternate visitors, who must be accompanied by a parent at all times.
End of life essential care partners are permitted for all Women’s and Infants’ Ambulatory Clinics.
One essential care partner is permitted to visit in the following circumstances:
- Maternal Disorders of Pregnancy Clinic
- New patients (first visit)
- Anatomy scans
- Postpartum patients with a baby six months and under
- Special Pregnancy Program: Fetal Clinic
- Postpartum patients with a baby six months and under (virtual visits to continue whenever possible)
- Patients having an amniocentesis/CVS
- Genetics Clinic
- Patients requiring a physical exam
- Women’s Unit and Urodynamics Clinic
- Patients with mobility issues
- Patients requiring a translator
- Patients requiring emotional support
Postnatal Ambulatory Clinic (PNAC)
If you are returning for a PNAC appointment with baby, please arrive with baby in stroller as a partner/visitor will not be permitted.
Lounges and Family Areas
All lounges and family areas at Mount Sinai are closed at this time.
What is the current food and drink policy at Mount Sinai?
- Essential care partners are asked to eat and drink before and/or after they visit. If they must eat or drink during the time of their visit they must leave the hospital and will be allowed to re-enter.
- There are two exceptions to this:
- In your private Labour & Delivery room, your essential care partner may eat and drink within the designated space ONLY IF you are not under investigation for COVID-19 or confirmed positive for COVID-19.
- In the NICU, essential care partners may only drink water in the designated space in the patient room as long as the care team is not present AND the patient is not under investigation for COVID-19 or positive for COVID-19. Eating food is not permitted. Your nurse will show you where the designated is within the patient room and provide additional instructions.
- There are two exceptions to this:
If I am COVID-19 positive or have symptoms, can I have a support person/partner during labour?
If you are positive for COVID-19, or have symptoms, a support person/partner who is a “close contact” will not be permitted to enter the hospital. We will permit an alternate support person who is not considered a “close contact” to visit. They will be provided with personal protective equipment to wear and will not be able to remove it for eating or drinking at the hospital. Your care team will be able to provide you with additional direction.
We will ensure you receive exceptional support and care during your stay with us and will provide further details on admission.
Please be honest with us about your COVID-19 status so that we can safely prepare for the birth of your baby.
What if I develop symptoms of COVID-19 or am confirmed positive for COVID-19 during my hospital stay?
During your stay, if you are under investigation for COVID-19 (you have been tested and are waiting for) or are confirmed positive for COVID-19, you will be asked to wear a mask at all times (as much as tolerable).
If at any time you are confirmed positive for COVID-19, your essential care partner must leave the hospital as they would now be considered a “close contact” of a positive COVID-19 case. An alternate support person who is not considered a “close contact” will be permitted to visit and will be provided with personal protective equipment to wear. Your care team will be able to provide you with additional direction.
Prenatal Information, Classes and Webinars
Can I still attend prenatal education and breastfeeding classes?
- All our classes, including a vaccination and pregnancy information session, are now available as real time, online sessions and you can register here.
- For those who are patients at / scheduled to deliver at Mount Sinai Hospital, a weekly virtual update with a perinatal psychiatrist and obstetrician is available. Registration details can be found here.
Can I still attend my antenatal (prenatal) appointments?
- You will be contacted one business day before your appointment, screened over the phone, and given direction at that time.
- Regardless of whether you have symptoms, it is possible you will have fewer appointments, and that you may have a remote appointment scheduled via teleconferencing.
- You will also be screened at the entrance to the outpatient clinic offices at 700 University Ave.
- You can be assured that each pregnancy will be reviewed individually and that the safety of all of our patients is our priority.
- At this time, no one can accompany you during your appointment visit. The size of our waiting areas make physical distancing challenging.
- If you require a support person, they will be asked to wait in their car or go home and come back. They will be contacted by cell phone during your appointment if needed.
- If you need your support person to help with accessibility, it MUST be approved by your doctor in advance.
- NO children under 16 years of age will be permitted unless they are the patient.
- If you are having a fetal procedure, please discuss support person/partner access with your physician.
- Staff will speak to your doctor for extenuating circumstances related to your reason for visiting.
What effect will COVID-19 have on my baby if I am diagnosed?
Based on the information we know to date:
- COVID-19 infection in pregnancy has been linked with increased rates of preterm birth, low birth weight babies, stillbirth, blood pressure problems and a chance of Caesarean section.
- To date, there have been no increased rates of baby related risk reported for women who have COVID-19 during pregnancy
- As a precaution, patients who have been diagnosed and have safely recovered from COVID-19 will have an ultrasound to assess fetal growth and well-being.
Birthing and Postpartum Information
What happens when I come into the hospital for any obstetrical care?
- Patients and essential car partners will be provided with a medical grade procedure mask. You will be required to wear it at all times while in common spaces of the hospital (e.g. lobby, hallways, elevators, etc.) Your partner will also have to keep the mask on while in your room.
- You may be asked by your health care team to wear your mask during care (if tolerated).
- When entering the main hospital at 600 University Avenue, and then again when you arrive on the 15th floor, you will be screened for symptoms.
- If you are coming for a booked procedure, such as a Cesarean Section, you will receive a prescreening phone call and further directions.
- If you are arriving in labour, or have concerns such as bleeding or reduced fetal movement, you will also be screened at the hospital entrance and then proceed directly to triage on the 15th
- If you have symptoms of, or are confirmed for COVID-19:
- You will be asked to clean your hands and put on a hospital provided mask.
- Your support person/partner who is a “close contact” will not be permitted to enter the hospital. We will permit an alternate support person who is not considered a “close contact” to visit. You will be directed to the appropriate location for further assessment.
- You will need to have a COVID-19 test done.
- Your booked procedure will NOT be cancelled but delayed until we have the test result so that we can care for you safely.
- Your care giving team will wear gloves, gowns and face masks while providing your care.
How will my baby be cared for in the hospital if I have suspected or confirmed COVID-19?
- Your baby will be tested during your stay using a nasal swab, umbilical cord blood and placental swab.
- If you are well, your baby will stay in the room in with you.
- Ensure you clean your hands frequently, but also before and after touching your baby.
- You will also be asked to wear a mask for all infant contact.
- If you are unwell, and unable to care for your baby, your baby will be cared for by our excellent team of health care providers.
- If your baby is admitted to the NICU and you are COVID-19 positive, you and your partner will not be allowed to enter the NICU, in an effort to protect your baby as well as the other infants there. You can designate an essential care partner, who is not a close contact, to visit your baby in the NICU.
- If you are COVID-19 recovered (had COVID-19 earlier in the pregnancy), your baby is not at any risk and will be treated with the routine standards of care.
Can I breastfeed and do “skin to skin” with my baby if I am COVID-19 positive?
- If you are have recovered from COVID-19, then you may breastfeed as usual.
- Keeping your baby “skin to skin” and breastfeeding is encouraged, but you will be asked to clean your hands, clean your chest and wear a mask at these times.
- If expressing breast milk with a manual or electric breast pump, you should wash your hands before touching any pump or bottle parts and follow recommendations for proper pump cleaning after each use.
- If possible, consider having someone who is well, care for and feed the expressed breast milk to the infant.
Going Home with your Baby
Ensure you have arranged a doctor’s appointment close to home for your baby after discharge. All newborns must be seen within 1-3 days after discharge.
- If you meet the low risk criteria for discharge, you may be discharged prior to 24 hours after birth and receive a 24-36 hour follow-up appointment (community or in our Postnatal Ambulatory Clinic). Let your clinical team know if you are interested in early discharge after you have been admitted.
- You will be provided with a list of community and online resources upon discharge (this includes information on breastfeeding).
- Our Postnatal Ambulatory Clinic (PNAC) is located on the 17th floor at Mount Sinai Hospital and is for essential pre-booked visits only. Please be advised there are no partners/visitors permitted at this time. Your health care provider will explain the process for booking a visit and for passing our hospital entrance screening should you have an essential visit booked, have symptoms, or are COVID-19 positive. Please ensure you are wearing a mask if you return to the hospital for a follow-up appointment.
- Family members or friends with any COVID-19 symptoms should NOT visit at your home.
- If there are children at home, instruct them about good hand hygiene and keep sick children away from the baby.
- If your baby becomes sick do NOT bring them back to Mount Sinai Hospital, go to your closest hospital that has paediatric services.
- Recommendations for the well-baby:
- Rooming-in, “skin to skin” contact and breastfeeding as above
- Hand washing and good hygiene is always recommended for any baby contact
- A parent who is COVID-19 positive or under investigation should:
- Put on a clean mask and wash hands thoroughly before each contact with baby.
- If breastfeeding or providing “skin to skin”, wash your hands, chest and put on a clean mask.
- Keep the bassinette more than 6 feet from mom at other times.
Limited Mount Sinai Hospital Services
- The food court and Second Cup are open but there are limited hours and seating.
- At 700 University Avenue, some food vendors are open with reduced hours and seating.
- All in-patient breastfeeding classes have been replaced with individualized breastfeeding support supplemented by videos and written materials.
- Our Baby Shop is open, but has restricted hours, you can also shop online at sinaishop.ca/collections/baby-and-maternity and have items delivered to your hospital room.
- All in-person ambulatory services, including our Post Natal Ambulatory Clinic and breastfeeding services, have been REDUCED to prioritize essential services. Virtual breastfeeding appointments are available at this time.
Resources Used to Create this Page
- Academy of Breastfeeding Medicine Statement on Coronavirus COVID-19, March 10, 2020 at: bfmed.org/abm-statement-coronavirus
- CAPWHN, COVID-19 Suggestions for care of the perinatal population at: https://capwhn.ca/covid-19-suggestions-for-care/March192020
- CDC information on COVID-19 and pregnancy, birth, infant care and breastfeeding.
- SOGC summary of recommendation on care during pregnancy, birth, postpartum, and care of the newborn
- Toronto Region COVID-19 Hospital Operations Table COVID-19 – Recommendations for Management of Pregnant Women and Neonates with Suspected or Confirmed COVID-19 Version Date: March 17, 2020 at: pcmch.on.ca/wp-content/uploads/2020/03/Toronto-Region-COVID-19-Management-of-pregnant-women-and-neonates-with-suspected-or-confirmed-COVID-March-17-2020-1.pdf
- Provincial Council for Maternal and Child Health