16 Aug 2021

Pregnant women urged to get Covid-19 vaccine

9:47 pm on 16 August 2021

Pregnant women are being encouraged to get vaccinated amid warnings they are more at risk of severe infection from Covid-19.

Cropped image of a midwife measuring blood pressure of a pregnant woman

Photo: 123RF

And new mothers who test positive for the virus are being reassured it is safe to breast-feed their babies.

Rosemary (who does not want her surname used) is in the final trimester of her first pregnancy.

She says being pregnant during Covid-19 has been challenging at times.

"Breathing through a mask is one of the hardest things to do. We had social masks made so I have one that says 'I'm the mama' and my husband has one that says 'I'm the daddy'.

She's also grappling with whether or not she should get vaccinated. And when should she get the vaccine? As a doctor's assistant, Rosemary became eligible at 34 weeks' pregnant.

"If I get sick, will my baby get sick? Does it cross the placenta? Is it going to have any developmental impacts for her?

"I was so late in the pregnancy that I didn't want to add any potential side-effects from the vaccine to how I was feeling at nearly nine months' pregnant."

US experience

In its latest global report the United States Centres for Disease Control says a record number of pregnant women are being admitted to intensive care with Covid-19.

It's now recommending that pregnant women are vaccinated against the virus and says the advice is based on a new analysis that shows no increased risk of miscarriage.

Previously it's simply said people should discuss the matter with their doctor.

Dr Mary Nowlan, of the Immunisation Advisory Centre in New Zealand, says Covid-19 presents real dangers for mothers-to-be including premature births.

"The infants born pre-term to mothers with Covid-19 need neonatal intensive care. This is three times the normal rate," she told a recent virtual discussion on pregnant women and Covid-19.

"There's also evidence in cases of severe Covid-19 of damage to the placenta particularly in the blood vessels and supply of the blood.

"This increases with pre-existing co-morbidities. The need for invasive procedures and ventilation increases in pregnancy and again those with pre-existing co-morbidities four-fold, five-fold. Severe Covid in pregnancy is associated with infections later in pregnancies such as late in the second or third trimester."

Multiple factors, including being pregnant, can affect the seriousness of Covid-19 infections in women, says paediatrician and Melbourne University professor Caroline Homer.

She says the risk of severe Covid-19 infection is higher for pregnant women, among other factors that could exacerbate the ability to fight the virus.

"We also know that pregnant women get more severe Covid infection or disease," she says. "Women who are older, being more than 35 years old, puts pregnant women at risk.

"Women who are larger, obese or overweight with a body mass index over 30 puts you more at risk. High blood pressure in pregnancy puts you more at risk of getting severe Covid-19 infection.

"Women who have diabetes and get Covid-19 are more likely to get very sick."

Homer also says pre-term birth rates could double for Covid-19 positive pregnant women.

"That means it is more likely your baby is going to have to have care in a nursery or in some sort of facility, sometimes being separated from you and from your family."

Expert warns against vaccine delay

Another immunisation expert Professor Nikki Turner says pregnant women shouldn't delay getting their injections.

She says a lot of data has been accumulated since the pandemic began.

"Some people may still prefer out of an emotional sense to delay it to the second trimester but there's no science behind that. That's just our emotional sense particularly if somebody's not at high risk.

"You don't want to delay it for too long because particularly with the new variants in New Zealand now, there is a high risk that Covid could come back to New Zealand at any stage."

Immunisation Advisory Centre (IMAC) Director, Nikki Turner before her COVID-19 vaccination

Dr Nikki Turner is urging women to get vaccinated in the early stages of their pregnancy if possible. Photo: RNZ / Samuel Rillstone

University of Otago Professor Nick Wilson says mothers-to-be are in the priority category and should be well informed about vaccination.

He says while there was a lot of thought put into the rollout, gaps remain.

"It's too slow, unfortunately. The government did have a very reasonable excuse at the start of this year that there were issues with supply. But that's no longer the case and unfortunately, they have not done a good-enough job on vaccinating the border workers.

"That should have been done extremely thoroughly first before focusing on the other groups. The priority should have been made much clearer.

"If there's a lockdown, we're not in the situation like Sydney where essential workers are spreading infection. So we should have had a much stronger focus on those particular groups.

"Covid-19 is such an important issue that nearly every dimension should be covered and we want to have very high vaccination coverage. So if pregnant women have concerns about things like vaccines, they do need expert advice and reassurance. It would make sense to have all that as available as possible."

Meanwhile, midwife Amy Wray is launching a breast-feeding app to help mothers gain access to resources and raise healthy babies.

The mother-of-five said she was inspired by her own mother - who was also a midwife and lactation consultant.

She recognises a need for other mothers to have access to resources that could help and guide them on their motherhood journey.

"This is to try and normalise breast-feeding for our New Zealand mums, like retrain some of that knowledge and have that knowledge, have that ownership of breast-feeding knowledge be put back in the hands of the whānau and the wāhine which is where it should belong."

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