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Conception to Pregnancy

The best option would be to vaccinate yourself and then plan a pregnancy. Planning a pregnancy is a very personal decision, and each one of us would like to make it as safe as possible. During a pandemic, the best option would be to protect ourselves with a vaccine and then plan a pregnancy.
Covid-19 is a mild disease in most young people. Isolate yourself, connect with your physician to be under follow-up for early detection of severe symptoms. Treatment of mild disease in pregnancy is symptomatic. For symptoms like fever, cold, and cough, monitor your pulse, oxygen and temperature three times a day and maintain a chart. This chart is very helpful to see the trends – whether they’re improving or worsening.
Covid-19 and its vaccine are both recent in terms of evaluations of its effects on pregnancy and the fetus. The current evidence suggests pregnant women with Covid-19 infection may have more chances of severe disease or complications. Vaccines (Moderna and Pfizer) currently have been taken by a large number of pregnant population in other countries and have not been shown to have any adverse effects. The vaccines available in India (Covishield, Covaxin) are now recommended by the Govt of India. The huge benefits of vaccination should encourage women to take the vaccine, to prevent Covid19 infection. Both these vaccines are not live attenuated vaccines (which are avoided in pregnancy). If a choice is given, women should opt to take it after 14 weeks of pregnancy (after organ formation stage) and take it best before 34 weeks to allow antibodies to develop and be protective by the time she comes to the stage of birthing. All Covid-19 vaccines are non-replicating vaccines and cannot cause infection in the mother or fetus. The international consensus of experts does not recommend any specific timing between different vaccines. They allow co-administration of vaccines, at different sites, preferably in different arms. Govt of India, however, recommends a gap of 14 days.

Reference May 28, 2021 https://main.mohfw.gov.in/sites/default/files/MoM%20NTAGI%20-%20May%2028%2C%202021.pdf
Both Moderna and Pfizer vaccines have been administered to pregnant women and ongoing registries have not shown any cause for concern. All Covid-19 vaccines available today are non replicating (mRNA or non-replicating viral vector based)). They do not have the capability to cause infection in the mother or baby. No risks have been shown with similar vaccines in the past. Covaxin and Covishield are nonreplicating vaccines too. It will be an individual’s choice, for recommendations cannot be made in the absence of data to say one is superior over the other.
Covid-19 prevention is the same, irrespective of pregnancy. Masks, hand hygiene, physical distancing remain the core principles along with reducing the chances of exposure by avoiding closed confined spaces, close contact settings (eating together) and crowded areas.
Ministry of Health and Family Welfare, Govt of India is currently advocating a period of 3 months. The CDC guidelines suggest that after the isolation time is over, one can take the vaccine. This is in disparity with our guidelines.
All Covid-19 vaccines are non-replicating vaccines and cannot cause infection in the mother or fetus. The international consensus of experts does not recommend any specific timing between different vaccines. They allow co-administration of vaccines, at different sites, preferably in different arms. Govt of India, however, recommends a gap of 14 days.
Covid-19 is a viral flu like infection. There is no specific diet that will help in treating this infection. A healthy, balanced diet with a good amount of hydration helps in recovery from any illness.
The mode of delivery will depend on multiple factors: the severity of the disease, the symptoms, the phase of labour, fetal and maternal condition. Covid-19 is not an indication for Caesarean section. It is a serious maternal infection requiring the decisions to be individualized.
Birthing at the hospital is safe. We ensured screening, minimized visitors, arranged the chairs with adequate distance between them and ensured that all the staff are in masks and have appropriately disinfectioned their hands and other surfaces. You and your birth companion should also maintain all precautions to prevent infection, masks to hand hygiene to physical distancing.

Reference May 14 2021 –www.cdc.gov/vaccines/covid-19/clinical-considerations/index.html

Postpartum

Most common way the neonate can get infected is after the birth from the infected caregivers. All caregivers, including the mother, should strictly follow Covid-19 appropriate behaviors (CAB), like wearing a triple layered surgical mask, hand hygiene before and after touching the baby, avoiding coughing or sneezing on to the baby etc.
The isolation is usually for a total duration of 14 days from the onset of the symptoms. If the mother was asymptomatic then the duration is 10 days from the day of positive test.
Yes, lactating women can take Covid19 vaccination.
It is ideal not to allow visitors to meet the newborn as they can be asymptomatic carriers and can spread the infection to the neonate while having close contact.
Avoid contact of the newly born with multiple caregivers or relatives. Caregivers should wear mask and practice strict hand hygiene. Do not allow outsiders to handle the baby. If any of the caregivers show any Covid19 related symptoms, they should immediately isolate themselves from the newborn. All the family members should get Covid-19 vaccination.
Yes, she can and should breastfeed her baby whenever possible. If mother is too sick or separated , then expressed breast milk can be fed via cup or spoon by the healthy attenders. Mothers should wear triple layered masks before and during breastfeeding, wash hands / apply sanitizer, change mask every breastfeed, and if she coughs or sneezes on her chest, then she should wash her chest with soap and warm water.
As soon as possible, and there is no need to withhold breastfeeding for vaccination.

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