Pregnancy and COVID-19

Last Updated: 2023-06-27

Below you will find information about COVID-19 that is specific to those visiting for prenatal appointments, those scheduled to give birth at Mount Sinai Hospital, postpartum patients or those who have an infant in the Neonatal Intensive Care Unit (NICU).

Masks are required in patient care areas, patient rooms and waiting rooms. Sinai Health is a mask-friendly environment. We support your choice to wear a mask in other spaces.

General Information

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.
  • Toronto Public Health Hotline should be contacted for questions about COVID-19
    Hours: 8:30 a.m. to 8 p.m.
    Telephone: 416-338-7600
    TTY: 416-392-0658
    Email: [email protected]

What effect does COVID-19 have on pregnant individuals?

  • COVID-19 infection can occur in pregnant individuals. In any patient, COVID-19 can be a life threatening illness; pregnant individuals are at risk. While the majority of pregnant individuals who acquire COVID-19 will experience a mild respiratory illness, 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 pregnancy has been linked with increased rates of blood pressure problems, preterm birth, low birth weight babies, stillbirth, and chance of Caesarean section.

How can I reduce my risk of getting COVID-19?

  • Wear a mask when in public spaces, especially if you are unable to maintain a 2 metre (6 feet) distance from others. Even with relaxed rules about masking, it provides protection against spread of viruses including COVID-19 that are transmitted via airborne droplets and particles.
  • 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.
  • Strongly consider the COVID-19 vaccine, including a booster if needed.

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 with 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 stream 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 200,000 pregnant individuals in the United States, a registry has tracked their pregnancies and determined no harmful effects for mothers and infants.

Antibodies from the vaccine have been detected in breastmilk and thus may be protective for baby against COVID-19 infection. We see similar effect from other vaccines in pregnancy (e.g. Tdap, flu) and one of the many advantages of breastfeeding is the immunity shared with baby through breast milk.

Hospital Visitor Guidelines

If I am scheduled to give birth at Mount Sinai, can I have a support person/partner during labour?

Birth is a major life event and our essential care partner policy is as follows:

Visiting guidelines

During Triage

24-hour access for ONE care partner is permitted.

Labour and Delivery

Patients experiencing a vaginal birth: 24-hour access for TWO care partners is permitted. The second care partner may be a family/friend or a doula.

Patients experiencing a Caesarean section: 24-hour access for ONE care partner is permitted.

At all times, visitors must:

  • NOT be symptomatic or COVID-19 positive
  • Wear a mask
  • Remain in the patient’s room
  • Maintain physical distancing

Mother Baby Unit

TWO visitors at a time from 7 a.m. to 7:30 p.m. The second care partner may be a family/friend or a doula.

Quiet Hours: between 7:30 p.m. and 7 a.m.
Only ONE visitor can remain overnight (unless there is an exception).

  • Care partners/visitors are not permitted to remove their mask at any time. This includes for eating and drinking.
  • 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 when they are in patient care areas.
  • Children are permitted to visit. All children over the age of two are required to wear a mask when in patient care areas.
  • Care partners/visitors will be asked to stay at the bedside and follow all infection control precautions.

Visiting guidelines

Antenatal Unit

Visiting hours: between 7 a.m. and 7:30 p.m.
TWO visitors at a time.

  • If you are moved from your inpatient room for an ultrasound, your care partner will need to remain in your room until you return.

Quiet Hours: between7:30 p.m. and 7 a.m.
Only ONE visitor can remain overnight (unless there is an exception).

NICU

24-hour access for TWO care partners/visitors at a time.

  • Any visitor must be accompanied by a parent.
  • All visitors must be over the age of 16 with the exception of siblings who must be over the age of two.
  • Siblings over age of 12 are considered visitors.

Ambulatory Clinics

Women’s and Infants’ Ambulatory Clinics/ outpatient appointments, including ultrasound appointments at CEOU: ONE care partner/escort.

  • Babies six months and under are able to accompany postpartum patients for all Women’s and Infants’ Ambulatory Clinics/outpatient appointments.

Neonatal Follow-up Clinic: TWO care partners/escorts

Maternal Disorders of Pregnancy Clinic: ONE care partner/escort

Postnatal Ambulatory Clinic (PNAC)

ONE parent and one visitor/escort

  • If you are returning for a PNAC appointment with baby, please arrive with baby in stroller

Lounges and Family Areas

In any area where there are patients such as a lounge, masks are still required. If this is a common area and patients are not present, masks are still encouraged but optional.

What is the current food and drink policy at Mount Sinai?

  • Care partners/visitors or visitors should not eat or drink in patient rooms.
    • There are two exceptions to this:
      1. In your private Labour & Delivery room, your care partners may eat and drink within the designated space ONLY IF you are not under investigation for COVID-19 or confirmed positive for COVID-19.
      2. In the NICU, 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 area is within the patient room and provide additional instructions.

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 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.

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.
  • Patients will be screened at the outpatient clinic 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, one essential care partner can accompany you during your appointment visit.
  • NO children under 16 years of age will be permitted unless they are the patient.
  • Babies six months and under are able to accompany postpartum patients for all Women’s and Infants’ Ambulatory Clinics/outpatient appointments.
  • 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 care partners will be provided with a medical grade procedure mask. You will be required to wear it while in patient care areas or waiting rooms of the hospital. Your partner will also have to keep the mask on while in your room or in a waiting room with other patients/families.        
  • You may be asked by your health care team to wear your mask during care (if tolerated).
  • Patients will be screened for symptoms when they arrive on the 15th floor.
    • If you are arriving in labour, or have concerns such as bleeding or reduced fetal movement, proceed directly to triage on the 15th floor and you will be screened
  • 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.
  • If you are well, your baby will stay in the room 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 a care partner, who is not COVID-19 positive and hasn’t been in close contact with you, 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 a confirmed case or 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. 

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. One parent and one visitor/escort is permitted at this time. Your health care provider will explain the process for booking a visit and for passing symptom 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 and friends meeting the baby:

  • 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.

Paediatric services for a sick 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:

  • 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 COVID-19 positive mom at other times.

Limited Mount Sinai Hospital Services

  • Food court and Second Cup are open to families and visitors.
  • 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.