Part 1: COVID-19 and knowledge for midwifery practice—impact and care of pregnant women
The emergence of viral diseases, such as COVID-19, represents a global public health threat, particularly the high-impact animal viruses that have switched hosts and are able to be transmitted within human populations. Pandemics threaten the general population; however, there are special groups, such as pregnant women and their babies, which may be at a higher risk of, or more severely affected by infection. Pregnancy is considered a unique immunological condition; therefore, current challenges include decisions on preventing and treating infections during pregnancy and the possible implications for the fetus and newborn infant. This integrative review, the first of a two-part series, analyses selected literature on COVID-19 within maternal and newborn care, drawing on key themes relating to the impact on the pregnant woman. The themes discussed are: the nature of the immune system in pregnant and newly birthed mothers, maternal risk, mode and timing of birth, care during pregnancy and childbirth, and the transition to parenthood including the implications for practice for maternal mental wellbeing.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a clinical syndrome caused by the coronavirus (COVID-19), became a pandemic following an outbreak of viral pneumonitis, first identified in Wuhan, Hubei, China. Coronaviruses are a large family of viruses that can cause a range of illnesses including the common cold, Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS). When a new strain of coronavirus is discovered, it is called a ‘novel’ coronavirus because it is new and has not been previously identified (Centers for Disease and Prevention [CDC], 2020). The International Committee on Taxonomy of Viruses formally named the virus SARS-CoV-2 due to its genetic similarity to the virus that caused the SARS outbreak in 2003 (World Health Organization [WHO], 2020).
Coronaviruses are not just present in humans, with animals also having coronavirus-related illnesses. These viruses can mutate and be passed on to humans (Parrish et al, 2008). When the disease crosses over from animal to human, it is referred to as a ‘zoonotic spillover’ (Johnson et al, 2015). The resultant disease can be more severe because humans have not had to fight the illness before and the infection can amplify by human-to-human transmission with spread on a global scale, with COVID-19 being a prime example (Johnson et al, 2015). While not initially identified as a population at risk, pregnant woman may be more vulnerable to severe infection (Favre et al, 2020).
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