On Tuesday, the Estonian Society of Midwives (Eesti ämmaemandate ühing), the Estonian Society of Pediatricians (Eesti lastearstide selts), and the Estonian Society of Perinatology (Eesti perinatoloogia selts) agreed on recommendations for monitoring pregnancy, obstetrics and monitoring newborns at risk during their first weeks of life during the COVID-19 pandemic.

It was decided that birthing partners and other family members would not be allowed at births. "The more people there are in health care facilities, the more difficult it is to ensure their movements are controlled and prevent the spread of infection," a statement said.

Agreed changes:

• Delivery assistance for a woman with a confirmed case of COVID-19 will be provided as usual. Caesarean section and other interventions will be carried out from indications of the health of the woman in labor or the fetus based on the current situation.
• If the mother is suspected to have COVID-19, it is recommended the baby be isolated from the mother until the maternal test results are confirmed.
• Breastfeeding is not recommended during the isolation period. If a mother with suspected COVID-19 tests negative, she may start breastfeeding. The mother has the right to decline this recommendation.
• If the mother has a confirmed case of COVID-19, it is recommended the mother and child be kept isolated for two weeks to reduce the risk of neonatal infection. The mother will be advised to pump breast milk and maintain breast milk production so that she can switch to breastfeeding in the future. This recommendation may also be rejected by the mother, but it should be borne in mind that there is a very high risk of droplet and contact infection during breastfeeding.
• To reduce the risk of infection, the number of visits to the hospital during pregnancy will be temporarily reduced.

Emergency care is available 24/7 in all clinics. These are temporary measures which are applicable only in emergency situations.

The decisions made are based on relatively limited information available and may change as new information becomes available and the situation changes.

The purpose of the recommendations is to protect mothers, children and obstetricians from infection in the face of the epidemic and to preserve the health of mothers and newborns, said the head of the West Tallinn Central Hospital Women's Clinic.

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