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To breed or not to breed: Should you try for a baby during a pandemic?

Suzannah Ramsdale asks the London couples making the decision

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o wrestling with morning sickness on a packed commuter train; no unconvincingly pretending your soda water is a gin and tonic at the pub; no disguising your growing tummy under shapeless smocks; no creepy work colleagues cupping your bump without asking. In some ways, being pregnant during the pandemic could be less challenging.

Then there’s the actual business of trying to conceive. Again, potentially easier to do while the world is on pause, with extra time on your hands to make the most of the tiny window of fertility flashing on your tracker. Mid-morning, lunchtime, and afternoon shags are all possible when you’re WFH.

On the face of it, trying for a baby during lockdown might seem like a good idea. The days and hours stretch on, for couples toying with the idea of starting a family, it could be tempting to fast track. Why wait? It’ll be something positive to come out of all this, after all.

But, of course, there are extra considerations to mull over. In April, Scotland’s chief medical officer Dr Catherine Calderwood urged people to think carefully about having a baby during the crisis.

“This [coronavirus outbreak] will last for some time,” she said during a press briefing before she resigned after being caught taking two lockdown trips to her second home. “The emergency services – the maternity services – will continue to run, though, so we have planned for all of the babies that would have been born to have exactly the same care that they would have had outside of this pandemic.

“But people are making difficult choices, and we would always encourage people to think: ‘Is this the right time for me? Am I in the best of health? Is this a good time for me to start thinking about having a baby?”’

At the beginning of the crisis, experts predicted a baby boom come December and January due to a combination of boredom and access to contraception. “Couples may not actively be planning a pregnancy in the current climate, but all of us across maternity and abortion services are bracing for an increase in unplanned pregnancies as a result of the prolonged period in lockdown combined with expected difficulties obtaining contraception,” said Clare Murphy, director of external affairs at the British Pregnancy Advisory Service.

But new research suggests quite the opposite has happened. According to a study about parenthood desires, published in the Journal of Psychosomatic Obstetrics and Gynaecology, over 80 per cent do not intend to try for a baby during the pandemic. Of the people who were planning to conceive, 21 per cent have changed their minds. Why? Financial instability and worries over possible health complications were cited as the top baby blockers.

The results of another study back this up. A survey, by personal finance company SoFi and Modern Fertility, shows that one-third of couples have changed their plans to conceive because of COVID-19. Forty-one per cent are delaying having kids for financial reasons, including worries of being furloughed or made redundant, and half of the people questioned said they were planning to delay getting pregnant due to fears over proper prenatal care. One in four were putting off pregnancy because they were anxious about catching the virus.

Birth control app Natural Cycles co-founder and CEO Elina Berglund says their data shows women have been using the app differently during the crisis. “We have seen changes in how our users use the app as the situation in the world is rapidly changing due to the new coronavirus,” she says. “The changes do not signal a baby boom, in fact – the opposite.”

According to Berglund, Natural Cycles is seeing a two per cent reduction each week of users utilising the app to plan a pregnancy and the rate of users switching from ‘prevent’ to ‘plan’ is slowing by three per cent every week.

Product developer Shirley, 31, who has a two-year-old daughter, has stopped trying for a second baby precisely because she’s scared they’ll be a baby boom. “I don’t want to have a baby right now because I think a lot of couples will have decided to give it a go and hospitals and midwives will be so inundated with all these babies in nine months’ time,” she says. “I worry about the level of care I’d receive. I’ve had a baby and needed an emergency c-section and then went into anaphylactic shock, so I know how important it is to have that level of care when you’re giving birth. I’d rather wait until I know hospitals are manageable. For me, it’s not sensible to try for a baby now.”

Shirley also worries about the effect a baby boom could have on the development of a child. “I think about the future and what that child will grow up with in their lifetime, for example, overfilled classrooms.

“There will be a whole generation of kids fighting for their place.”

Lawyer Emily, 34, says the pandemic has put her and her fiance off having a baby at all. “Because of worries about climate change, I was on the fence about having a baby anyway, and now, seeing the effects of coronavirus and how unstable society is, it’s made me seriously question whether it’s fair to bring another human into the world.”

Other people have had to press pause on trying for a baby for reasons out of their control. Advertising manager Alex, 35, has had her IVF treatment put on hold, but she’s even more determined to get pregnant once her clinic is up and running again.

“Logistically, it would be easier to deal with not having to hide that phase where you can’t tell anyone... getting sick, being at work events pretending to drink when you can’t,” says Alex. “There would be none of that awkward phase. I also wouldn’t have any social FOMO - there’s nothing to miss out on.”

But really, the crisis has made Alex and her husband take a step back and consider what’s important. For them, that’s family. “My husband and I have been spending so much time together and it’s made us closer,” she says. “It’s made us take stock of what’s important in life, and that assessment - of life and the wider situation - has reconfirmed our want to start our family.”

Advertising executive Alex, 32, got pregnant just as the pandemic was taking hold and has found both pros and cons to being in lockdown. “Emotionally and physically I’ve never felt like this before in my life. I’m exhausted and the last few weeks have been incredibly difficult. If I had to go into work and experience this in front of people it would have been very, very tough. I’ve been able to experience the pregnancy at my own pace at home which has been a silver lining.”

The downside, she says, is the feeling of isolation from friends and family and access to prenatal care. “Yesterday I went for a hospital visit and it was so weird. I couldn’t take public transport so had to walk for an hour there and an hour back, which was hard being as tired as I am.

“But I think pregnancy in general is difficult no matter what the situation is around you. It’s scary, uncertain, your body is doing all these weird things and your brain is all over the place. Emotionally you’re a wreck. It’s just difficult.”

Obviously, having a baby is a personal decision but, especially now, it seems everyone has an opinion. So what do the doctors say?

Louise is an infection control specialist at a London hospital and has been on the frontline during the COVID-19 crisis. She says there are a few important factors to consider, the first is that there is so much we still don’t know about the coronavirus.

“There are all sorts of viruses, like zika, chicken pox, herpes, with more significant risks to pregnancy, but we don’t know enough about novel coronavirus, there’s an unknown factor,” she says.

“We know pregnant women are more susceptible in influenza season and every year women get influenza and don’t do as well if they’re ventilated because you’re ventilating two people and that’s a difficult thing to do. We turn people on their stomachs to expand their lungs, which of course you can’t do in pregnancy so the mortality rate for pregnant women who end up in intensive care is higher. Coronavirus is a similar risk in some respects. You have to accept that there is viral risk in any pregnancy, end of story.”

Louise says she would also encourage people to think about how their lifestyle might look when things get back to normal. What kind of job do you have - can you work from home? Will you be expected to travel? What kinds of people will you meet?

“Many people are asymptomatic so you have to think about who you’ll come into contact with,” she says. “I would advise against travelling full stop on planes, so no babymoons!”

It’s also worth thinking about the extra stress being pregnant in a pandemic could cause, she adds. “I think it creates a more stressful pregnancy and we know stress can impact the foetus. So women have to be able to manage that.”

On top of that, if social distancing is still an issue, women could face the prospect of giving birth without their partner, unable to see friends and family and without the support of baby groups and NCT.

“Coronavirus will be with us for years to come," says Louise. "Loneliness and isolation are a factor in postnatal depression and there would be a risk of that. If you’re knowingly going to get pregnant then you need to know who you are and how you manage things. Are you comfortable on your own with your partner?

“I think the mental health toll and the lack of support would worry me more than the health aspect.”

So is a pandemic pregnancy a bad idea?

“If you’re young and you can hold off then great, but the coronavirus could still be an issue in a couple of years and, if you’re an older mother, those few years could make more of a statistical difference to your outcome and the outcome of your baby then having a baby during COVID.

“For women over 35 with their first baby, the risk increases and goes up as you get older. It’s a balance, but the risk of having a baby in COVID times will be far less than age.”

Her verdict? “Life goes on,” says Louise. “People get pregnant in war zones, in refugee camps, and we’re in a safe country.”

What to consider if you decide to try for a baby during the pandemic:

Executive Director for Professional Leadership for the Royal College of Midwives (RCM) Birte Harlev-Lam says:

Attend antenatal appointments

“It’s vital pregnant women continue to attend their antenatal, postnatal appointments and scans even in the current crisis, maternity services are open, and midwives are there to support and care for you and your baby. Maternity units are increasingly providing consultations on the phone or by video online, but this does not mean there are less important.”

Let your midwife know if you have any COVID symptoms

“If you or your partner has coronavirus symptoms, it’s vital that you let your midwife know before you attend an appointment. You’ll still get the care you need, but your midwife will be able to take the precautions they need to keep themselves as safe as possible. The same applies when you go into labour. Let the maternity unit know so they can be ready for you and help you welcome your new baby into the world.”

Self-isolate in third trimester

“Pregnancy in a small proportion of women can alter how your body handles severe viral infections and midwives have long been aware of this.This is particularly true towards the end of pregnancy, hence the recommendations for increased measures after 28 weeks.”

Certain groups develop more severe COVID symptoms

“Ongoing new UK research suggests that some women are at greater risk of becoming more unwell with COVID-19 and needing admission to hospital. These women are from Black, Asian and Minority Ethnic (BAME) backgrounds, women with pre-existing medical conditions, women over 35 years of age and women who are overweight or obese. There is an urgent need to find out why women from certain ethnic groups are more likely to become seriously unwell if they contract COVID-19. However, it’s important that we do what we can now to support women from BAME backgrounds to ensure they receive the right care during their pregnancy. That is why the RCM has launched a campaign to reach out to women who are at increased risk.”

There’s a low risk of transmitting the virus from mother to baby

“In the recent UK study of 427 pregnant women with coronavirus, the data reported outcomes for babies who were born to women with coronavirus severe enough that the woman required hospital admission. One in 20 babies born (12 babies in total) had a positive test for coronavirus, but only half of these babies – six babies - had a positive test immediately after birth, suggesting that transmission of the coronavirus infection from a woman to her baby is low.”

As always, healthy mothers have the best chance of a good pregnancy

“Women should try to be an ideal weight before they become pregnant as there is strong evidence of the risks of obesity and excess weight gain in pregnancy and if not, they should follow midwifery advice to exercise and manage their weight in pregnancy whilst maintaining a balanced and nutritious diet. Evidence also suggests that diabetes during pregnancy can increase the risk of stillbirth. Smoking in pregnancy can have a significant and serious impact on the developing baby. Babies born to those who smoke in pregnancy are more likely to be born prematurely and have a low birth weight. Stopping smoking in early pregnancy can almost entirely prevent adverse effects.”