DELIVERING a baby at a private hospital is typically costly but giving birth as a Covid-19 patient will set one back financially a whole lot more. This is mainly due to the cost incurred by precautionary measures that need to be taken, such as isolation and the personal protective equipment (PPE), said obstetricians and gynaecologists.

They said that patients might be taken aback by the large sum and therefore are told of what to expect beforehand.

Gynaecologist, Dr Wai Kok Yau, who is based in the Klang Valley, said private hospitals are accepting mothers infected with Covid-19 who want to give birth at their facilities.

“It depends on the patient’s willingness to stay in a private hospital, because the cost will be higher.”

The increase in costs could range between RM20,000 and RM30,000, and this is on top of the regular charges where a normal C-section delivery can cost up to RM15,000 in a private hospital.

Dr Low Kah Pin, an obstetrician and gynaecologist at a private hospital in Penang, said mothers who test positive for Covid-19 are usually transferred to government hospitals, even if they had been receiving pre-natal care at a private hospital.

Treatment will be given at private hospitals only if government hospitals cannot accommodate them.

Low said Covid-19-positive expectant mothers are only regarded as non-infective two to three weeks after recovery.

Even then, mothers who have recovered from Covid-19 before their delivery are still treated with caution and would be isolated.

“Doctors and nurses handling the birth would wear PPE and conduct the delivery in a negative-pressure operation theatre,” he said.

Negative-pressure rooms in hospitals – such as isolation rooms – are used when there is a need to contain airborne particles or contaminants within the room. This is to prevent contaminants from reaching other areas outside the room.

A mother who has recovered from the coronavirus by the time she delivers her child will still have the baby kept away in isolation for three days before it can be discharged, Low added.

The baby is screened to ensure that it is not Covid-19 positive.

Opting for C-section

Low said a caesarean birth, or C-section, is the best option for Covid-19-positive mothers-to-be to ensure that their newborn does not get infected.

A baby in the womb is unlikely to get infected, unless there is placental abnormality.

Where a natural birth will require the mother to inhale and exhale vigorously when pushing the baby out, a C-section will limit the mother’s release of aerosols carrying the Covid-19 virus.

“The virus is in droplets and can be airborne, and might spread to the medical staff, the husband who may be in attendance, and the baby. Therefore, natural birth is not recommended,” he said.

“We recommend a C-section for Covid-19 mothers because the delivery procedure is shorter and the baby is covered and protected from below, away from the aerosols from the mother’s breath.”

Wai, meanwhile, said the hospital he works at has yet to receive infected pregnant mothers, but has dealt with cases of women who have recovered from Covid-19 waiting to deliver their child.

These mothers must first complete 10 days of observation prior to the delivery for doctors to ensure that they are virus-free.

The delivery process for C-section is the same as for a non-Covid-19-infected mother, except for the use of PPE.

Wai said mothers who have recovered from Covid-19 and had just delivered their baby must continue to protect themselves and the child.

They should not accept visitors except for the baby’s father, who must test negative for the virus. 

Breast milk does not transmit Covid-19

Gynaecologists have debunked the myth that breast milk from a Covid-19-positive mother will infect the baby.

However, these mothers are advised to avoid nursing while still infectious, Low said.

He added that while breastfeeding is a personal choice, most mothers choose not to if they have been infected with Covid-19.

Low said while breast milk does not transmit the virus, he knows of a case where a baby tested positive 36 hours after birth. However, this was more likely because it was not isolated from its Covid-19-positive mother immediately after delivery.

Based on the Health Ministry’s guidelines, the baby should be isolated from the mother to reduce the risk of transmission. 

“However, if the mother refuses to be separated from the baby, she will then have to sign a form bearing responsibility for the risk she is taking,” Low said.

The Covid-19-positive mother will also be advised to practise all precautionary measures, such as wearing a mask, thoroughly cleaning the breast milk pump, and washing parts of the body that may come into contact with the baby. – May 30, 2021.