Informed Choice Maryland Policy Statement: Safe and Healthy Birthing Policy for Covid-19

April 3, 2020

Informed Choice Maryland strongly endorses the World Health Organization (WHO) guidance on pregnancy and breastfeeding for Covid-19 infected mothers and babies. The evidence-based WHO recommendation encourages companions to be with the mothers during labor, and encourages healthcare providers to support mothers and babies in maintaining skin-to-skin contact and breastfeeding on demand while rooming together in hospital, birth center, and home settings, unless otherwise contraindicated by emergent conditions such as necessary NICU support. This is the policy we believe will produce the best outcomes. We endorse the WHO guidelines for mothers infected with Covid-19 to wash hands frequently and practice respiratory hygiene, including use of masks when possible, which are demonstrated to prevent person-to-person Covid-19 transmission.

We recognize that the available peer-reviewed evidence on mother-to-infant transmission is inconclusive; however there is to date no evidence that Covid-19 has been transmitted to any infant by contact with an infected mother after birth. (Some data suggest that mother-to-child transmission is possible in utero.) There is to date no evidence that Covid-19 can be transmitted from mothers to infants through breastmilk. However, there is strong evidence that breastmilk provides antibody protection against infectious pathogens, and supporting contact between mother and baby directly after birth is imperative in achieving the best possible outcomes for mothers and infants. In addition to increasing positive breastfeeding outcomes, skin-to-skin contact protects infants from infections and promotes rapid recovery from illness by regulating body temperature, increasing oxygen saturation, and regulating heart rate.

Current CDC guidance on Covid-19, which directly conflicts with the WHO guidelines, advises facilities to restrict any birth partner or family member from labor and delivery and to “consider temporarily” separating mothers and newborns when the mother is infected with Covid-19; we find that guidance to lack supporting evidence and consider it to be potentially detrimental to mothers and babies. The United States ranked 33rd out of 36 OCED countries for infant mortality in 2018, and is the first country to report infantile Covid-19 deaths.  

Federal law protecting parental rights under the 14th Amendment guarantees that any restrictions on parental rights must be narrowly tailored to the precise public urgency; strict scrutiny applies. A universal policy of separating Covid-19 infected mothers and suspected infected mothers from their babies is unconstitutional because it interferes with parental rights to the care, custody, and control of their child regarding best practices to maintain the optimal health of their infant. Informed Choice Maryland strongly supports the evidence-based WHO guidance to promote the best possible outcomes for mothers and infants during the Covid-19 pandemic.

7 Thoughts on “Informed Choice Maryland Policy Statement: Safe and Healthy Birthing Policy for Covid-19

  1. Stick with WHO guidelines. Families and companions should be there. There are no current data that would suggest that there are more effective methods otherwise. In addition, babies are gaining so much more from immunological factors gained from mom’s breast milk and with skin to skin contact time than separating them. Not to mention, if mom has developed an immunological response to COVID-19, wouldn’t it make sense that breast feeding should be prioritized to pass those benefits on? By the way, as an FYI I (and my colleagues) have two COVID-19 papers that are currently in peer review, and are set to publish shortly. I might know a little bit about this.

  2. This is sad people are reacting this way to safety. Too much freedom in the midst of disaster and attitude like your organization is not giving freedom but destruction. You were applied all these in the past but what happened. What kind of society and mental , physical and spiritual health we have. Stop blaming and accept the responsibility of prevention at any cost to save lives, if people are dying what kind of contact or freedom to hope

  3. Stop separating mother and baby! This is inhuman! Government control is intolerable! We have human rights!

  4. This is really unbelievable and also dangerous. This would have devastated me when I gave birth, and my outcomes would not have been as good. Also, babies need their Mothers especially right after birth! It’s for their health.

  5. It is more detrimental to the mother and newborn to separate them. The newborn literally was attached to its mother and then birthed. You can’t get any closer than that, but it makes sense to separate the two once out?!

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