Our priority is to ensure the safety and well-being of our patients and residents, and our people.

Only pre-approved visitors can visit patients at our sites. Please check our COVID-19 information page to learn more about what to expect for your appointment/visit and how to be approved as a visitor.


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Obstetrics

COVID-19 and pregnancy


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@pandemicpregnancyguide
- reliable information from our physicians on pregnancy during COVID-19

Last Updated: April 21, 2020

Please note: the information below may change. Please check back often.

Due to coronavirus (COVID-19), you may have questions and concerns about having your baby. At St. Michael’s Hospital, your care team is here to support you and answer any questions you may have. Please read the information below if you:

  • Are visiting for prenatal appointments
  • Are coming to the hospital to deliver your baby
  • Have an infant in the Neonatal Intensive Care Unit (NICU)

If you have tested positive for coronavirus (COVID-19), please contact your doctor or midwife.

General information

Where can I find information on Unity Health Toronto’s response to COVID-19?

There is a Unity Health Toronto webpage with COVID-19 information for patients and families. The information is updated regularly.

What should I do if I am pregnant and I have symptoms of COVID-19?

If you are pregnant and you have any of the following symptoms please go to a COVID-19 Assessment Centre:

  • Fever (temperature of 37.8°C or greater); OR
  • Any new/worsening symptom (e.g. cough, shortness of breath (dyspnea), sore throat, runny nose or sneezing, nasal congestion, hoarse voice, difficulty swallowing, new olfactory or taste disorder(s), nausea/vomiting, diarrhea, abdominal pain)

It is preferable, if you are able, to visit the COVID-19 Assessment Centre at St. Michael’s Hospital.

You may visit a different COVID-19 Assessment Centre if that is more convenient for you. To find out more information about COVID-19 Assessment Centres, visit the city of Toronto COVID-19 assessment centres page.

What if I think I may have been exposed to COVID-19 but I don’t have any symptoms?

If you think you may have been exposed to the virus but do not have any symptoms, complete the Ontario Ministry of Health self-assessment tool. The tool will tell you what to do next. Do this before calling Telehealth Ontario or visiting a COVID-19 Assessment Centre.

What should I do if I have any questions about COVID-19 or I am not sure what to do next?

  • If you have any questions about COVID-19, contact the Toronto Public Health Hotline:
    Hours: 8:30 a.m. to 8 p.m.
    Telephone: 416-338-7600
    TTY: 416-392-0658
    Email: PublicHealth@toronto.ca

  • If you have any symptoms, or are not sure, you can also contact your primary care provider or Telehealth Ontario at:
    Telehealth Ontario
    Telephone: 1-866-797-0000
    TTY: 1-866-797-0007

How will I be tested?

You will get a nasal swab to test for COVID-19. If the test is positive for COVID-19, you will get instructions from your local public health unit.

What should I do if I test positive for COVID-19?

  • Contact your doctor or midwife to let them know.
  • If you have to go to St. Michael’s Hospital for an appointment, tell the staff at the door that you have COVID-19.

What effect does COVID-19 have on people who are pregnant?

The information we have so far shows that people who are pregnant:

  • Are NOT more likely than the general population to get COVID-19.
  • Are NOT more likely to get severely sick if they get COVID-19.
  • Mostly only get mild or moderate cold/flu-like symptoms.

How can I reduce my risk of getting COVID-19?

  • Wash your hands often with soap and water for at least 20 seconds. Dry your hands with a paper towel or reusable towel that is clean and dry.
  • Use alcohol-based hand sanitizer if you do not have soap and water.
  • Avoid touching your eyes, nose and mouth.

Hospital visitor policy

Please note that our visiting policies may change at any time. We will post any changes on our website.

What are the restrictions during the COVID-19 pandemic?

To protect everyone’s safety, NO visitors are allowed in the hospital at this time. You can find more information on Unity Health Toronto's COVID-19 information for patients and families page. However, there are some exceptions, including for people giving birth and for babies in the NICU (see details below).

Labour and Delivery Unit policy:

One support person is allowed to accompany the healthy pregnant person during the labor and delivery and postpartum process.

Neonatal Intensive Care Unit (NICU) policy:

One healthy parent or support person is allowed into the NICU at a time. In the case of multiple births, one parent is allowed per baby.

Can my partner or support person be with me while I am delivering my baby?

Due to the spread of COVID-19, we have new rules about who can come to the hospital. This is to protect the health and wellbeing of our patients and our staff.

  • Only 1 partner or support person can accompany a patient in the labour and delivery unit and in the postpartum unit.
  • Your partner or support person must be healthy (free from fever, cough, sore throat, runny nose, colds, vomiting or diarrhea). This person must not have travelled outside of Canada within the past 14 days.
  • Your partner or support person must pass the screening criteria to come with you into the hospital.
  • Your partner or support person will receive a sticker after they pass the screening at the Queen Street entrance. They should wear it at all times during their visit.
  • Your partner or support person should stay in your room at all times. They should not leave your room or re-enter the hospital. For this reason, bring any food and other items needed during your time in the hospital.
  • If your partner cannot accompany you (if you or your partner have a fever, cough, sore throat, runny nose, colds, vomiting, or diarrhea), they can stay in touch with you through your personal device or by using the bedside phone. There will be no charge for use of our phone and internet services. If you don’t have your own device, the hospital is setting up a program to lend devices to patients.

If my baby is admitted to the NICU, can my partner and I still visit them?

Yes, we want you to visit your infant. Parents are an important part of our care team. At this time, only 1 parent or support person may visit the baby at a time. No other family members, friends or siblings may visit.

If both parents want to visit, you may only switch once in a 24 hour period. You may decide what time is best to switch. For example, parent #1 may want to visit from 9 a.m. to 9 p.m. then go home to get some rest. Parent #2 may then visit from 9 p.m. to 9 a.m. the next morning.

All visitors will have to pass a screening test to make sure they are healthy (free from fever, runny nose, colds, vomiting or diarrhea). They must not have travelled outside of Canada within the past 14 days.

What if I have multiples in the NICU?

We are allowing one parent or guardian per infant. If you have twins in the NICU, both parents or guardians can stay with their infants. Both will need to pass a screening each time they enter the hospital.

What if my partner or I don’t feel well, but still want to visit the NICU?

If you are not well, you must stay home. Babies need healthy parents. They are also very vulnerable to infections. Everyone in the NICU must follow strict hand hygiene guidelines which will help keep everyone safe.

What will my partner or support person do about food while they are at the hospital?

They should bring their own food from home. This helps to limit the number of times they need to exit and enter your room.

  • Food must be in containers that can be wiped and disinfected if necessary.
  • If the food needs to be refrigerated, bring a small cooler.

If your support person cannot bring their own food:

  • They can visit the Marketeria on the 6th floor of the hospital once per day.
  • We order extra sandwiches for partners to limit the need to leave your hospital room.

How can I protect myself and my family while at the hospital?

The most important thing you can do to prevent COVID-19 and other illnesses is to clean your hands regularly and avoid touching your face.

  • Clean your hands often, especially before eating and after touching shared surfaces or objects (for example door handles, elevator buttons and toys).
  • To clean hands, use soap and water or use an alcohol-based hand sanitizer with at least 60 per cent alcohol.
  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose and mouth.
  • Stay home when you are sick.

If I am alone at the hospital, who will help me when it is time to leave?

We will arrange for a staff member to help you with your belongings. If someone will drop off clothing or a car seat, a staff member will help deliver these items to you on time.

I have been told that I need to return for a follow up appointment. What do I do?

If you have been told to go to a follow-up appointment, follow the instructions you receive.

  • Appointments on weekdays for the Pediatrics clinic are on the 2nd floor, 61 Queen St. East.
  • Appointments on weekends are usually on the 15th floor, Cardinal Carter Wing, in the Postpartum Unit.
  • Please contact your FM-OB provider or family physician to book your newborn visit which typically takes place 24-48 hrs after discharge from hospital: http://www.stmichaelshospital.com/programs/familypractice/clinic-information.php

At this time, only one caregiver can bring infants to their follow-up visit. This person should expect a telephone call the day before their visit. This call is to ask screening questions about any travel or symptoms. The caregiver will be screened again when they come to the hospital or 61 Queen St. East

If you have any symptoms or have recently returned from travel, tell the screener when they call and when you arrive at the hospital. We will give you a mask, ask you to wash your hands and give you more instructions about your visit.

How long will the restrictions for visitors last?

We do not know when we will be able to lift restrictions for visitors. All Ontario hospitals have similar restrictions, following guidelines set by the province. This is necessary to slow the spread of COVID-19 and protect our patients and staff.

Please contact your care team if you have questions or want to talk about your concerns.

What are some ways I can stay connected with people who are not able to visit me?

  • We encourage video calling. For example, you can use Skype, Facetime, Whats App, or Zoom. We do not allow video recording when we are providing care, or recording staff without consent.
  • The hospital is working on lending devices to patients who do not have access. We will help you make video calls on these devices using Zoom.
  • Other ideas include sharing messages and photos with loved ones.

What if there are complications? What if I have a special circumstance?

The visitor policy includes an appeal process. Appeals are reviewed by a special team with representatives from Ethics, Patient Relations, senior management and the care team for your family member. This team will make a decision based on our guiding values.

To request an appeal, please contact Patient Relations: 416-864-5215 or patientrelationsSMH@unityhealth.to.


Prenatal information

Can I still go to my prenatal appointments?

  • Yes, you can still go to your prenatal appointments. We ask that you come alone to appointments. This helps to lower the risks to you, our staff and other patients.
  • Patients will be told what type of appointment they will be scheduled for. Options include:
    • In-person visit
    • Phone appointment
    • Virtual visit (video call) using the Ontario Telehealth Network or Zoom
  • Patients will receive a call before their in-person appointment to ask about any symptoms or any contact with COVID-positive people.
  • If this is the case, the appointment will either be rescheduled for a phone or virtual appointment, or be moved to a special clinic for patients with symptoms.
  • At any point, if you have questions about your clinic appointment or symptoms, please call the OB clinic at 416-867-7421 or your SMH FM-OB provider at your family practice site.

If I have COVID-19, what effect will it have on my baby?

  • We have information about the effects of other respiratory viral infections (influenza, SARS, MERS). Based on this information, there may be an association with low-birth weight babies and preterm birth. This may be in cases of severe maternal illness.
  • As a precaution, patients who have been diagnosed and have safely recovered from COVID-19 will have an ultrasound to assess fetal growth and wellbeing.

  • Birthing and postpartum care information

    What will happen when I come to the hospital for my care?

    • You will enter the main hospital at the Queen Street entrance and be screened for symptoms.
    • You will then go to the 15th floor through the Cardinal Carter North elevators. In the Obstetrical Unit you will be screened for symptoms again.
    • If you are coming for a booked procedure, such as a cesarean section or induction of labour, you will receive a pre-screening phone call and further directions.
    • If you are in labour when you arrive, or have concerns such as bleeding or reduced fetal movement, you will be screened and may be brought into triage or a delivery room.

    What if I have symptoms or have COVID-19?

    • We will ask you to wash your hands and put on a mask.
    • We will ask your partner to leave for your safety and for your baby’s safety.
    • You will need to have a nasal swab done.
    • Your booked procedure will not be cancelled. However it may be delayed until we have the test result.
    • Your care team will wear gloves, gowns and face masks while providing your care.

    Can I have a support person if I have suspected or confirmed COVID-19?

    • A support person is not allowed if you have suspected or confirmed COVID-19.
    • This creates an increased risk of infection for your baby, our patients and staff.

    How will my baby be cared for in hospital if I have suspected or confirmed COVID-19?

    • Your baby will be tested during your stay using a nasal swab.
    • If you are well, your baby will stay in the room with you.
    • Wash your hands frequently. Make sure you clean them before and after touching your baby.
    • You will need to wear a mask for all baby contact.
    • If you are not well and cannot care for your baby, the pediatric team will discuss your baby’s care with you and your support person. Your support person may care for your baby in your room, or your baby may be admitted to the NICU for care.
    • If your baby is admitted to the NICU and you are COVID-19 positive, you and your partner will not be allowed to enter the NICU. This is to protect your baby and the other babies in the NICU.
    • Your health-care team will talk to you about how to support your baby during this time.

    Can I breastfeed and do “skin to skin” with my baby if I am COVID-19 positive?

    • Practising “skin to skin” with your baby and breastfeeding is encouraged.
    • You will need to wash your hands frequently and wear a mask.
    • A baby may be exposed and possibly infected with COVID-19 with physical contact. For this reason, mothers may choose to separate themselves from their babies.
    • If you use a manual or electric breast pump to express milk, wash your hands before touching any pump or bottle parts. Follow instructions for proper pump cleaning after each use.
    • Consider asking someone who is well to care for and feed the breast milk to the infant.

    Can my baby get sick soon after birth?

    • We have not seen a lot of disease in newborns born to people with COVID-19.
    • 1-5 per cent of all babies born in hospitals may need to spend a brief time in the NICU for a variety of reasons, unrelated to coronavirus.
    • If your baby needs breathing help, including a breathing machine, we will isolate them from other babies in the NICU.
    • A swab will likely be done to see if your baby has the coronavirus. Thankfully information from around the world has shown that babies do not seem to get sick from COVID-19. Some babies may just carry it in their nasal cavity or throat.


    Going home with your baby

    When do I need to book my baby’s first doctor’s appointment after leaving the hospital?

    Your baby needs to see a doctor (usually a family doctor) 1 to 2 days after they are discharged. This is not easy to arrange with short notice, it can take up to 2 months to get into a family doctor’s office. Make sure you start to plan and arrange this before coming to the hospital. If your doctor isn’t available, let your nurse know. They can help arrange a visit with one of our doctors.

    If your family doctor is at St. Michael’s Hospital, please let the family medicine receptionist know that you have a newborn. Your baby will be booked into one of the morning protected time slots at the family medicine clinic 24-48 hrs after discharge from hospital.

    If you or your partner has COVID-19 or is suspected of having it, you will be sent to a special follow- up clinic after your discharge from the hospital.

    What precautions should I take once I am home with my baby?

    • Ideally, no one should visit your home. This includes your family and friends. If someone must come, ideally they are well, and are free of all viruses.
    • Some people may need someone to help them at home due to medical needs including mental health issues. In this case families and their healthcare providers must balance the health of the parents with the risk of introducing an infection to the home.
    • If you have other children at home, teach them about good hand hygiene. Keep anyone who is sick away from the baby.
    • Follow the best practices for rooming in, “skin to skin” contact and breastfeeding. These are described in the section above. Always wash your hands before and after touching your baby.
    • It would be ideal if you could arrange breastfeeding support virtually or ahead of time since it can be difficult to access breastfeeding support services at this time.

    If you are your partner has COVID-19 or is suspected of having it:

    • Wear a clean mask and wash your hands thoroughly every time before you touch your baby.
    • Keep your bassinette more than six feet away from you when not holding the baby.

    What do I do if my baby gets sick?

    If your baby has a fever, difficulty breathing, is not feeding well, or if you have any other concerns, do not bring them back to St. Michael’s Hospital. Instead, go to the nearest emergency room that has pediatric services such as Sick Kids, St Joseph’s Hospital, Michael Garron Hospital, North York General Hospital, or the Scarborough Hospitals.


    Hospital services before and after delivery

    • Groups and Classes - All hospital groups and classes are suspended. Toronto Public Health offers an online prenatal program.
    • Lactation Consultants (LCs):
      • If you are in the hospital, you can get support from our LCs Monday to Friday.
      • If you have gone home, our LCs are available by phone. Call the breastfeeding clinic at 416-867-7421 to book an appointment.
      • In very serious cases, in-person appointments may be available in our clinic at 61 Queen St. East.
    • Social workers are available Monday to Friday during regular business hours.
    • Spiritual Care services are always available (24/7) during this difficult time.

    Resources if you need help coping

    If you are in distress, call:

    • Telehealth Ontario: 1-866-797-0000
    • Mental Health Helpline: 1-800- 531-2600
    • The Distress Centre of Toronto: 416-408-HELP (4357)
    • Assaulted Women’s Helpline: 1-866-863-0511

    Mental health resources for patients and families

    • ConnexOntario: Call ConnexOntario at 1-866-531-2600 or visit www.connexontario.ca for mental health, addictions and problem gambling support.
    • BounceBack: This free program provides guided mental health self-help support using workbooks, online videos and phone coaching. Call 1-866-345-0224 or visit bouncebackontario.ca for more information.
    • CAMH: Information and support to deal with stress and anxiety related to COVID-19. CAMH also offers a peer-to-peer online forum where you can share your stories and experiences with others who have also been affected by the stress of the pandemic. Visit camh.ca for more information.
    • Mindfulness and meditation: There are a number of services and mobile apps offering free meditations during this time, such as:

    COVID-19 information in other languages

    Thank you to all those who helped make this COVID-19 info page possible:

    • Amy Burke (L&D nurse)
    • Kacper Michalak (Education Coordinator)
    • Dr. Eli Shore (Obstetrician)
    • Dr. Tali Bogler (Family Practice Obstetrics)
    • Amanda Hignell (Social Work)
    • Michelle O'Connor (Clinical Leader Manager, Obstetrics/Gynecology/NICU)