U of T students, faculty help expectant parents navigate COVID-19 with Pandemic Pregnancy Guide

Doctors Tali Bogler, Eliane Shore and Sheila Wijayasinghe, as well as medical students Sepand Alavifard and Sarah Freeman, have come together to create the Pandemic Pregnancy Guide (PPG), a virtual hub focused on pregnancy and COVID-19 related information on Instagram. 

With less in-person time with maternity care providers, pregnant patients are finding themselves with many unanswered questions, says Bogler, who is a family physician and chair of the family medicine obstetrics program at St. Michael’s Hospital. She hopes that the platform’s multidisciplinary and evidence-based approach will ease the worries of expectant and postpartum parents and empower them with information. 

Faculty of Medicine writer Ciara Parsons recently spoke with Bogler, a lecturer in the department of family and community medicine, about why the team was motivated to create the Pandemic Pregnancy Guide, how the pandemic has impacted expecting parents, and the type of content the team has planned for the future. 

What was the motive behind creating the Pandemic Pregnancy Guide? 

As COVID-19 began to surface, I realized there was an obvious need in my practice to answer questions about how the pandemic may affect pregnancies, especially because I care for a lot of expectant parents in my family practice obstetrics practice.

Expecting parents can feel overwhelmed during normal circumstances, especially first-time parents – but with the added stress of the COVID-19 pandemic and all the uncertainties that come with it, these individuals are all feeling a lot more anxiety. 

Our group decided to create the Pregnancy Pandemic Guide because COVID-19 has led to expectant parents having fewer one-on-one sessions with their maternity-care providers, and an increase in virtual care appointments. There’s also been the cancellation of in-person supports like prenatal classes, hospital tours and breastfeeding classes. We wanted to make sure that patients seeking information had a place to go where they could learn more.

The Pandemic Pregnancy Guide uses social media, specifically Instagram, to operate as a virtual hub of information about pregnancy, and a place where people can ask questions. It’s kind of like a virtual prenatal class, but with a focus on COVID-19 and pregnancy.  

What types of care are being converted to virtual care? 

We are limiting in-person appointments to keep patients and their families safe. For example, for low-risk pregnancies, we’re trying to have every other appointment completed by virtual care, either by phone or video call.

During these virtual appointments, we ask about things like the baby’s movements, which is a great way to assess fetal viability, or if the patient has signs or symptoms of high blood pressure. Additionally, we might ask about the parent’s weight, blood pressure and if they can measure the size of their growing uterus from home. 

How do you choose what information you’ll include on your social media accounts? 

We create content based on the types of questions we are hearing from our patients and Instagram followers. The content is also based around current emerging research related to pregnancy and COVID-19 and includes Q&A interviews with experts from different specialties. For instance, Dr. Wijayasinghe recently interviewed Dr. Mark Yudin, an obstetrician who specializes in infectious disease and pregnancy. 

We have also had interviews with our pediatrician, midwifery and pelvic floor physiotherapist colleagues, as well as prenatal mindfulness movement classes with a doula and yoga instructor. In the future, we plan to include insights from lactation consultants, psychiatry and social workers in our upcoming Q&A interviews. 

Do you think that having resources like this helps to fight misinformation about pregnancy during the COVID-19 pandemic?

There is so much misinformation out there about COVID-19 and how it may affect pregnancies. With so many different articles and resources available, expectant parents don’t know which resources to trust or where to turn for guidance. It can be overwhelming to try and sift through the information to determine what is legitimate.

From the feedback we’ve received on our social media page and from our patients in the clinic, it seems that our audience is thankful to have a fact-checked, evidence-based information source to turn to. We spend a lot of time curating our content before we post anything to make sure it is as up-to-date and accurate as possible. 

What are some of the biggest impacts or disruptions pregnant patients may face during this pandemic? 

Patients are being impacted by COVID-19 at all stages of their fertility journey, including pregnancy-planning, pregnancy and postpartum period. Many hospitals and clinics are restricting partners from attending ultrasounds and routine visits, which is typically an exciting time for patients and their families. Limitations around support persons during labour are a huge concern for many expectant parents, as many sites have restrictions in place limiting visitors (primarily only one support person if labouring individual and partner screen negative for COVID-19) to optimize patient and provider safety.  

As physicians and health-care providers, all we can do at this time is provide the best care we can under these exceptional circumstances and make the process feel as supportive as possible for patients.

The perinatal time is one that often builds community for individuals. During the pandemic, many have voiced that they feel isolated. Beyond the medical information we are sharing, we hope that this virtual platform will also allow for a sense of community and sharing of stories to help people feel less alone during this incredibly important time in their lives.