Answer: At present work from home is advisable especially in the last 3 months of pregnancy. Do not use public transport.

For first time mothers, it is especially more stressful, however, all pregnant women will experience stress during this pandemic as it is a new situation. First trimester is usually the most stressful of all as it brings with it undesirable symptoms like nausea, vomiting, fatigue, weakness and giddiness, fear of pregnancy loss makes it very difficult for some women to cope. With appropriate medications, counselling and dietary changes, women usually overcome these symptoms by the end of 12 weeks. As women reach their second trimester, they are more relaxed and calm.

It is important for all pregnant women to get their facts right about COVID-19, its mode of transmission and risks associated to better protect themselves and avoid believing rumours and fake news circulating in social media, which is likely to create unnecessary panic. COVID-19 is caused by a contagious newly identified virus SARS COV-2. The virus is similar to those causing common cold but is more infective and can cause serious health problems, especially in those with immunocompromised status like diabetes or lung problems.

Pregnant women do not appear more likely to contract the infection than the general population. Pregnancy itself alters the body's immune system and response to viral infections in general. The symptoms may include fever, dry cough, muscle pain, tiredness, loss of smell and in advancing cases breathlessness. Majority of reported cases of COVID-19 pneumonia in pregnancy are milder and with good recovery There are currently no data suggesting an increased risk of miscarriage or early pregnancy loss in relation to COVID-19. So far very few babies have tested positive once the mother had COVID later in pregnancy. But most babies were not infected. Most cases of COVID-19 globally have evidence of human to human transmission. There are two routes by which COVID-19 can be spread: directly from close contact with an infected person (within 2 metres) where respiratory secretions can enter the eyes, mouth, nose or airways. This risk increases the longer someone has close contact with an infected person who has symptoms; and secondly indirectly by touching a surface, object or the hand of an infected person that has been contaminated with respiratory secretions and then touching own mouth, nose or eyes.

At first, follow social distancing to stay safe at this time.

In keeping with the mode of transmission, it is necessary to prevent the spread of virus by:

• Following strict social distancing (keeping a distance of at least 2 mt with another person).
• Wearing face masks at all times and frequent hand washing.
• Visit to hospitals only when called with no/one attendant to ensure safety.
• Keeping in touch with your obstetrician on phone regarding the scheduled visits.
• Continue with their routine Antenatal visits as per advise of obstetrician although they maybe fewer in number or more spaced according to clinical profile. Simple queries should be addressed on phone itself. Patient should also make arrangements and stock up essential medicines for few months in case there of closure of clinic or society.
• Advised to self-monitor baby movements at home according to the advised protocol.
• Should take adequate rest. Should eat healthy and follow well-balanced diet.

Diet and nutrition invariably influence the immune system competence and determine the risk and severity of infections. Recent studies have shown an important role of immune boosters like vitamin C, Vitamin D and Zinc in the diet and their deficiency associated with increased susceptibility to infectious diseases, particularly upper respiratory tract infections.

Meditation for relaxation and stress busting is important as stress can negatively impact pregnancy. Excessive stress during pregnancy is associated with preterm labour, preterm delivery, gestational hypertension, gestational diabetes and can also negatively affect growth of baby and can result in low birth weight babies. Every possible step should be taken to avoid stress. Watching favourite television shows and book helps to avoid negative thoughts from mind. Keeping busy with at home activities like cooking, gardening, decorating, or learning new things help. Stay connected with friends and family regularly. Avoid alcohol, smoking and caffeine. Regular sleep at same time daily 1 to 2 hours in afternoon and 8 hours at night is important. Regular mild to moderate exercises at home like yoga or simple walking at home premises helps to ward off stress.

After delivery due to sudden hormonal changes, sleep deprivation, new responsibilities, and lack of time with added lack of support from family members in COVID times can increase stress for new mothers. Avoid being master of all trades, skip household work, take adequate sleep, eat timely healthy meals, try meditation, taking help from partner, and taking out some quality time for self care to overcome challenging times.

Although no one can go back and make a brand new start, anyone can start from now and make a brand new ending. - Carl Bard

In this crucial time, pregnant women should visit a gynaecologist as soon as the pregnancy is confirmed. Below are the tests which need to be done timely for a smooth pregnancy.

During first trimester, about 11-13 weeks, few antenatal tests are required: (i)Level 1 Scan/ Nuchal Scan (ii)Double Marker Test

During 18-20 weeks, the following tests are important:

• Level 2 Ultrasound
• Quadruple Marker
• Thyroid
• CBC
• GCT
• URINE Routine
• Injection Influvac
• Injection Tetanus

In 26-28 weeks, Boostrix Injection is necessary and around 28 weeks fetal growth scan and doppler is a must.

When you reach 32 weeks of your pregnancy, you will start feeling fetal movements. Do keep a check on the movements and count, it should be around 5 fetal movements after each meal.

Visit your gynaecologist for a routine checkup in about 34-36 weeks time. Next visit should be in 39 weeks or when in labour.

The above-mentioned tests are a must for every pregnant women especially in these testing times, so that we can take timely action if any complication arises. Mothers who have conceived during the current Covid-19 scenario should take few extra measures to keep herself and the baby safe from this virus. Below are some tips which need to be followed religiously to avoid the virus: