Vaccination, health pass ... which is now recommended for pregnant women
"Pregnant under three months old, I am not allowed to be vaccinated before September.My spouse is a restaurateur and I am at the restaurant every day.Will I have to be tested every two days or are there any derogations?»Asks Céline, from Frontonas (Isère).
Like Céline, there are still many (and many) to ask us about the vaccination of pregnant women against the COVVI-19.The opportunity to take stock of three questions, while the Secretary of State for the Social Economy, Solidarity and Responsible Olivia Grégoire, pregnant, received her second injection in front of the cameras on Tuesday July 27, precisely to reassure pregnant womenAbout vaccination.
Will it be possible to be vaccinated in the first trimester of pregnancy?
In the National Assembly, Tuesday, July 20, the Minister of Health, Olivier Véran, assured during a question session of answers to the government that the first trimester of pregnancy did not constitute a contraindication to vaccination, openingThus the way to the possibility, for pregnant women under three months old, to receive an injection of vaccine to Messenger RNA (Pfizer-Biontech and Moderna)."There is an indication to vaccinate, whatever the stage of pregnancy," confirmed the Minister of Health just before vaccinating Olivia Grégoire, five months pregnant, at Necker Hospital in Paris in Paris.
Until then, health authorities recommended vaccination only from the second trimester of pregnancy.The College of French Obstetrician Gynecologists (CNGOF) also recommended this by "precautionary principle".
"About 10 % of women make a miscarriage during the first trimester of pregnancy," explains Professor Cyril Huissoud, obstetrician gynecologist at the Croix-Rousse hospital in Lyon, and member of the college.We did not want vaccinated women to attach these false strata to vaccination ”."An artificial link would not have failed to be done on social networks and that would have thrown the stigma on the vaccines," adds Olivier Picone, obstetrician gynecologist at the Louis-Mourier de Colombes hospital (Hauts-de-Seine), also a member of the CNGOF.
Problem: this recommendation has sometimes been the cause of confusion, including in vaccination centers."Some have deduced that vaccination was contraindicated for women at the beginning of pregnancy," regrets Olivier Picone.
Read also: testimony.COVID-19: "I am pregnant, the second dose of vaccine was refused"
Several women have written to us in recent weeks to point out to us that vaccination had been refused in vaccination centers, as in Rennes, during their first trimester of pregnancy.The ambiguity between recommendation and contraindication now lifted by the Minister of Health, this situation should no longer happen again.
Pregnant women of less than three months, like Céline, will therefore be able to be vaccinated without delay.
According to LehuffPost, the recommendations of the guidance council of the vaccination strategy on the vaccination of pregnant women should also evolve "in the coming days", to stick to the declarations of Olivier Véran.In his latest opinion on the subject, published on April 6 (updated on May 7), the Council chaired by Professor Alain Fisher advised to vaccinate pregnant women from the second trimester of pregnancy.
Asked about France Inter, Tuesday, July 27, Alain Fischer now confirms that "they can vaccinate in the first quarter"."We know that pregnant women must be vaccinated, they are protected from accidents related to the covid and that protects their baby," he added.
Pregnant women must be vaccinated "as soon as possible, that is to say from the first quarter," abounded Yves City, the head of maternity service at the Necker hospital in Paris, live Surbfm TV, thesame day.
For its part, the National College of Obstetrician Gynecologists wants to be reassuring: "There are no known side effects for pregnant women", whatever the term of their pregnancy, underlines Professor Picone.
Women were also vaccinated at the start of their pregnancy, without knowing that they were pregnant.For them, "there is no worrying element to date for the mother and for the unborn child, whatever the vaccine," said the site of the National Medicines Safety Agency (ANSM).
Will unvaccinated pregnant women give birth in the hospital?
Definitively adopted by Parliament on July 25, the bill relating to the management of the health crisis - which must still be validated by the Constitutional Council - has in its article 1 that the health pass will be compulsory, "except in the event ofemergency ”, in hospitals for people who are welcomed for scheduled care, as well as for accompanying people and visitors.Childbirth being an emergency, it should not be subject to this rule.
Read also: dismissal, health pass ... What the anti-Cavid bill definitively adopted
The question arises, on the other hand, for consultations with a gynecologist or a midwife."It is essential that the management of pregnancies can continue in the usually required conditions," said the national college of obstetrician gynecologists and the research group on infections during pregnancy (GRIG) in a joint press release, on the 21stJuly.
If he pushes pregnant women to go and be vaccinated, Cyril Huissoud thus assures that the members of the college will take care of each of them, whether they have a health pass or not."We consider that pregnancy is an emergency, because an emergency can occur at any time," said the gynecologist in Ouest-France.
If the text of the bill does not provide any exceptions at the moment, government spokesperson Gabriel Attal promised, on July 19, that "clarifications" would be brought "in the coming days" so that pregnant women are notnot penalized by the implementation of the health pass.
And if no development is planned, they will be able to present the negative result of a PCR or antigenic test of less than 48 hours or proof of recovery of the COVID-19-a positive test dating from at least 15 days and less6 months.One or the other of these documents will allow access to the establishments concerned by the health pass from early August, including hospitals, as well as bars and restaurants.
Read also: Sanitary pass: What solutions for non -vaccinated pregnant women?
Widely developed during confinements, teleconsultation is also possible for certain meetings.In November 2020, the High Authority for Health (HAS) also recommended that pregnancy monitoring alternates "remote consultations and in the office or in maternity". « Les téléconsultations seront possibles pour l’entretien prénatal précoce, les consultations des quatrièmeet sixième mois et la consultation d’anesthésie au huitièmemois », précisait-elle.
As a supporter, spouses should also be affected by the obligation to present a health pass in health establishments, including during the delivery.To which is to the national college of obstetrician gynecologists: "They are not accompanying people like the others, but real care actors, argues Professor Olivier Picone.They must be able to be present during childbirth and postpartum, even without sanitary pass, and provided of course to respect the barriers to the maximum ".
"In any case, we will not have the means to control them," warns his colleague, Cyril Huissoud.
What about pregnant women affected by compulsory vaccination?
Pregnant women who exercise a profession concerned by the vaccination obligation will have no choice.They will have to be vaccinated on October 15, under penalty of salary suspension - and not dismissal, as had been envisaged at first.
The CNGOF had considered in a press release dated July 21 that vaccination could not be imposed in the first quarter of pregnancy, to avoid "that a cause and effect relationship be established inappropriately between the realization of the vaccination anda spontaneous miscarriage ".The same reason that led him not to recommend vaccination for pregnant women only from the second trimester of pregnancy.
This situation "can force them to announce their pregnancy very early to their employer," said the press release.
The members of the college that we have asked do not call into question this obligation in most cases.And insist on the need for pregnant women to be vaccinated."They are at risk vis-à-vis the COVVID," emphasizes Professor Huissoud.Pregnant women infected with the virus are much more likely to be hospitalized or develop complications related to pregnancy, including when they do not make serious forms, and including for women who do not have anyadditional risk factors ».
"It is covid that must be afraid, and not the vaccine," concludes his colleague, Olivier Picone.
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