Pregnancy is a special time full of excitement and anticipation. But for expectant mothers facing the outbreak of the coronavirus disease (COVID-19), fear, anxiety and uncertainty are clouding this otherwise happy time. For example, Angelique Raissa never imagined that she would be giving birth during a pandemic. And even though her pregnancy is only in the second trimester, she is already struggling with fear and anxiety of how things could turn out. Her biggest worry is that of the looming coronavirus, which she says has put her life and that of her unborn baby at risk. The possibility of contracting coronavirus while pregnant, during delivery or worse, passing it onto her baby, is weighing heavily on her. She doesn’t know who will be allowed with her when she goes to deliver; will she be alone in the labour ward? What would happen if she contracted the virus? Could the virus be a potential cause for a miscarriage, what would happen to her unborn baby in the unfortunate event that it gets the virus? Raissa wonders. Many expectant mothers are fearful of going to appointments while they are taking precautions, such as staying home and practicing physical distancing when outside. Net photos Pregnancy is normally full of excitement but with the current state, many expectant mothers have had the COVID-19 pandemic strip them of that emotion, and it has been replaced with fear. A number of expectant parents are wrestling with this immense pressure and anxiety, especially when it comes to their safety and that of their unborn babies. However, research is currently underway to understand the impacts of COVID-19 infection on pregnant women. Data is limited, but at present, there is no evidence that they are at higher risk of severe illness than the general population, according to World Health Organisation. However, due to changes in their bodies and immune systems, medics highlight that pregnant women can be badly affected by some respiratory infections. It is, therefore, important that they take precaution to protect themselves against COVID-19, and report possible symptoms (including fever, cough or difficulty breathing) to their healthcare provider. It is still unknown if a pregnant woman with COVID-19 can pass the virus to the foetus or baby during pregnancy or delivery. To date, the virus has not been found in samples of amniotic fluid or breastmilk. Accessing care for expectant mothers Despite social distancing orders, pregnant mothers still need care, this is why health care providers are diligent to finding solutions. Dr Pasteur Mberimbere, a gynaecologist/ obstetrician at University Teaching Hospital of Kigali, says as it is with other people, all patients, including pregnant women, are evaluated for fever and any other signs and symptoms for a respiratory infection. Generally, those patients with respiratory symptoms are separated from other waiting patients. Subsequent management is then offered by a dedicated team, and assessment is done to see if the patient is meeting the criteria of isolation, he explains. He, however, points out that expectant mothers in time of COVID-19 are assessed case by case because they are carrying a pregnancy, hence, it’s advised to see them as often as usual. Ideally, screening procedures begin before arrival on the labour and delivery unit or prenatal care clinic. “During our prenatal consultation, patients are instructed on what to do, and in case they have respiratory symptoms on the day of their appointment, appropriate measures are taken according to the guidelines,” the medic says. “In line with the recommendations from the Ministry of Health, if a patient has respiratory signs and symptoms, they are encouraged to call triage prior to coming at the hospital, then they are assessed over the telephone.” The desire to restrict patient traffic in healthcare facilities has prompted hospitals to limit the number of caretakers for expectant mothers. During delivery, one person is allowed to attend the delivery, and this too is strictly done in line with MoH guidelines, Dr Mberimbere says. “After delivery, the mother is followed up on as usual with the right postnatal care and only discharged from the hospital at the right time. As health care personnel, we are doing our best to care for mothers as we adhere to standards that will prevent the spread of the virus.” How to prepare for childbirth during the coronavirus pandemic Under normal circumstances, the birth of a child is an overwhelming experience but in the middle of a pandemic, pregnancy, labour and delivery are even more complex and nerve-wracking. But with some coping strategies, one may be able to handle pregnancy during the coronavirus pandemic. Talk to your healthcare provider. Information from the Huffpost website indicates that birth policies are changing constantly, hence now is the time to have an in-depth conversation with your gynaecologist or midwife about what their policies are right now. That’s always a good idea, but right now it’s particularly important to be specific. You can ask about aspects of birth that have changed specifically as a result of the pandemic. Create a very specific technology plan. If you have a smartphone or a tablet or a laptop, now is the time to think about how they can help you before, during and after birth. Some medics, for example, have begun working with clients virtually rather than providing in-person support. Know you can always explore other options — but safety is paramount. If you are concerned about your current childbirth plans, you could look into transferring to a new provider or practice. But switching care providers during pregnancy can be challenging, even under less extraordinary circumstances. Many care providers have policies about accepting new patients — and those policies are in flux as COVID-19 disrupts many birth plans. You’ll have to consider issues like insurance, transferring records, and more. It is also essential to understand the potential risks associated with home birth. Remind yourself that you’re not alone. Labour and delivery aren’t the only things changing because of COVID-19. Social distancing now means that many women won’t have friends or family around to meet the baby soon after birth, or to lend an all-important helping hand during the postpartum period. In addition to having a clear plan about how to connect via technology before, during, and after birth, it can help women stay calm and centred if they plan to surround themselves with comforting items.
