Testing positive for COVID-19, especially during the early days of the pandemic, was a scary experience for anybody and a much more difficult challenge for pregnant women.
Some expectant mothers who tested positive for the viral infection share their experiences with PUNCH HealthWise.
A woman identified as Mrs. Afolabi is not new to motherhood. In fact, she was already preparing to have her third baby in May 2020, when the unexpected happened.
Two weeks to her delivery date, the nursing officer tested positive for the deadly coronavirus.
Not that Mrs. Afolabi showed any symptom associated with the disease as she went about her duties in one of the primary health centres in the Epe Local Government Area of Lagos, actually.
But she saw the initial red flag when she and her two children were compelled to present themselves for the COVID-19 test after her husband tested positive for the virus.
It was at a time when there wasn’t much research into the effects of the disease on pregnancy, she told noting that the thought of delivering a disabled or dead child on her due date was a serious psychological challenge to her.
She said that she was crying and wishing the result would become negative overnight by some sheer miracle.
“I felt like I was slammed onto a wrestling mat, again and again. I became restless and kept praying, not just for safe delivery, but for me not to have a worse case that would lead to death.
“Even though I am a nurse, I was afraid. I thought I was going to die with my unborn child. I had heard that COVID-19 killed, coupled with the fact that I was pregnant; so I was confused and afraid,”
According to the physician that managed Afolabi at the Obstetrics and Gynaecology Unit, Gbagada Isolation Centre, Lagos, it is always difficult for expectant mothers not to surrender to anxiety and fears about COVID-19.
This, he said, is due to changes in their bodies and immune systems, adding that pregnant women can also be susceptible to some respiratory infections.
“During pregnancy, the immune system weakens, which makes them more susceptible to getting sick or having a more severe form of a disease. The same applies to COVID-19. However, it might vary for individuals
“Experts managing them are also at risk because of the proximity, while managing the patients due to the virus being airborne.
“Also, repeated exposure increases risk and if the expert’s immune system is not optimal for whatever reason, he/she is at risk, so experts have some fear while managing the patients,”
says the attending doctor.
The anxiety and the unknowns of COVID-19 were genuine, according to experts
The doctor, who does not want his name mentioned, added that due to the “deaths being attributed to COVID-19 worldwide and the uncertainties surrounding the new disease, the pregnant women had to undergo caesarean section so as not to transmit it to their babies.
“They were the first set of COVID-19 positive pregnant women who were being managed (even at the time in Africa and worldwide). So, there were relatively genuine fears.”
The other concern was the mode of delivery itself
The day-to-day anxiety and unpredictability became an inherent part of Afolabi’s life, but it became even harder when she had no control over choosing to give birth.
She had been told that she would deliver through a caesarean section, and she became more worried. The doctors nonetheless managed the situation by putting her on some medications and taking adequate care of her.
“I was worried and I began to question the whole thing like why would I be made to have my baby through CS when I had my two other children vaginally. Honestly, I’m afraid of CS,”
While not much is known about pregnancy and coronavirus, the World Health Organisation says it still does not know if a pregnant woman with COVID-19 can pass the virus to her foetus or baby during pregnancy or delivery.
WHO said: “To date, the active virus has not been found in samples of fluid around the baby in the womb or breast milk.”
However, the team of experts at the Gbagada Isolation Centre confronted both the infection and anxiety of Afolabi head-on.
She was admitted for some days at the isolation centre where she was stabilised, monitored, counselled, and reassured of her safe delivery. She was then prepared for the CS while still undergoing treatment for COVID-19.
“We observed physical distancing between her and the baby following delivery and we performed COVID-19 test on the baby one or two days following delivery and the baby tested negative.
“We had optimal paediatric care for the baby, continued treatment of COVID-19 for the mother, and retested the mother at the appropriate time.
“When the mother tested negative to the virus, we discharged her and the baby to continue post-natal care at the appropriate health facility,”
the doctor said.
Afolabi is thrilled to be alive to take care of her children, and she said concentrating on her baby got her through her toughest moments.
“Thank God, I am okay now, the baby is fine and I have returned to work,” she said.
“All I have to say is that pregnant women can survive it when well-managed by the right people. Protect yourself, know that there is someone who has gone through what you are going through and has survived and there is hope,”
Joyce Wakama (not real name) also shared in the mental torture of carrying a pregnancy alongside COVID-19 infection in the same May 2020.
The 30-year-old nurse who works at a tertiary health institution had just been confirmed pregnant at the time.
“I worked with a colleague whose husband tested positive for COVID-19 two days after we worked together. And when she went for her test, she tested positive. So, I had to go for my test,”
Before Wakama received her test result, she had woken with a sore throat, she narrated. Soon after, she couldn’t taste or smell anything. She added:
“I waited for about a week before my result was released. I just felt some mucus around my throat, I was always trying to cough out something but there was nothing there.
“I was scared because I was confirmed pregnant a day before my colleague tested positive. But my husband and son’s results were negative.”
She was then isolated and treated accordingly by the experts at her hospital. She said:
“But the drugs I was given were making me weak and I could not eat well and everything became irritating to me, perhaps because I was pregnant, so I had to stop my medication. Apart from the drugs, I was well-fed.”
The 30-year-old nurse was at the isolation centre for two weeks before she was discharged. In the back of her mind, she had a distressing worry – She was scared of having a malformed baby.
Unlike Afolabi, she was not scared of dying or losing her unborn child; she was scared of giving birth to a congenital malformed baby. She said:
“But I went online to check and I found out that the advantages of taking the drugs outweighed the disadvantages.”
According to the lead Obstetrician and Deputy Director, Institute of Viral Haemorrhagic Fever and Emergent Pathogens, Irrua Specialist Teaching Hospital, Edo State, Dr. Joseph Okoeguale, COVID-19 is a relatively new disease and what is currently known about it is rapidly evolving and might change in the future.
“A lot of researches are ongoing. Congenital malformations from COVID-19 itself have not been documented but researches are ongoing as to the possibility. However, there remain concerns about the medications being used as trial drugs for treatment. These have to be prescribed more cautiously by physicians who manage the disease,”
He added that most of the available evidence is still very new; so, many researches are still ongoing.
“There is no concrete evidence available that the disease or the drugs have adverse effects on pregnancy. There were few recommendations from WHO and according to them, most of the trial drugs used for non-pregnant adults can also be used for pregnant women.
“Apart from that, most of the drugs used during the COVID-19 are naturally safe during pregnancy,”