Pregnancy is one of the most beautiful experiences (well, in some cases for some women). Other women go through pregnancy with its accompanying discomforts throughout their trimesters until they finally put to bed. Each pregnancy comes with its own challenges but have we thought of the unimaginable stress of being pregnant in a Lockdown? Where everyone is instructed to stay home because of a pandemic that is capable of wiping out everyone. How are pregnant women coping with their antenatal care in this lockdown, how will they manage their labour? What of their arrangements with electives and emergency CS?
COVID-19 or Coronavirus can be transmitted through droplets of saliva and mucus of an infected person. When these droplets of saliva fall on your face directly or on surfaces and you touch them and touch your face or skin, you may also get infected. The virus can last for about four to 72 hours on various surfaces.
Afrikanmum.com spoke to some pregnant women to understand how they are managing the stress of pregnancy in a Lockdown.
Modesta Wordi-Obour gave birth safely last week. She tells us that since the lockdown took effect, she had two more antenatal visits before she put to bed. Mrs Wordi-Obour explains how it was so difficult and scary for her.
“You know you have to worry about being pregnant and going to the hospital, worrying your head over this COVID-19 pandemic, and try to observe the social distancing protocols so you don’t get infected when the antenatal department of my hospital is not observing the protocols”.
Mrs Wordi-Obour explains that it was during her last visit for her antenatal that the doctor told her she was 2 centimeters dilated and that she should call home for her things to be brought to her for delivery.
She revealed how scared she was on the morning of her last antenatal visit because the COVID-19 cases in Ghana kept rising. It had to take the intervention of her husband who convinced her of the need to be at the hospital. To put her mind at ease, he got a taxi driver to take her from their home to the hospital so she could get the necessary medical attention.
Mrs Wordi-Obour says her son is healthy and strong, and she’s supposed to observe the postnatal visitations to the hospital. She says it’s because it’s extremely important to get the necessary medication for her son, “Yes I’m scared and I don’t know any other means of getting him his injections without having to go to the hospital if not, I will try to skip this too by staying home”. She’s currently home with her mother and is observing all the social distancing protocols which were lifted because her son had to be circumcised. ” We had to get a specialist to come home and do it for him.”
Speaking on how she felt after she was delivered of her son, Mrs Wordi-Obour said only two people were allowed into the ward, and that was her mum and husband. “I had a sideward which was less congested, we were four in a room”.
She added cheerfully that, their next review is in six weeks and that’s a long time for a lot of things to change positively “Maybe this will be history by then”.
Speaking with another expecting mum by name of Yvette Fynn (not her real name), she said considering that she was almost due, her antenatal visits were now supposed to be once a week but doctors have advised that she only comes when there is an emergency or three (3) weeks after her last visit. Explaining the emergencies, she said they included bleeding, water breaking and other dangers related to pregnancy. She said her doctor put in place stricter measures to protect her long before the president announced the lockdown.
Mrs Fynn said doctors recommended that she got her own bed mats, sanitizers and tissue to protect themselves from COVID-19, and even before entering the consultation room. “In the case that you don’t have all these protection tools, you won’t be allowed to enter the doctors consulting room,” she explained.
She added that their temperatures are carefully taken before they are allowed to see the doctor.
Since Mrs Fynn has a private car to drive around town, she said hospital visitation has not been a problem since the police are yet to stop her whenever she’s on her way to the hospital.
She equally noted that her hospital is “observing all the necessary precautionary measures and social distancing protocols to the latter”.
When asked about her fears regarding contracting the virus, she responded, “I have fears, especially when I come into contacts with health workers”.
She said in her clinic, doctors are managing cases of expecting mums who are 36 weeks and above. Others with special cases are allowed to visit when they have an emergency but are spaced out to keep every expecting mum at a safe distance.
Mrs Yvette Fynn said she doesn’t know if this will end soon since the cases keep increasing and it is scary although she admitted: “I hope it ends soon”.
In another interview with Sandra Adjokor, an expecting mum who has about 4 weeks before she puts to bed mentioned that for her, instead of visiting a week or two, the visit has been extended to monthly basis and then for emergencies only. Except for the number of her midwife who has asked her to call whenever she experiences any form of discomfort.
Miss Adjorkor spoke of how the police have made life so uneasy when you meet them on your way to the hospital. They are not interested in what you have to tell them; they just send you back home. “I’ve also encountered a police officer who returned me when I was going to the clinic recently, it took the driver’s ingenuity to look for a different route to help me get to the hospital,” she hinted.
Speaking on whether her hospital has been respecting the social distancing protocols, she said, “When it comes to my hospital and social distancing, they do so well because they observe it to the latter. So I know they are doing their best to keep us safe”.
As far as she is concerned, her hospital is doing what they can to protect her but the problem she is facing currently is the police who are not ready to listen to her when they stop her. They only tell you to go back, they don’t want to listen to you.
“Just last week when my husband was coming to check on me since I’ve moved to stay with my sister who is closer to the hospital, they sent him back,” she added.
Speaking to Dr Obeng-Frimpong of the Korle Bu Teaching Hospital on issues raised by these women, he noted that, the goal of every midwife and doctor is to ensure that at the end of the 40 weeks of pregnancy both the mother and her baby are healthy.
He explained it is for such reason the concept of antenatal care was instituted in the first place.
He further explained that for a doctor who has examined his patient and has projected that she would be fine for the next 3 weeks, it is absolutely not right to make her come to the hospital earlier than that and expose her to the virus.
Dr Frimpong indicated there were some conditions which may affect mother and child may not give warning signs and so would not prompt a mother’s visit to the hospital.
According to Dr Frimpong, asking an expectant mother to stay home and visitations scheduled depending on her symptoms experienced may not help the clinician to achieve his or her aforementioned goal. “In fact, it can be dangerous!” he explained.
He adds that the bottom line is regular attendance to Antenatal Clinic and is encouraged because of the benefits.
Dr Frimpong, however, noted that we are in a Pandemic and it’s not ordinary time to expose a pregnant woman to this deadly virus. “Pregnancy suppresses her immune system and so she is at risk of suffering severe COVID-19 disease in case she contracts it,” he said.
So to keep her safe, the clinician can give her the drugs she can take on her own and educate her on the danger signs she should look out for so that she can be vigilant.
“If it is done this way, then we can have a win-win situation,” he added.
On Caesarian section (CS), he explained that there is an elective CS and emergency CS.
“Emergency CS should be performed at all costs in spite of these times, for which reason it’s called emergency CS”.
“Conditions like severe hypertension in pregnancy, a woman in obstructed labour, eclampsia and any condition which might kill the mother and/or the baby if immediate intervention is not given, “that’s when emergency CS comes in,” he noted.
He, however, explained that elective CS basically is the opposite of emergency CS. He said Doctors will do the CS but when it is prolonged it won’t harm the patient.
In these cases, based on the assessment of clinicians, patients are booked for surgeries.
“In this COVID-19 era, the clinician is aware of what the virus can do to his patient and so he arranges the dates such that the patients do not crowd. So that they don’t be at risk of contracting the virus because he has the aforementioned goal in mind”.
If inviting more patients for elective CS will cause more harm than good, he will opt for spacing them, “Remember the goal as a healthcare provider is the health of their patients(both mother and baby)”, Dr. Frimpong concluded.