Michelle Farrugia was in the Dominican Republic with her husband on vacation when news surfaced in March that the COVID-19 health crisis had been declared a global pandemic.
The couple returned to their Bowmanville, Ont., Home when a number of cases began to climb around the world. Shortly afterwards, amidst stress and turmoil in the early days of the pandemic, Farrugia learned she was pregnant with their first child.
“We were so excited, and then reality hit, like,‘ oh my God, we’re going to be pregnant during a pandemic, ’” Farrugia said. “We absolutely didn’t think we’d still be in it nine months later.”
Farrugia, along with her husband Mark Weldon, greeted little son Nolan James Weldon on Dec. 3, about a week earlier than expected. Like other parents of December babies, Farrugia experienced her entire pregnancy in the COVID era.
Although Farrugia avoided COVID infection during pregnancy, this was not the case in every person who was expecting.
Canada has seen more than 2,000 cases of COVID in pregnant women since March. And preliminary findings from the national surveillance project show that those infected with the virus in pregnancy had an increased risk of hospitalization (11 percent of cases studied from March 1 to September 30) and admission to the ICU (2.3 percent) compared to those who they are not – pregnant women of similar age. The study also found that 15 percent of babies born to women with COVID-19 in Canada were born prematurely, approximately twice the national average.
Dr. Deborah Money, a professor of obstetrics and gynecology at UBC who led the project, stressed that severe outcomes are rare, however, and most pregnant women with COVID have mild illnesses and are recovering.
Some of the problems in hospitalization could be explained by cautious biases, she said, with pregnant women more likely to be admitted to the hospital when something goes wrong.
It is also not surprising to see more serious outcomes of COVID in pregnant women, she added, as such a pattern exists in other respiratory viruses.
“We think it’s a combination, probably a change in the immune response and physiological changes associated with pregnancy,” Money explained. “And later in pregnancy, the capacity of the lungs is somewhat limited when the uterus is compressed there.”
A child who acquires COVID, either in utero or shortly after birth, is also rare, Money said, even though it has happened. The newborn in Calgary had a positive test for the virus in November and spent two weeks in hospital recovering.
Although Farrugia did not have to worry about any of this as a healthy woman, the pandemic affected her pregnancy in less direct ways.
Examinations by personal physicians were limited in the early stages of a pandemic, unless a pregnant patient demonstrated a higher risk of complications. When personal care was needed, those visits were modified by wearing masks and distancing.
Some jurisdictions limited the patient to one support person, while other areas required them to attend on their own.
Farrugia had a phone appointment with her GP after a home pregnancy test on April 1, but didn’t actually go to the doctor until the first ultrasound at week 12. It was hard to deal with not knowing how her baby was feeling at the time.
“You find out you’re pregnant, but you can’t check out right away to see if there’s a heartbeat or anything like that,” she said. “So you’re just trying to nurture your body hoping everything will be fine.”
Farrugi’s husband was with her at the time of the birth, but visitors were not allowed to go to the hospital. With Christmas so soon after Nolan’s birth, Farrugia says it’s disappointing not to share the baby’s first holiday with her large family.
Cristina Pereira of Brampton, Ont., Faces a similar experience.
Her second child, daughter Claudia, was born on Sunday in the planned C-section. While wife Pedro was allowed to enter the room, Pereira missed the social celebration she felt when her son Samuel was born three years ago.
Going through her third quarter at the COVID hotspot – one neighborhood in Brampton recorded a positivity rate of nearly 20 percent last month – was also difficult, increasing Pereira’s anxiety about the health of her child and her baby and further stifling her social interactions when hit by another blockade.
Although Pereira described her second pregnancy as “isolating”, she is now worried about how maternity leave will feel.
“I have to (have to) adjust to the new baby and be the mother of two children while more closures are happening … I can’t join mom’s groups or have an out-of-school facility available for my children and my well-being.”
Dr Vanessa Poliquin, OBGYN and an assistant professor at the University of Manitoba, says social isolation is a concern when it comes to mental health before and after birth.
Poliquin reminds its patients to engage in self-help and urges them to “maximize virtual platforms to interact with their support system” when possible.
“Pregnancy and being a new parent to a little man is stressful in the best of times, but it’s elevated (now),” she said.
When it comes to COVID treatment or vaccines, pregnant women are generally excluded from clinical trials, making it difficult for healthcare organizations to decipher safety data for these populations.
The Society of Obstetricians and Gynecologists of Canada (SOGC) issued a statement last week stating that for those more likely to get the virus or suffer a severe outcome, “the risk of not being vaccinated with COVID-19 outweighs the theoretical and undescribed risk of being vaccinated during pregnancy or during pregnancy. breastfeeding. “They added, however, that the advice could change” as further evidence becomes available.
The experiences of those who have gone through a pregnancy in the last nine months have varied from person to person, Poliquin says, but she admires the resilience of her patients.
“Pregnancy, a new parent requires a lot of courage,” she said. “And for people who become new parents during this pandemic, I think they will have a special courage and strength.”
Melissa Couto Zuber, Canadian Press
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