I SIT in the car park of CUMH and await the phone-call to advise me that it’s time to enter the hospital for my anomaly scan — the detailed scan that hopefully provides reassurance about baby’s development to date. I attended this scan during my first pregnancy, so I know what to expect.
Today’s anxiety is heightened however, because my husband is not permitted to attend due to the ongoing COVID-19 pandemic. A necessary but daunting precautionary measure.
After 20 minutes of waiting, I receive the go-ahead by phone to check in at reception. I walk across the footbridge and enter via a triage tent, where a large sign prompts me to disclose any potential coronavirus symptoms or recent travel to affected areas. My temperature is checked, and I‘m allowed to proceed.
Inside it appears to be business as usual, apart from the almost empty waiting rooms and the two-metre distance between occupied seats. Everybody is adhering to the guidelines, and understands the necessity for them. Yet here are women at every stage of pregnancy, all feeling the effects that this global emergency is having on their pregnancy journey.
The uncertain trajectory of our current reality is undoubtedly causing emotional upheaval for all pregnant women. Goal posts are constantly shifting, our worlds are turning upside down, and nobody knows for sure how this will play out. There is the fear of how COVID-19 could affect the health of you or your unborn baby, worry about who will be allowed to accompany you to appointments and/or the birth, questions about what happens after baby is born, and resentment that you’re missing out on what a pregnancy “should” be.
Additional stresses such as financial implications, childcare arrangements, and impact on work schedules further exacerbate an already stressful situation.
Because COVID-19 is such a new disease, the available information in pregnancy is continually evolving, and it’s important to stay informed through reliable sources such as the HSE website, the RCOG guidelines, and your hospital’s own policies. Keep an eye out for updates from these trusted sources on a regular basis. Avoiding the online pregnancy discussion forums that fuel fear with misinformation is also wise.
Currently, early research shows pregnant women do not appear more likely to contract COVID- 19 than the general population. However, pregnancy alters the immune system which can occasionally cause more severe symptoms with viruses in general, and the same is thought to be the case for COVID-19, particularly in the third trimester (28 weeks).
It is also thought that a high temperature in the first trimester (weeks 0-13) can lead to complications, and COVID-19 may pose a risk in this regard. Vertical transmission (from mother to baby during pregnancy or labour) is deemed “probable”, by the Royal College of Obstetricians and Gynaecologists, but the significance of this is to be determined.
As of yet, there is no evidence of damage to the foetus, or any increased risk of miscarriage, which is promising news.
Taking reasonable precautions, such as stringent social distancing during pregnancy, and cocooning if pregnant with significant heart disease (either congenital or acquired) or if you have an underlying condition that compromises your immunity is the current guidance in Ireland in order to avoid any unnecessary risks, given the current paucity of information in these early stages of the disease progression.
Despite the ban on accompanying partners at appointments, it really is business as usual in terms of pregnancy care wherever possible. Vaccinations (influenza and whooping cough) as well as bloods, scans and gestational diabetes screening where applicable remain imperative to the health of mother and baby, and their schedules are being adhered to. Some GP consultations are conducted by telephone, with the option of a physical examination where required. It’s important not to neglect these aspects of your pregnancy care because of the current situation. All healthcare staff are continuing to do an amazing job of prioritising the health of you and your baby through this pandemic, so be reassured that you’re in good hands.
Remember, too, that classes for birth preparation, breastfeeding, pregnancy yoga and pilates are all still available from multiple providers online. It’s not what we expected to have to do, it’s possibly not ideal, but they are still essentially meeting their two key functions: education and connection.
They provide an opportunity to (virtually!) meet other women in the same boat during the isolation of social distancing, and impart important practical information in relation to pregnancy, labour and the postpartum period. Feeling prepared will help to put your mind at ease, and online classes will certainly serve that purpose.
These really are unprecedented times, and we’re all facing into situations that spark the feeling of “this is not what I ordered!” with regards to our pregnancy journeys. We wish that it was a time of care-free browsing for buggies, casual coffees with friends, and joyful celebrations with loved ones.
The fact remains however that for now, that is just is not to be. We are well within our rights to feel robbed of those experiences. Take all the emotional support that you need from loved ones and healthcare professionals during this difficult time. But also try as best you can to appreciate the special moments that we are still lucky enough to experience; feeling those first kicks, witnessing your growing bump, or getting to spend some unexpected quality time with other children before the new arrival. We can face the rest of it if and when we need to.
I head back over the footbridge with a scan picture in one hand, and my phone in the other, ready to give my family the good news that baby is healthy and well. As I pull out of the car park, I reflect on how COVID-19 could further impact this pregnancy in the coming months. Nobody knows for sure. I promise myself that despite the isolation and uncertainty, I’m going to do my best to embrace this pregnancy for what it is, to take each day as it comes, to stay informed, and remain hopeful — that’s really all that any of us can do.
Despite the isolation and uncertainty, I’m going to do my best to embrace this pregnancy for what it is, to take each day as it comes...
Dr Michelle O’Driscoll is a Lecturer of Clinical Pharmacy in UCC, while continuing to work in the community pharmacy setting.
Her research lies in the area of mental health education, and through her company InTuition she delivers health promotion workshops to corporate and academic organisations nationally