Michelle Farrugia was in the Dominican Republic on vacation with her husband when news hit in March that the COVID-19 health crisis had been declared a global pandemic.
The couple rushed back to their Bowmanville, Ont., home as case counts began climbing worldwide. Soon after, amid the stress and commotion of the early days of the pandemic, Farrugia found out she was pregnant with their first child.
“We were so excited, then reality kind of hit, like, ‘oh my goodness, 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 husband Mark Weldon, welcomed baby boy 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.
While Farrugia avoided a COVID infection throughout her pregnancy, that wasn’t the case for every person expecting.
Canada has seen more than 2,000 COVID cases in pregnant people since March. And preliminary findings of a national surveillance project show that those who contracted the virus during pregnancy were at an increased risk of hospitalization (11 per cent of studied cases from March 1 to Sept. 30) and ICU admission (2.3 per cent)compared to non-pregnant women of similar ages. The survey also found that 15 per cent of babies born to women with COVID-19 in Canada were premature, approximately double the national average.
Dr. Deborah Money, an obstetrics and gynecology professor at UBC who’s leading the project, stressed that severe outcomes are rare, however, and most pregnant people with COVID experience mild sickness and recover.
Some of the uptick in hospitalization might be explained by cautious bias, she said, with pregnant patients more likely to be admitted to hospital when something’s wrong.
It also wasn’t surprising to see more serious COVID outcomes in pregnant people, she added, since that pattern exists with other respiratory viruses.
“We think it’s a combination, probably of the changes in the immune response and physiological changes related to being pregnant,” Money explained. “And later in pregnancy, there’s somewhat restricted lung capacity when the uterus is squeezing up there.”
A baby acquiring COVID, either while in the womb or shortly after birth is also rare, Money said, though it has happened. A newborn in Calgary tested positive for the virus in November and spent two weeks in hospital recovering.
While Farrugia didn’t have to worry about any of that as a healthy woman, the pandemic impacted her pregnancy in less direct ways.
In-person medical appointments were limited in the initial stages of the pandemic, unless the pregnant patient proved higher risk for complications. When in-person care was needed, those visits were modified with mask-wearing and distancing.
Some jurisdictions limited the patient to one support person while other areas requested they attend alone.
Farrugia had a telehealth appointment with her general practitioner after taking a home pregnancy test on April 1, but didn’t actually see a doctor until her first ultrasound at 12 weeks. Not knowing how her baby was doing in that time was tough to handle.
“You find out you’re pregnant but can’t get checked out (right away) to see if there’s a heartbeat or anything,” she said. “So you’re just trying to nurture your body hoping that everything’s gonna be OK.”
Farrugia’s husband was with her at the time of delivery, but no visitors were allowed in the hospital. With Christmas so soon after Nolan’s birth, Farrugia says it’s been disappointing to not share the baby’s first holiday with her large family.
Cristina Pereira of Brampton, Ont., is facing a similar experience.
Her second child, a daughter named Claudia, was delivered on Sunday in a planned C-section. While husband Pedro was allowed in the room, Pereira missed the social celebration she felt when son Samuel was born three years ago.
Going through her third trimester in a COVID hotspot — one Brampton neighbourhood recorded a positivity rate of nearly 20 per cent last month — was also tough, increasing Pereira’s anxiety for her and her baby’s health and further stifling her social interactions when a second lockdown hit.
While Pereira described her second pregnancy as “isolating,” her concern now is on how maternity leave will feel.
“I (have to) adapt to a new baby and being a mother of two while more closures are happening … I’m not able to join mommy groups or have extracurricular outlets available for my children and my own wellbeing.”
Dr. Vanessa Poliquin, an OBGYN and assistant professor at the University of Manitoba, says social isolation is a concern when it comes to pre- and postnatal mental health.
Poliquin reminds her patients to practice self-care, and urges them to “maximize virtual platforms to interact with their support system” when possible.
“Pregnancy and being a new parent to a little human is stressful at the best of times, but it’s heightened (now),” she said.
When it comes to COVID treatment or vaccines, pregnant people have been largely excluded from clinical trials, making it hard for health organizations to decipher safety data for those populations.
The Society of Obstetricians and Gynecologists of Canada (SOGC) released a statement last week saying that for those more likely to contract the virus or suffer a severe outcome, “the risk of not getting the COVID-19 vaccine outweighs the theorized and undescribed risk of being vaccinated during pregnancy or while breastfeeding.” They added, however, that advice could change “as further evidence becomes available.”
The experiences of those going through their pregnancies over the last nine months will have varied from person to person, Poliquin says, but she admires her patients’ resilience.
“Being pregnant, being a new parent, that demands a lot of courage,” she said. “And for people who are becoming new parents during this pandemic, I think they’re going to have a special variety of courage and strength.”
Melissa Couto Zuber, The Canadian Press
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