For every mother, giving birth is a joyous experience. Pregnancy, with all its pain and discomfort, is an occasion of happiness and celebration - not only for the mother but for the whole family. However, in the era of Covid-19, the experience is fraught with anxiety and uncertainty. After all, the whole landscape of health care is different now.
"Changed hospital policies, concerns about cross infection due to SARS-CoV-2 virus, and changes in doctors' office hours and, to an extent, loss of human touch have all affected and may cause stress and emotional conflict in pregnant women," says Dr Neelam Kler, Chairperson, Department of Neonatology at Delhi's Sir Gangaram Hospital.
Aditi Sharma, 25, is due to deliver any day now. "My baby will be born in a world which is grappling with life and death at the moment and is full of uncertainty...it's a world where I fear whether we both can stay away from infection," she said.
Shortage of PPE kits makes regular visits of doctors difficult, adding to anxiety among pregnant women
Testing for Covid-19 before a delivery is mandatory and it was a nightmare for Rashmi Kapoor who tested positive a day before she was due to give birth. After she tested positive, she could not be admitted to the maternity hospital where she had planned to give birth; her water broke suddenly and she was stuck on the road for six hours. "We approached multiple private hospitals. One asked for a deposit of Rs 5 lakh, and made us wait for three hours before refusing us a bed. Finally, we had to take her to (government-run) LNJP Hospital. Little did we know how horrible this was going to turn out", shared Inderjeet Singh, who is her older brother.
"No one would answer the hospital helpline, my sister would not get water to drink, breakfast was just bread and milk, and sanitation facilities were filthy with overflowing toilets. Even a healthy person can fall sick in these conditions, let alone a Covid positive pregnant woman. The only saving grace - she was not alone. There were many pregnant women in the ward, all going through the same crisis," he adds.
Choked, filthy toilets in the Covid ward for pregnant women
While breastfeeding is extremely critical within an hour after birth, there is a lot of confusion with the guidelines for Covid-19 patients and many mothers like Rashmi have not been able to feed their babies. "Though currently there's no evidence that the novel coronavirus can be transmitted through breast milk, it is spread through droplets, and when a mom holds her newborn to her chest or breast, the risk of contagion increases. That's why many hospitals have asked Covid positive mothers to wear masks around their infants. Some have gone further, and physically separated mothers who have severe Covid-19 symptoms from their newborns," explains Dr Mangla Dogra who runs a nursing home in Chandigarh.
A recent study published in the May 2020 issue of Lancet, which examined breast milk from two nursing mothers infected with SARSCoV2, found SAR COV 2 virus in the milk samples.
The fear and uncertainties have led to many more issues. "Pregnant women are vulnerable to the Covid-19 infection because of the changes in their body and the immune system so it has been advised by the government that pregnant women should take extra precautions just as the elderly. This creates a sense of fear and anxiety in women who are pregnant. They are missing their ante-natal check-ups which may cause further complications later on," warns Dr. Jyoti Vajpayee, a gynecologist based in Lucknow.
Pregnant women waiting for clean drinking water
Emotional well-being is also critical at this point as many women are delivering alone without their friends and family around them. "Isolation makes it difficult to talk to people and she may feel alone in dealing with her world within the confines of the hospital bed. And post her delivery, she may feel terrified to breastfeed her baby", shared Dr Anita Rego, Director, Pearlss 4 Development and advisor to Association of Psychiatric Social Work Professionals.
Due to Coronavirus, the hospital staff is already stretched, meaning many pregnant women who are in Covid wards have to spend long hours in the hospital room waiting for any update on their child. "It's an emotional time for any woman and we are delivering babies by ourselves without our families. At these times, the hospital staff needs to act as the woman's family and support her through the tough time," says a harrowed mother in Gurgaon.
It hasn't been an easy task for healthcare workers as well. A shortage of PPE kits and blurred guidelines for private hospitals are a few challenges. The health system and health workers are prioritizing the corona pandemic. Pregnant women but cancer patients, those who require regular dialysis, heart patients - all of them have taken a backseat.
"UNICEF has warned that pregnant women and babies born during the pandemic are threatened by the strained health system and disruption of health services," says Poonam Muttreja, Executive Director of the Population Foundation of India.
India accounts for as many as 15% of maternal deaths globally. So it is even more necessary that public health facilities be equipped to screen, isolate, and care for both infected and non-infected pregnant women.
(Ambika Singh Kahma is a reporter and anchor with NDTV's special projects team working on various social issue campaigns.)
Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.