Kate Glaser had chalked up her exhaustion to being 39 weeks pregnant and having twin toddlers in the house. She also wondered whether her flulike symptoms were a sign that she was about to go into labour. But when she woke up one morning with a 100.4-degree fever, she called her doctor and got a rapid COVID-19 test.
Two nurses came to deliver her results in the waiting room. They were dressed in full gowns, masks, face shields and gloves.
"I knew by the eerie silence and the way they were dressed that I was COVID positive," she said. "It was an emotional moment; I felt really disappointed and shocked and, as a mum, I felt a lot of guilt. What did I do wrong?"
Guilt, embarrassment and panic
Glaser returned home and isolated from her husband and the twins in her bedroom, where she spent hours mentally replaying all her activities leading up to the positive test result. She also made a public post on her Facebook page about her positive status, and what she was feeling - guilt, embarrassment and panic. The post went viral, and Glaser started hearing from women around the world who were pregnant and worried about COVID-19. The majority of the 2,300 comments she received were supportive; a few were harshly critical.
"I was going down a rabbit hole of guilt and stress," Glaser said, adding that for her, as much as the physical symptoms were bad, the mental stress of COVID was much worse.
The impact of stress on pregnancy
Prolonged stress can have real consequences on pregnant people even outside of a pandemic and has been tied to low birthweight, changes in neurological development and other health effects in children. And the pressure associated with a positive COVID-19 test increases these mental health risks.
The anxiety is not without reason. As of November 30, there have been more than 42,000 cases of coronavirus reported in pregnant women in the U.S., resulting in 57 maternal deaths. Health officials have said pregnancy increases the risk of severe disease for mother and child, and being coronavirus-positive in late pregnancy may increase the rate of preterm birth.
How being COVID-positive affects your prenatal care
Prenatal care and birth plans are also disrupted by a positive test result. In Dubai, women who test positive for COVID-19 prior to birth are required to deliver at Latifa hospital, or one of the hospitals that are not COVID-free , often meaning birth plans have to change
"Women are expressing so much fear about being infected, but also about going to the hospital, delivering and being separated from their child," said Laura Jelliffe-Pawlowski, a US public health researcher who is the primary investigator of HOPE COVID-19, a new study that focuses on the well-being of women who are pregnant during the pandemic.
The study launched in July and will follow more than 200 women around the world, from pregnancy to 18 months postpartum, to understand how COVID-19 and the pandemic response affects pregnancy and infant health outcomes.
Incredible levels of anxiety in pregnant women
Jelliffe-Pawlowski and her team have analyzed the data from the first group of women, and they are finding "absolutely incredible" levels of stress and anxiety. "Sixty percent of women are experiencing nervousness and anxiety at levels that impede their everyday functioning," she said, citing preliminary data. "There are a number of women, particularly lower-income women, expressing how hard it is to choose to stay in a job that puts them at risk versus quitting the job and not having enough food for their baby."
She also said more than 84% of women reported moderate to severe anxiety about giving birth during a pandemic. "Many women do not want to get tested because they will be stigmatized or separated from their baby or not allowed to have people in the room to support them," she said. She added that similar visiting rules often hold true for babies in the NICU after being born preterm during the pandemic: Only one parent can be present in a 24-hour period. "It's heart-wrenching to see families go through those choices."
The absurdity of being blamed for catching COVID
Jelliffe-Pawlowski is particularly interested in how stress affects births and long-term outcomes for children as psychological stress is highly associated with preterm birth. After the attacks of Sept. 11, 2001, the risk of preterm births almost doubled for people living near or working at the site of the fallen towers. She's also concerned about long-term effects of stress and anxiety on maternal bonding during the pandemic.
Margaret Howard, a psychiatrist at Women & Infants Hospital in Providence and postpartum depression researcher at Brown University thinks it is absurd for pregnant women who test positive for an infectious virus to bear any guilt or stress associated with their diagnosis: "Are mums in a special category where they are expected to not get COVID? What about a sinus infection? Hay fever? Cancer? Why is COVID a moral failing for mothers?"
From a formality to a life-changing event
When Erica Evert, a pregnant mom in northern Virginia, received her positive COVID-19 test result, it didn't make sense. She was near the end of her pregnancy, and hadn't left the house in 4 1/2 months, except for OB-GYN appointments to check on the baby.
"My first thought was, is this a false positive? I feel fine. And my second reaction was to start bawling," said Evert. She was scheduled to have a cesarean section with her second baby and the test was merely a formality - until it was a life-changing event.
The hospital gave her a choice: She could deliver the next day and be treated as a COVID-19 patient - separated from her baby with no skin-to-skin contact, per the hospital's policies. Or she could wait 10 days from the date she received the positive test result and deliver with her regular plan. She had four hours to make a choice she wasn't expecting. "I kept thinking: am I going to make a decision that results in my child dying?" said Evert.
Through social media, Evert found Glaser and the two started exchanging messages about being pregnant and COVID positive. Evert, who had no symptoms, had her C-section 10 days after her test. She still doesn't know if the test was accurate; her toddler and mom tested negative, and she later tested negative for antibodies.
The next day, Glaser, weak and feverish, went into labour and delivered her daughter in an isolated wing of the hospital, wearing a mask. She was able to breastfeed and have skin-to-skin contact, and the baby tested negative for the virus a few days after birth. (Hospitals can have very different policies around coronavirus-positive births.) They texted each other pictures of the babies and continue to stay in touch.
Pregnant women need connections
Their experiences echo what Jelliffe-Pawlowski is finding in her study more broadly: During the pandemic, pregnant women need connections with friends and family.
Until she started exchanging messages with Glaser, Evert struggled to find others going through the same experience. (Parents-to-be can now turn to Facebook groups like COVID-19 Maternal Well-Being, COVID-19 Babies and Parenting in a Pandemic, which include discussions about COVID in pregnancy. Or, they can simply seek out others who have the virus, which Evert hopes they do. "It just helped me so much, just to know that there's one person going through the same situation."
Are you pregnant during the pandemic in the UAE? We would love to hear from you. Please email babyandchild@gulfnews.com
