Childbirth in the age of Covid-19

Of all the times to be pregnant, this would seem to be the least ideal. The coronavirus is disrupting everything, including the experience of being expectant, with many of the women who were previously excited now filled with trepidation about giving birth during a pandemic.

"My biggest worry is my health during this period,” an expectant woman told Saturday Standard. “Ensuring I don't get coronavirus, that I am getting the right vitamins and nutrition during this period. I also fear the hospital environment. I am worried about interaction with other patients and the doctors during antenatal clinics.”

For some, they have to continue working, a situation that is not ideal at this time. Even in their homes, they have to be careful who they bring in to offer help.

“It's almost impossible to limit interactions as I commute to work and go shopping. I have had to neglect some house chores because I can't bend, but I am worried about calling, for instance, the laundry person because I don’t know whether she has been exposed to the virus,” said our source.

Emergency cases

She is right to be wary, according to an obstetrician/gynaecologist at the Kenyatta National Hospital (KNH).

“A pregnant woman is usually immuno-compromised. Covid-19 kills mostly those with co-morbidities, so a pregnant woman is at high risk. They really have to be at the forefront of protecting themselves. The key thing is social distancing, washing their hands and if advised to get tested, to do so,” he says.   

Maternity services at KNH, which receives referrals from all over the country, have been affected by the pandemic. The obstetrician/gynaecologist said that the hospital was no longer doing elective cesarean sections but for emergency cases.

“Even for women in labour, you don’t just come and we admit you. You have to be in active labour, having dilated 6cm and above. That’s because we don’t want crowding and we also want to shorten your length of stay, to minimise your exposure to the virus,” says the doctor.

Maternity mortality levels in Kenya are of concern and coronavirus is likely to make it worse if the situation escalates.

“Throw in this pandemic that is putting pressure on the already-strained healthcare system, there is going to be trouble,” says the doctor.

Despite being the biggest referral hospital, KNH has had an unexpected occurrence. The hospital is not really overwhelmed, because knowing that KNH is a hotspot for coronavirus, some patients are seeking healthcare elsewhere. It is hard to tell if this is ideal.

“Some may be delivering at home, which we also don’t want, because it is risky. Someone called requesting me to help them deliver at home because they are afraid of coming to the hospital,” the doctor says.

However, not all expectant women are afraid. For now, those with access to private healthcare are not worried. One such woman is Sheilla Nyatome, Operations Manager at Jonathan Jackson Foundation.

“I am at peace concerning the level of care I will receive. I will be delivering from the same private hospital that I had my first child. The experience I had with them was great. The level of care was excellent. I visited them recently and their facilities are still excellent and they seem well-equipped,” Nyatome says.

That seems to be the case at the Aga Khan University Hospital in Nairobi which has put in place protocol to ensure uninterrupted care for all the patients, according to Dr Majid Twahir, Chief of Staff and Associate Dean, Clinical Services.

“We have put in place precautions to protect our staff and patients seeking care. Additionally, we have put in place protocol to employ in situations where a delivery involves a Covid-19 case,” Dr Twahir said.

Despite this, even women like Nyatome who are confident about receiving top notch care have some things to worry about.

“With my first child, I did not have enough breast milk. The WHO recommends breastfeeding to help the baby fight infectious diseases, what will happen in case it is inadequate again with this Covid-19 pandemic?” she poses.