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To Be Pregnant During a Pandemic

What it’s like to bring life into a world marred by COVID-19.

WORDS AND IMAGE BY ANGELO CANTERA

Pregnancy in the midst of a pandemic.

B ack in 2019, a woman told me that it’s been her longtime dream to be a mother. But just last week, while she was finally nine months pregnant, she said that there’d be moments when she’d wish that she wasn’t.

“Not now, at least,” so she told me. “It just doesn’t seem like a good time anymore.” “Now,” after all, are the days when many consider hospitals unsafe. “Now,” the borders of Metro Manila are manned by armed guards. In the stores near her home, there are shortages of hygiene products like toilet paper and disinfectants. And in all manner of media, an abundance of news about sickness, panic, and death.

Her name is Nouie Natividad Ang. And when we spoke that Saturday evening at a house in Pasig City, she was one of the many fearful of the coronavirus disease 2019 (COVID-19.)

“I don’t want to bring [my child] into this world when the situation is like this,” she said. “Newborns are very sensitive and fragile even without the factor of a deadly virus spreading throughout the country. And with this coronavirus, the situation is really scary.”

Before it started making headlines late last year, COVID-19 was a then mysterious virus spreading flu-like symptoms throughout Wuhan, China, its place of origin. But now, it is nothing short of a global problem.  As of the writing of this feature, it has already claimed more than 16,000 lives. It has infected over 300,000 individuals and destabilized several countries around the world.

“I first heard about it in December,” she said. “I was on my way to Singapore to get married and my obstetrician told me to be careful because there is a new kind of pneumonia out there. It wasn’t identified as a coronavirus back then. And now it’s here.”

In the Philippines, the death toll of the virus has gone past 30 and among the casualties include health care professionals who have chosen to confront it. It has already infected more than 500 and the repercussions of these numbers now weigh heavily on the country as a whole.

Currently, it continues to test the local health sector which is grappling with disturbing deficiencies—from the scarcity of protective gear to the shortage of test kits needed to identify carriers. The spread of the virus also compelled the national government to put Luzon under quarantine, a measure expected to last for about a month. Because of this, non-essential operations, mass gatherings, various modes of public transportation and other forms of livelihood are currently suspended despite the shortage of economic safety nets for low-income individuals. And then there is the ailment’s capacity to unravel disappointing, if not unsettling, truths. For example, it helped the public identify who among our elected officials are vastly ill-equipped to deal with the virus.

In other words, the presence of COVID-19 in the Philippines has been both debilitating and revelatory. And for a pregnant woman like Ang, this is troubling.

“We’re not exactly known for being the most advanced country in the world,” she said. “So, it worries me knowing that there is a possibility for this to worsen or linger. And I don’t want that for my child.”

According to Dr. Marizel Ann M. Sucayan-Sta. Ana., Ang’s sentiments are rather common these days. As an obstetrician working in Metro Manila, she continues to encounter women who are deeply concerned because of COVID-19.

“When they come to the clinic,” she said, “they ask plenty of questions mostly to clarify or verify what they have read or seen in social media [about the virus.]  Their main concerns were possible complications during pregnancy; the effect of the disease on their baby, and breastfeeding.”

Transportation can also be a problem for some women. Due to the nature of the Luzon-wide quarantine (a measure that bans the likes of taxis and tricycles from operating,) those who have no access to private vehicles need to rely on their local government units to take them to medical establishments.

“I’m also worried over the thought of going to a hospital to give birth,” Ang said. “I remember that when I went for a check-up before the [quarantine] was imposed, there were a lot of people wearing masks and I couldn’t help but think about the possibility of getting infected or getting my baby sick.”

According to Dr. Sucayan-Sta. Ana, however, pregnant women in the country should not be discouraged.

“It is still safer to give birth in birthing homes or in hospitals, especially if the pregnant woman has medical or obstetrical complications,” she said. The doctor also added that the Philippine Obstetrics and Gynecological Society, and the Philippine Infectious Diseases Society for Obstetrics and Gynecology have formulated protocols to triage and manage pregnant patients who are suspected of (or are infected with) the virus.

“The protocol is now being adapted and implemented in different healthcare institutions,” she summarized. “Thus, pregnant women are assured of standardized and evidence-based management.”

Additionally, the World Health Organization (WHO) stated that, as far as COVID-19 is concerned, there is currently no evidence suggesting that pregnant women have a higher rate of infection compared to the general population. If this is true, NPR.org said that this is a “welcome surprise.” According to the online publication, the similar coronavirus responsible for SARS had “a much higher fatality rate for pregnant people (about 25%, according to the limited data available from the 2003 outbreak) than for the general population (about 10%).” Nevertheless, WHO still advises caution. “Due to changes in their bodies and immune systems,” the group said, “we know that pregnant women can be badly affected by some respiratory infections. It is therefore important that they take precautions to protect themselves against COVID-19, and report possible symptoms to their healthcare provider.”

As for the issue of newborns getting infected in the womb, various bodies claim that there isn’t enough data to accurately discuss the matter.

“Currently, there is no evidence of mother-to-child transmission,” Dr. Sucayan-Sta. Ana said. “Babies born from mothers infected with COVID-19 tested negative for the disease.” According to a report by the Guardian on March 14, a newborn baby in London tested positive for the virus but it remains unclear whether or not the child got it while inside the womb or during delivery.

“Since there are only a few pregnant women who have contracted the disease,” Dr. Sucayan-Sta.Ana said, “insufficient data were gathered to make conclusions.”

This is one of the main problems with COVID-19. Due to its novelty, many aspects of the virus remain a mystery and this has allowed it to cause a major complication around the world: fear.

I n the Philippines, fear of COVID-19 is apparent. Not long after the first case of local-to-local transmission in the country was reported, bouts of panic buying began depleting stores of hygiene products and medical supplies.

“They’re just gone,” my editor-in-chief Kendrick Go told me while I was with him weeks ago. He had just been to a supermarket near his apartment in Binondo and found shelves that are emptied of disinfectants and toilet paper. “The hoarding has begun,” he said.

Much later, I booked a motorcycle taxi to meet another interview subject and the driver told me the same thing his colleagues have been saying for months: “pasensya na, sir. Wala na akong mask eh. Naubusan yung mga binibilhan ko eh [Sorry, sir. I no longer have any face masks. The stores I buy them from ran out.]”

To be fair, face masks have been in short supply since the middle of January thanks to the ash fall resulting from Taal Volcano’s eruption. But, after the first case of COVID-19 in the Philippines got reported, the challenge to acquire such an item went from difficult to nearly impossible. Hence a variety of disheartening imagery online like that video from ABS-CBN–that clip of a delivery man using a sanitary napkin to protect half of his face.

“There are a lot of unknowns around COVID-19,” psychologist Angela Arriola Yu told the readers of Manileno recently. And according to her write up, this is one of the reasons why people fear it enough to engage in unwise behavior like hoarding.

That being said, however, certain aspects of the virus have been pinned down. For example, the guidelines on how one can avoid it. Wash your hands as often as you can with soap and water or 70% isopropyl alcohol. Cover your mouth and nose properly when you cough and sneeze. Disinfect surfaces commonly touched by your hands. Try to maintain a distance of at least three feet between you and other people.

“And as much as possible,” Dr. Sucayan-Sta.Ana added, “stay inside your home.”

Of course, there are those who have no choice but to go out. Ang was an example. No more than a day since I conversed with her, she informed me that she was getting ready to go to the hospital and give birth. A day after that, a Facebook post began getting a large number of likes and heart reactions. It was a video of her newborn baby girl, a mouthy and apparently healthy bundle now bearing the name Luna. After seeing this, I couldn’t help but remember the conversation we had last year when she told me about her dream to be a mother. During that time, the virus wasn’t even an issue; her only parenting concerns back then were impending labor pains and the common challenges of raising a child.

At some point during that conversation, she looked at me and said this: “It’s going to be worth it. It’ll be hard but worth it.”

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