The spread of the coronavirus pandemic in Nigeria has worsened the travails of pregnant women, many of whom now live in fear and anxiety, SOLA ABE reports
“Since the first coronavirus case was reported in Nigeria, I have always been scared of stepping outside of my house. It is really scary, and anxiety is already setting in,” Adedamola Olabode, who is in the third trimester of her pregnancy, told this reporter.
Nigeria reported its first case of COVID-19 on February 27, 2020. The index case was an Italian who returned from Milan, Italy to Lagos on February 25, 2020; he was said to be working in Nigeria.
After receiving treatment, he was discharged on March 20 as he tested negative for the virus. However, since the Italian’s case, more people have been diagnosed with the deadly infection.
As of the time of writing this report, over 6000 cases had been confirmed, 1,840 discharged, and 200 deaths recorded.
While the government has put safety measures in place to ensure that the outbreak of the virus in the country is contained, many people are afraid of contracting it.
For women who are navigating pregnancy during this global pandemic, stress and worry have increased to greater levels.
“I had an antenatal appointment last week, but I was really scared about going for it,” Olabode said.
Although she enrolled in a private hospital where she was assured that there was no cause for worry, she is one of many pregnant women in the throes of anxiety. They are worried sick about their safety and that of their unborn babies.
According to her, the hospital has put some measures in place to ensure that their patients are safe.
“On my last appointment, we used a floor of the hospital for the antenatal rather than the regular hall we were using before. We were about eight pregnant women and were not allowed to sit together. We were also given our own chair covers; so, on each appointment, you are to come with your chair cover,” Olabode said.
She, however, said those measures taken at the hospital had still not stopped her from being scared.
“It is actually the fear of the unknown. I believe that the safest place to be is in my house,” she added.
COVID-19 is a new virus and there’s little information about it, which makes it scary for many people across the world.
According to the World Health Organisation (WHO), the disease can spread through small droplets from the nose or mouth of an infected person when he or she coughs or exhales.
‘Hospital is the scariest place to be’
To reduce the spread of the disease, people have been advised to stay indoors, maintain social distancing if they are to go out and ensure that they maintain proper hygiene.
Barbara Ezeyim, whose expected delivery day is just a few weeks away, expressed her fears about the situation in Nigeria.
Ezeyim describes the hospital as a scary place even though she is using a private medical facility.
“For me, the hospital is the scariest place to be now. I called my doctor about my options but he assured me that everything will be fine. He said that they are putting precautions in place, especially for pregnant women who are due at this time,” she said.
Sadly, in Nigeria, there have been reports of health workers contracting the virus from citizens who did not disclose their status or who were not aware of their status, thereby putting more people at risk.
A few days ago, a medical doctor, simply known as Olufunmilayo on Twitter, shared the story of a 38-year-old woman who delivered of a baby at the Alimosho General Hospital in Lagos.
According to him, the unnamed woman developed womb infection a few days after her delivery and was taken to the Lagos State University Teaching Hospital for treatment.
But she lost her life after testing positive to the dreaded coronavirus disease.
He said it was yet unknown how she contracted the virus, adding that the woman had put some health workers at risk.
Olufunmilayo said over 2,000 people had been exposed to the infection at the hospital, but some of his followers on Twitter contested the figure.
One of the followers, identified as Rose Candice, said she was supposed to be at that hospital for her antenatal but she was too weak to attend.
Candice expressed gratitude to God for escaping what may have turned out to be a tragedy for her.
Antenatal visits drop by 650,000
The virus has killed at least three pregnant women in the country. A 29-year-old pregnant woman who was said to have sneaked into Ekiti State from Lagos died on April 22.
The Federal Medical Centre, Abeokuta confirmed that a pregnant woman died of the virus in the hospital on May 1, while another was reported on May 4 to have died at the Dutse Isolation Centre in Jigawa State.
Citing the latest data from the National Health Management Information System, the Minister of Health, Dr. Osagie Ehanire, at the press briefing of the Presidential Task Force on COVID-19 on Thursday, May 14, said visits by pregnant women to hospitals had dropped by 50 percent.
He said the ministries of health and the Federal Capital Territory met on Thursday and agreed on the need to ensure the delivery of routine services in all hospitals in Nigeria.
He said, “Latest statistics from the NHMIS indicate that outpatient visits dropped from four million to about two million; antenatal visits from 1.3 million to 655,000. Also, skilled birth attendance from 158,374 to less than 99,000 while immunisation services reduced to about half.
The Federal Government had, on March 30, imposed a two-week lockdown on the Federal Capital Territory, Lagos and Ogun States. The lockdown, which was later extended by three weeks, was eased on May 4. Some states have yet to lift the lockdowns imposed on residents.
In Lagos, some public hospitals have put strict measures in place to ensure that pregnant women are safe.
A resident, simply known as Dada, who is 30 weeks pregnant, said she wasn’t able to attend her last antenatal appointment because she was sent back home by her hospital.
Dada, who didn’t want to disclose the name of the public hospital, explained that the management told women whose pregnancies were less than 38 weeks old to stop attending classes.
“They attended to those whose pregnancies were 38 weeks old but the rest of us were advised to return home unless we have a complaint,” she said.
According to her, the hospital said classes would resume only if the pandemic in the country ends quickly.
A health worker at the Gbagada General Hospital, who didn’t want to be named, said the medical facility had not stopped its antenatal classes, but that only women close to their due dates could attend.
“Pregnant women still come for their antenatal but they are not as many as before. We only attend to people who are near their due dates or people who have other complaints,” she said.
She noted that some women could not come for antenatal because of a lack of public transport during the lockdown period.
Are pregnant women at higher risk?
There are fears in some quarters that pregnant women are more vulnerable to coronavirus disease, but there is currently no evidence that it is true.
A new report by UK Obstetric Surveillance System stated that pregnant women are not likely to become ill with severe COVID-19 than non-pregnant women but most of those who have problems are in their third trimester.
“The majority of women who did become severely ill were in their third trimester of pregnancy, emphasising the importance of social distancing for this group,” the report read.
The UKOSS report also revealed that pregnant women from black and ethnic minority backgrounds are more likely to be admitted to hospital for COVID-19 than other women.
On mother to baby transmission, Dr. Karen Kotloff, head of the Division of Infectious Disease and Tropical Pediatrics at the University of Maryland, USA, said nobody has been able to detect evidence that the mother can pass it during pregnancy to the baby.
The latest guidelines from the Royal College of Obstetrics and Gynaecology (RCOG), UK, also stated that there is currently no evidence to suggest that COVID-19 causes problems with a baby’s development or causes miscarriage.
It, however, noted that emerging evidence suggests that transmission from a woman to her baby during pregnancy or birth is likely to happen. But, in cases like this, the affected babies were said to be discharged from the hospital and are well.
A few days ago, the governor of Lagos, Babajide Sanwo-Olu happily announced the birth of a baby boy who was delivered by a COVID- 19 patient at one of the isolation centres in the state.
Although the governor did not comment on whether the child contracted the virus, he noted that both mother and child were doing well.
President of the International Confederation of Midwives, Franka Cadée noted that the virus has not been found in vital fluids of pregnant women that could be transmitted to a baby.
“The COVID-19 virus has not been found in vaginal fluid, in cord blood or breastmilk. To date, COVID-19 has also not been detected in amniotic fluid or the placenta,” she told the United Nations Children’s Fund.
In other reported cases of COVID-19 in babies, the infection was found at least 30 hours after birth.
“Although the available evidence to date offers no evidence of harm, it is not possible to give absolute assurance to any pregnant woman that contracting COVID-19 carries no risk to her baby and no risk to her,” the RCOG report states.
Pregnant women are, however, advised to follow all health rules and maintain proper hygiene like every other person.
Kotloff said, “There are limited precautions that can be very effective, and they’re the same precautions that all people should take: Isolate yourself, wash your hands anytime you’ve been in close contact with someone else or have been touching surfaces that the public has access to.”
Although there is no evidence that an infected woman can pass the virus to her child through breastfeeding, Kotloff advised nursing mothers to take precautions such as wearing a mask to cover the nose and mouth.
“She should wash her hands before touching the baby. And in countries where pumping is available, she needs to make sure that when she pumps, her hands are clean and her face is covered…or turn it over to someone else if you can. That would be another option — to have another nursing mother nurse your child.”