Expectant mother with COVID describes reality of extra strain placed on mothers-to-be

UK coronavirus cases increases by 59,937

I am 48 years old and 37 weeks pregnant, edging ever nearer to my due date. My third baby could be here any day now. This week I was due to go into hospital for my final scan and to discuss my birthing plan with my consultant. But my plans have been thrown into disarray – all because I have Covid.

Last Saturday evening, I developed a temperature and a cough.

Earlier in the day I had taken the precaution of having a test as another family member had tested positive for coronavirus.

Everyone had warned me to be careful in my latter stages of pregnancy.

But I am pretty robust and fit for my age and, naively, I believed I would be one of the lucky ones to escape it, despite pregnant women being placed in the clinically vulnerable group.

How wrong I was.

An estimated one in 30 people were infected with Covid-19 in London between December 27 and January 2, according to the Office for National Statistics.

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Calculating my dates, I think I caught it on December 28 and I am now unlucky enough to be one of those statistics.

As we know Covid has already shown it knows no boundaries and respects no borders. The full reality of that hit home when I received my positive result last Sunday.

Worried, I called the 24-hour triage assessment number at my local hospital in south-west London and spoke to a midwife.

I told her about my circumstances, informing them that I was due to have a pre-labour scan on Wednesday and a follow-up appointment with my consultant the same day.

She said that because I had tested positive for the virus I wouldn’t be able to attend the clinic, but I might be able to come in for the last appointment of the day and they would have to deep clean the room afterwards.

I was told to ring back on Wednesday, the day of my appointment, but being an investigative journalist and, after years of covering health stories, I knew I couldn’t wait that long so I rang on Monday.

After a couple of inquiries, I was finally referred to a senior midwife, who told me there was no possibility of moving the scan appointment on Wednesday, that all the scans were fully booked and because I had Covid, they would not be able to gown up in full PPE given their limited time and resources.

I was then told the earliest time I could come in was 14 days after testing positive, which meant this coming Saturday at 8.30am.

I pointed out this was only 13 days shy of my due date, January 29, and I queried what would happen if I went into labour early. I was told rather glibly by a midwife not to worry and, if I did, they would deal with the situation when I came into hospital in labour.

This left me feeling remarkably uneasy.

Despite having had two births before at the hospital, being pregnant in a pandemic with the added complication of having coronavirus did not fill me with any confidence.

I put the phone down and spoke to my parents.

One point my mum soon raised was that surely it was down to the consultant and not the midwife to make the call about whether I should come in.

After all, given my age and the fact that I had a Down syndrome twin pregnancy in 2019, which turned out to be not viable, and a previous miscarriage, was I really going to be left for another 10 days with Covid and all the risks it could potentially involve?

With this in mind, I decided to write to my previous consultant and her secretary on Tuesday saying that while I completely understand how overstretched maternity services and the rest of the NHS are right now, given my previous history and age I needed to have a proper plan in place and to have some kind of assurance that I would be looked after.

On Wednesday morning, my current consultant called me at 8.30am and was very apologetic to hear what I had previously been told.

It was at this stage that a whole new situation and risk factor opened up to me, which has taken me the rest of the week to digest. In a small proportion of women, pregnancy can alter how your body handles severe viral infections, and some viral infections such as flu and Covid-19, are worse in pregnant women.

My consultant explained to me that when you have Covid, your blood is stickier and you are more likely to form blood clots.

At the moment they are seeing an increased number of pregnant women with Covid who develop tiny blood clots in their lungs after a week or so of having the virus.

Pregnant women are five times more likely to experience a blood clot, and since researchers have discovered how significant clotting disorders in Covid-19 patients are their gravity has become clearer.

While doctors had thought the vast majority of lung damage in patients was due to viral pneumonia, they have become aware just how pronounced blood clots are in those with coronavirus and how clots reduce the amount of oxygen that can move around their bodies.

And this is what is causing sufferers, like myself, who currently have mild symptoms and otherwise appear well, to suddenly “fall off the ledge” a week or 10 days into the virus, taking an abrupt turn for the worse and developing severe breathing difficulties.

Now the new protocol, which was introduced by my hospital on New Year’s Eve – and I only found out about it after speaking to my consultant – is to offer pregnant women with coronavirus a course of blood-thinning injections, which you administer yourself daily.

My consultant told me she would order a course of injections, called Fragmin, and get them delivered to me.

A few hours later, I received a call from another maternity doctor at the hospital, who is working with a Covid doctor, who informed me she was ringing all pregnant women with the virus to advise them about having these injections.

I was told that because of my age I am considered more high-risk and that I should take the injections for at least 10 days. I understand that this is the safest course of action but it is not without its risks.

I was told that if I am on blood- thinning medication and go into labour then I have to stop taking the injections.

Also, if the labour is within 24 hours of my last injection then I will not be allowed pain relief that includes a spinal block or epidural because it can cause severe bleeding in the spinal region.

Furthermore, they advised me that if I did have a C-section, it further increases the risk of blood clots, like any surgery, and previous studies have found women who give birth via C-section are four times more likely to develop blood clots.

With this in mind, I am still planning to have a natural birth and I have decided to take the injections for the next 10 days.

But I am mindful of taking them too close to my due date.

During delivery, being on any medication that prevents your blood from clotting can cause you to lose extra blood and I was told that I will potentially have to be given other medication to stop the bleeding.

At the start of the year I was looking forward to giving birth but the latest turn of events has filled me with some trepidation.

The NHS has never been so stretched and at my hospital, which amazingly did manage to squeeze me in for a scan on Friday, 40 percent of maternity staff either have Covid or are self-isolating. It is really so tough right now for them.

And while it’s not about trying to catch anyone out, pregnant women need to be fully armed with the facts so they can make an informed decision and know what their choices are.

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