An agonizing wait for expectant mothers

In August last year, Anu Maharjan got pregnant with her second child. In the midst of the pandemic, the news of a child on the way felt like a new beginning. But just two days later after learning of her pregnancy, Maharjan’s husband started showing symptoms of Covid-19. He got a PCR test done and tested positive. 

Maharjan was devastated. 

“I felt hopeless, I even thought of aborting the child. I was broken,” said the 35-year-old. 

Before taking any further steps, the couple decided to consult with their doctor. Luckily, Maharjan herself tested negative and was told by the doctor that she could still give birth to a healthy child. But nine months later, with her due date in around a week’s time, she is doubtful. 

“I thought that by the time of my baby’s birth, things would have gotten better. But the situation has become worse now,” said Maharjan.

The second wave has exploded, with coronavirus cases sweeping the country. The health care system is on the verge of collapse with an overwhelming number of patients seeking treatment. As Covid-19 patients throng hospitals and clinics, others are being turned away or are themselves reluctant to visit these institutions, afraid of catching the coronavirus. 

There are limited studies on how the coronavirus has impacted vulnerable groups around the world, but according to the World Health Organization, pregnant women are at higher risk of developing severe symptoms after contracting the virus. The public health body further highlights that pregnant women with COVID-19 might be at increased risk of adverse pregnancy outcomes, such as preterm birth.

While the Nepal government had rolled out vaccines to the general population, pregnant women were not advised to inoculate themselves, as studies are limited on the potential risks.

“As the vaccines have not been provided to pregnant women, they are extremely anxious about contracting the virus. It’s different in their case, as it’s a matter of two delicate lives,” said Dr Sushma Lama, an assistant professor at the ‎Patan Academy Of Health Sciences, who specializes in Obstetrics and Gynecology. “The increased risk of Covid-19 and the new variants have also made them more anxious, which is not good.” 

To ease her patients’ stress, Dr Lama has been providing counseling sessions online and through the phone. “I am available to talk to my patients online whenever they need me,” she said. “Of course, it's different from in-person meetings, which is not possible right now, not just because of the lockdown but because the hospitals are high-risk areas of contracting the virus.”

However, many do not have the privilege of accessibility in the first place. 

“One’s privilege, social status, and financial state contribute largely to the type of treatment they receive,” said Anita Prajapati, a mental health professional who is herself seven months pregnant. 

Prajapati did not have access to a supportive doctor who could help her in her time of need. 

“In my case, a doctor, instead of providing related information, used extreme prognosis like ‘baccha khera jancha’, when I had been hospitalized because my sugar levels increased significantly. I personally did not see any kind of empathy from their side, especially when stressors are increasing,” she said.

In response to the surge in Covid cases, a majority of the country’s districts, including the districts of the Kathmandu Valley, have gone into lockdown. The prohibition orders have come as small relief for pregnant women like Maharjan. 

“Even though I am mostly at home, the lockdown has sort-of lowered my fears of contracting the virus, as other family members including my husband are mostly at home now,” she said.

Maharjan’s cesarean is scheduled for later this month. Although she is fortunate that she possesses a car with which to travel to the hospital, she fears a lack of medical supplies like oxygen and proper care at a time when hospitals are overwhelmed with Covid patients. 

A number of hospitals in the valley, including Patan Hospital, Grande Hospital, and Tribhuvan University Teaching Hospital, have prioritized maternal care, despite the given failing healthcare scenario. According to Dr Lama, special consideration will be given to pregnancy cases as they are classified as emergencies.

But for those who do not have access to private transport, even getting to the hospital could be difficult. 

Manju Kasti, a 32-year-old banker, tested positive for coronavirus in late October last year. A month later, she was pregnant, and by then, Covid negative too.

“I was at ease when the lockdown was announced but I still have to go to work twice or thrice a week. And I have to visit my doctor for my check-ups,” said Kasti. 

Kasti is now six-and-a-half months pregnant. Despite her situation, she has been traveling to the hospital and her office on a scooter with her work pass. 

“My doctor told me to ride the scooter at my own risk, but the risks are lower in the second trimester. The only other option is to take the local bus, which is not possible right now,” she said. 

There are unique ways in which wars and crises affect women and other marginalized sections of society. The Covid crisis is one of them, with starkly different effects on people based on their gender, ethnicity, class, etc. 

And although substantial improvements on maternal health have been observed over time in Nepal -- with maternal deaths decreasing from 539 to 239 per 100,000 live births between 1996 and 2016 -- a lot still needs to be done to ensure the health and well-bring of pregnant women, especially in times of crisis. 

 For the time being, the support of their loved ones is all these women have to see themselves through the pandemic.

“Connect with people who listen to you, ask for help if you need it. And if you feel sad, don't deny it, just accept it, acknowledge it,” said Prajapati. “Try structuring your day with simple steps like exercising, taking care of your diet, mindful breathing, meditation, and working on your hobbies. Connect with other pregnant women and share how you feel with them. You are not alone.”