For pregnant women in Nigeria, COVID-19 presents additional healthcare burden

When Amarachi Moses announced to her husband that they were expecting their first baby soon, their joy knew no bounds.

Eight weeks into pregnancy, Ms Moses began her antenatal sessions.

For Ms Moses, the sessions were worth looking forward to. “I enjoy(ed) every moment with other women in the hospital. We played and engaged ourselves in other activities,” she told PREMIUM TIMES.

But a few months later, the coronavirus pandemic hit Nigeria, first subtly, then hard.

This heightened her anxiety of giving birth in the time of a pandemic. Not only this, all the plans she had seemed to have been blown away.

“Nobody was expecting this,” she said.

For her, when Nigeria’s index of the COVID – 19 was reported in Lagos, life was still business as usual, until the antenatal sessions were halted so the women could practise physical distancing.

At the Kubwa general hospital in Abuja where Ms Moses had her antenatal sessions, pregnant women were told to stop coming for the weekly routine sessions and to only come when they had complications.

“I registered at the general hospital in Kubwa and they said that anybody that does not have a case for now should just stay at home till when they are due,” she told PREMIUM TIMES.

This decision was to minimise the risk of the transmission of the infection by the women.

The Federal Capital Territory is the fourth hardest-hit state in Nigeria with health workers scurrying to keep the curve flattened.

This leaves many expectant mothers like Ms Moses without any option but to look for new ways to stay healthy.

Now at home due to the lockdown, she said she can only do some prenatal workouts with her husband.

“There is no antenatal, I just stay at home and do some workouts with my husband. And sometimes, I take a walk around my house,” she said.

When asked if the hospital provided any alternative measures, she said “none for now”.

But she is optimistic that her baby will arrive well “with or without the pandemic and things will work out fine.”

“I have no fear. I believe in God and he will put me through,” she said.

Irregular antenatal sessions

Fatima Musa, another pregnant woman, says her only fear is how she would cope during her third trimester.

She says often a fever could cause her to panic and wonder about the movement of the child in her womb.

According to her, once she observes this, she tries to keep calm and inform her doctor about it.

But she added that,most times, she “feels healthy and does not have any reason to visit the hospital since antenatal had stopped at the University Teaching Hospital Zaria due to the lockdown in Kaduna.”

Another Lagos-based expectant mother, Olayinka Kolawole, told PREMIUM TIMES that she still goes for antenatal sessions in the hospital, “although this is different from the usual antenatal.”

Ms Kolawale said the antenatal sessions at Christ Apostolic Church Hospital is “conducted in a different way”.

She said at the hospital in Lagos, “social (physical) distancing and other preventive measures are being observed but only a limited number of persons see the doctor at a time”.

“We don’t hold social gathering where we sing and do some workouts as part of prenatal exercise. What we do is that selected persons get to see the doctor at a time,” she said.

Another, Elizabeth Ayo, told this reporter that the first three weeks of the lockdown “were unprecedented and quite challenging for her as she had to deal with the new lifestyle.”

Antenatal sessions at Cedacrest Hospital, a private hospital in Abuja where she registered with, were not held during those weeks. She said staying indoors was boring.

When she was told antenatal sessions had resumed, she was elated.

“My hospital made a plan for us to come Monday and Wednesday 10 a.m. to 2 p.m. The hospital is always almost empty.

“There is a system they use for booking appointment with the doctors: our bio-data are ‘arranged’ and (we are) connected to doctors who would indicate that it is each person’s turn for the regular check up.

“From there, they prescribe drugs or tell you the next step on what to take,” she said.

Ms Ayo said that women who are almost due come for the check-up every week while those who are less than 25 weeks visit at four-week intervals.

“There, you get to talk to the doctor on phone. So, you can call him, tell him whatever you are feeling, he tells you what to do and what not to do.

“Normally, when I go for my antenatal, they usually take my urine sample but the last time they didn’t take my urine sample because the lab is closed,” she added.

Panic mode activated

For post-natal mothers like Ijeoma Owecha who had her baby at the Nigerian Air Force (NAF) hospital, Abuja, before the lockdown commenced, the tale is similar.

When she learnt that an isolation centre will be built beside the hospital, she asked to be discharged.

“I was afraid of coming into contact with COVID-19 patients, though the hospital management might have found a way to control the situation. I just couldn’t bear it and I did it out of concern for my baby,” she said.

The World Health Organisation has warned that the transmission of the virus from a pregnant mother to the newborn is probable.

She said her panic made her forget to keep close contact with doctors there.

“As at when I was discharged, I didn’t have any personal contact with a doctor,” she said. “There was this nurse who we got her number then my mum called her sometimes to keep tabs on me. But as per contact with a doctor, it’s a NO.”

She said since the pandemic started, she has resorted to attending a primary healthcare facility at Area 2, Garki beside the National Library for medical check-up.

She later had her baby at the NAF hospital.

The women also lamented the hike in the prices of baby products and the possibility of being infected while purchasing them.

“I just picked few small things, though I still need some things. I can’t go to the market because of rowdiness and fear of contracting the disease,” Ms Moses said.

Asides this, she said there is a hike in the prices of these commodities “if purchased from local stores on the street”.

Ms Musa said she was lucky to have purchased some items before the lockdown began.

She said markets in Kaduna State have been partially open “which makes things easier for her”.

She also complained about the hike in prices of baby items in the market. Ms Kolawole said she is still unable to purchase the necessary things because of the increase in prices.

“The last time I went to market, I went with N20,000 and I could not buy anything (all I needed) in the market,” she said.

Ms Ayo is worried about getting baby items now “because of the rush, one might end up doing impulse buying and might not buy what one needs.”

“If one buys out of fear of not getting it, one may spend more and eventually may not buy everything. But we wil survive,” she said.

‘Protect these women’

A gynaecologist, Oliver Ezechi, said protecting pregnant women during the age of the pandemic is important.

He told PREMIUM TIMES the Society of Obstetrics and Gynecology of Nigeria recently brought out a guildeline on the management of pregnant women during the pandemic.

“Their movement is not restricted. (But) It will no longer be antenatal as usual where they gather in one place. Now, it’s now on appointment,” he said. “When you get to the hospital, you see the doctor and leave. This is because of social distancing. The day you have appointment, you come, see the doctor and go.”