Pregnancy and the pandemic.

Pregnant people in Ireland are still being endangered while being treated with disdain during the pandemic in Ireland. I was pregnant during the pandemic, my pregnancy almost exactly corresponded with the emergence of Covid in 2020, and now I have a child. Is that me coming out as a parent? I suppose it is. Being a parent is incredible, and terrifying, and exhausting, and exhilarating, and confusing and overwhelming and joyful and painful and heartwarming and heartbreaking and all those other new parent feelings. But I'm not here to write about that. I am here to write a little about how Ireland is continuing to fail its pregnant people, its new mothers and fathers, and old mothers and fathers for that matter, its parents of all descriptions and those that want to be parents or try to be or almost are but are not. The Irish state has treated all these people very badly during the pandemic, and it continues to do so, endangering their lives and health, and the lives and health of their children, babies and foetuses.

Throughout my own pregnancy in 2020 I was repeatedly told that pregnant women were not at any more risk of catching Covid than anyone else. In addition, doctors talked to me about how there was no research but anecdotal evidence indicated that pregnant women were more likely to have mild or asymptomatic cases of Covid. And I was told that Covid possibly couldn't ever and certainly didn't usually affect the baby, or the foetus, depending on what you want to call the human being growing inside a pregnant person, and at what point you wish to give it what title. Of these three things communicated to me by various medical professionals at multiple points during my own pregnancy, the first is largely irrelevant, the second is untrue, misleading and wilfully ignorant of what the research did show, and the third is false, dangerous and has had horrific consequences for many women and their pregnancies over the past two years in this country. These dangerous untruths were peddled not just to me but to many other pregnant women and those considering getting pregnant, and they formed part of an overall approach by government and health services that often treated pregnant people and their partners with dangerous disrespect or callous disregard in relation to Covid.

Unsurprisingly, this attitude from health authorities since the start of the pandemic is continuing to reverberate with awful impacts now, particularly influencing low rates of vaccination among pregnant people and their partners, and relatively high rates of serious illness and admission to ICU. This is an injustice, and an unfolding, avoidable tragedy. It's not too late to change. Those links are just from the past week in October 2021. Change is vital now to protect the health and lives of the 50-70,000 people who will give birth this year in Ireland, and the same number next year, and the unknown, much higher number who will be pregnant during this pandemic but will not ultimately give birth to a living baby. This is getting some, but wildly insufficient attention, it should be headline news over and over again. The state is failing huge numbers of adults and huge numbers of babies before their lives have even properly begun.

Of the three wrong things I was told, the first is largely irrelevant. It does appear that pregnant women are no more likely to catch Covid than women their age who are not pregnant. In other words, pregnancy does not seem to increase a person's vulnerability to becoming infected with Covid-19 if they are exposed to the virus. That's all very well, but I would say that this is not the primary concern for pregnant people. And in a situation like now, where cases are soaring, reaching almost 3000 a day yesterday, the likelihood of exposure and infection has increased hugely for everyone, and thus, risk has increased just as much for pregnant women. When I was pregnant I was very concerned about becoming infected with Covid, and went to considerable lengths to protect myself and my pregnancy and to reduce my risk. I think most pregnant people feel the same, and act accordingly. This is because I and, I believe, most other pregnant people, are not focussed on whether they have a higher or lower risk of being infected than their non-pregnant colleague or neighbour, but instead are primarily concerned about the consequences if they do get infected.

This leads us to the second, much more dangerous untruth that I was repeatedly told. It is not the case that pregnant women tend to get milder cases of Covid. It is not the case that we don't have any evidence about this or that new research has only emerged recently, and wasn't available in 2020. Instead, the research has shown since early in the pandemic that pregnant women are more likely to have more serious cases of Covid and are more likely to require hospitalisation if infected, than people who are not pregnant. This is important and crucial information to impart to pregnant women and that they need to have to protect themselves and to make decisions about their risks and about the supports that they need. It would also be important information for anyone considering trying to conceive. It would also strongly suggest that pregnant people should be treated as a more at-risk group in public health terms, both entitled and advised to take additional precautions regarding Covid. But that is not how they have been informed, treated or supported in Ireland throughout the pandemic.

Pregnant women were not listed as a more vulnerable group. Bizarrely, people travelling into Ireland from another country who might have increased Covid risk were advised by the government not to have direct contact with pregnant women. So there was some recognition of the danger. But the government advice for the general population in Ireland and for pregnant women themselves did not say that they were more vulnerable and did not advise any additional caution in terms of contact with positive Covid cases. This disregard borders on the negligent.

At the same time, pregnant women being vulnerable was given as the reason that draconian restrictions were imposed on them and their partners during their maternity care, with partners not allowed into maternity units or hospitals until shortly before the birth, and in some cases refused entry even during labour. I have written a little about this; having recently come through my pregnancy, alone without my partner, the baby's father, every time in the hospital for nine months until just a couple of hours before I gave birth, it is still so painful for me to think about that I cannot yet write more fully about this experience. And we were lucky to have good news throughout the pregnancy scans and tests and to have a 'good' labour. Other have written more about the terrible impacts of these illogical, non-scientific and traumatic restrictions during antenatal healthcare. This is the disrespect faced by pregnant women, their partners, families and loved ones. Despite this appalling attitude from healthcare authorities when it came to restricting the behaviour and choices of pregnant women, partners, fathers and others, pregnant people were not prioritised for any protections, testing, entitlement to work from home, or for vaccinations once they became available. They were just expected to get in line like everyone else, despite the greater risk of serious illness for them. As recently as August 2021, unvaccinated pregnant teachers talked of their fear and anxiety about being expected to return to work and to full contact with young children in their classes.

The third untruth I and others have been told is that Covid possibly could not and certainly wouldn't usually have any impact on the pregnancy or baby. This is not true and it has been known to be false for a long time. For the pregnant woman, becoming infected with Covid increases the likelihood of pre-term birth and may increase the likelihood of other pregnancy complications. Most terribly, it increases the risk of stillbirth. This was borne out tragically in Ireland in 2021 where Covid placentitis caused six stillbirths and a second-trimester miscarriage. These are awful losses for the all the parents concerned. Considering there are around 200 stillbirths every year in Ireland, this represents around 3% of all of these deaths in the country in 2021. That is huge. Presumably it is an additional 3%, that would not have happened without Covid. Yet this terrible outcome and proportionally large impact got very little media attention, and the health authorities talked about how rare and surprising this was. Not how avoidable and tragic it was. This is so upsetting that I still find it difficult to discuss, and it is something that every pregnant person lives in (usually silent) fear of. But we need to talk about it, and most importantly, we need action to prevent this. This is not even a small risk of a terrible outcome. It is a relatively large and significant risk of what many would feel is the worst possible outcome for a pregnancy. And we don't even know about other impacts outside of Covid placentitis, or earlier losses or undetected illness. This needs to change.

There's a lot more to say. But I need to go and care for my baby. Tens of thousands of other parents need to do the same tonight, during and despite this pandemic. Tens of thousands of other people today need to care for themselves and their pregnancy or their pregnant partner, while navigating Covid. We need to talk more, respect more, support more, and do more for all of them.