When 26-year-old Leen al-Shurafa found out she was pregnant with her first child on March 11 after two months of trying, she was “over the moon” with happiness.
Just four days later, Lebanon announced a nationwide lockdown in response to the outbreak of coronavirus. Like many of the approximately 125,000 pregnant women in Lebanon, the first thing on Shurafa’s mind was how the global pandemic would affect her and her baby.
“At first, I was calm and thought that by the time my due date came around, the pandemic would have subsided,” Shurafa told Al Arabiya English.
“But now as I am in my third month and with news of a vaccine needing at least one year, I am getting anxious.”
According to the Lebanese Health Ministry’s daily report Friday, 729 people have been infected with COVID-19 in Lebanon, of whom 24 have died.
Global medical research has so far found no evidence that pregnant women are more likely to experience severe coronavirus symptoms than other healthy adults, nor that the virus can be transmitted from mother to baby in the womb, during birth, or through breastfeeding.
Nevertheless, concerns around catching the virus and the possibility of changes to prenatal care schedules has made what is already a stressful time for pregnant women, even more difficult.
“Being pregnant, women automatically become more cautious,” said Dr. Faysal Elkak, a senior Obstetrics and Gynecology physician at the American University of Beirut’s medical center.
“Women are worried about catching the virus without knowing, and many are very anxious.”
Dana Hossein, a 33-year-old who is 29 weeks pregnant with her second child, is due to deliver on July 21.
“I’ve had sleepless nights about my pregnancy,” she said.
To try and alleviate some of pregnant women’s concerns, a group of doctors, midwives and other relevant health professionals came together in March to form the national taskforce on pregnancy and coronavirus.
For Elkak, one of the founding members of the taskforce, it is essential to ensure women are provided with all the information they need in a positive, reassuring, and sensitive way.
“It is unethical to make pregnant women bear an unnecessary burden by making her overly anxious,” he said.
To ensure pregnant and breastfeeding women have access to the necessary information, videos containing tips on how to protect themselves and their babies have been sent out via SMS, aired on all major TV channels, and uploaded to social media. Helplines to answer women’s questions have also been made available.
Pregnant women are encouraged to follow the same precautions as the rest of the population, including reducing contact with others, staying at home and engaging in regular hand-washing practices.
Even if they test positive for coronavirus, women can still have a vaginal birth and breastfeed their baby, as long as they wash hands and wear a protective mask.
However, it was not only the pregnant women themselves who have raised concerns about how to cope during an unprecedented global health crisis.
A lot of unknowns
Many health workers also had questions about the procedures they should be adopting when treating pregnant women during the novel coronavirus outbreak, according to Rima Cheaito, the head of the scientific committee at the Lebanese Order of Midwives.
“Coronavirus is new and information on [how it affects pregnancy] was quite limited,” Cheaito said.
Therefore, part of the national taskforce’s mandate is to monitor COVI-19 in pregnant women, develop healthcare guidelines and conduct relevant training with healthcare professionals.
“We wanted to create a unified language and standard protocols to be adopted nationwide,” Cheaito explained.
Prenatal clinics have been advised to reduce the number of patients in the clinic at one time, space out appointments, including by postponing “non-essential” visits, and screen patients for COVID-19 symptoms before they attend in person.
“They’ve changed a lot at my doctor’s office; you no longer sit in a waiting room, everything is sanitized and they try not to bring you in unless it’s urgent,” Hossein said.
While some countries in Europe and North America have seen a shift toward home births as women worry about delivering in overstretched hospitals where they are exposed to a higher risk of infection, the same trend has not been seen in Lebanon.
“Home birth is not popular in Lebanon anyway, and our recommendation remains that hospitals are the safest place for women to deliver,” Elkak said.
Shurafa considered a home birth, but later decided the risk of being out of hospital in the case of complications during her first pregnancy was one she was not willing to take.
Her main concern now is the prospect of facing labor alone, as hospitals have now limited visitors due to concerns of the spread of the coronavirus – in some cases visitors are banned entirely.
“Labor is already hard enough to think about with the coronavirus,” she said.
Beyond the stresses of changing medical appointments and reconsidering birth plans, Hossein said she was sad to be missing out on some of the less taxing aspects of pregnancy.
“I can’t go out and go shopping for my baby,” she said. “The whole excitement of being pregnant is gone.”