TORONTO — After months of diligently following every piece of public health advice she heard, a 33-year-old Toronto social worker had her worst fears come true when she tested positive for COVID-19 only a few weeks before she was set to give birth to her second child.
Within days, Megan was in the ICU, fighting not only for her own life, but her child’s.
Now in recovery from her harrowing ordeal, she still wanted to share her story to alert others who are pregnant of the risks that come with contracting COVID-19, and the need to consider vaccination during pregnancy.
“I don’t want any other woman to have to go through what I went through and experience the trauma that I’ve had,” Megan, who asked to be identified by her first name only, told CTV News.
Canadian data shows pregnant women are five times more likely to get infected and hospitalized than women who aren’t pregnant, likely because of the hormonal changes that come with pregnancy.
But since pregnant women were not originally included in the phase three trials run by vaccine-makers, many have been unsure whether to take the vaccine while pregnant.
Megan, who contracted the virus when she was more than eight months pregnant, still has no idea how she became infected.
She does work in health care, but worked mostly from home, only attending her work in-person one day a week.
“We don’t go into stores, we do everything online, we do grocery pickup,” she told CTV News. “I am extremely, diligently careful. I do everything virtually, I wash my hands incessantly. I am super, super careful, so I really don’t know.”
When she began to feel an extreme fatigue in March, at first she thought it was just the late stage of her pregnancy causing the feeling. Then she developed a cough.
She went to get tested, and when the results came back positive, she “was in complete and utter shock.
“I felt almost like, ‘oh my God, I [got] a plague,’,” she said. “I’ve managed to escape this for an entire year, and I’m like a few weeks out from delivering a baby, and I’m COVID positive.”
Her condition quickly worsened, as she developed double pneumonia caused by COVID-19.
Tests showed she had the variant that first emerged in South Africa. She pushed for a discharge from the hospital, sure she could manage her condition at home, but soon she was back.
It wasn’t long before she was so sick doctors were considering putting her on a ventilator.
“I didn’t know what was gonna happen to me,” Megan said, growing emotional. “I didn’t know what was gonna happen to the baby. It was, I couldn’t speak to anybody, I was completely alone.”
While she may have felt alone, she wasn’t the only pregnant woman who was going through this struggle.
“[The doctors] said that they have seen more pregnant women coming in with COVID and being severely ill in the last month than they’ve seen in the entire year of COVID, and a lot of it has to do with these variants going around,” Megan said.
Sources report that there are currently five pregnant women in one Toronto ICU, making up over 20 per cent of the unit’s beds.
Doctors estimate that over 4,000 pregnant women have become infected with COVID-19 in Canada. There have been around 1,133 hospitalizations because of severe COVID-19 since March 2020, and around 66 of those patients ended up in ICUs.
Recent numbers may be even higher, doctors say.
Dr. Jon Barrett, chair of obstetrics and gynecology at McMaster University in Hamilton, has two such patients in the ICU right now.
“The pregnancy is the key risk factor. The ones that I’ve seen recently had no other identifiable risk factors,” he said. “And I think that’s probably a bit different from the earlier waves, [where] we often had an underlying additional risk factor to the pregnancy, but now it’s just the fact that you’re pregnant is the risk factor.”
“And from our data now, which we’ve been collecting more and more, it’s very clear that pregnant women are at increased risk of ending up in hospital and ending up in intensive care.”
Pregnancy complicates the health-care response, because there are two patients who require attention, Barrett explained.
In several cases he’s seen, doctors have had to perform emergency C-sections to save the infant and the mother. One of his patients had to have a C-section this week at just shy of seven months pregnant.
When Megan was in the hospital battling COVID-19, she said she was desperately hoping that there would be no surprises with her pregnancy.
“I was just praying to God that the baby would stay safe and that I would get home and that I would be able to stick to the plan that I had made,” she said. “You know, we make a plan, and God laughs.”
She went into labour in the intensive care unit, still hooked up to oxygen machines and running a high fever.
“I couldn’t eat or drink anything in case I was going to be taken to the operating room,” she said. “They had no idea how my labor was going to progress. I was in total and utter agony.”
In the chaos of the COVID-19 ICU, nurses held her hand while contractions wracked through her body.
Another complication was that doctors hadn’t been sure whether or not to give her certain medications that would help with her illness because of potential toxicity to her baby.
“They gave it to me when I was going into labour, because […] I was crashing,” she said. “They had X-rayed me again and saw that the pneumonia was spreading even more, and they decided the benefits of giving me the medications outweigh the risks because I was so, so sick.”
The increase in pregnant people falling severely ill with COVID-19 is down to a few things, Barrett said. The variants circulating now are more easily transmissible, meaning that even people who follow the health recommendations closely — those concerned about staying safe due to a pregnancy, for example —can contract the virus. Younger people are also contracting the virus more, and that is a cohort more likely to be pregnant.
“When we first started the pandemic, it didn’t seem as the pregnancy was an increased risk and then report[s] started coming out from other countries,” Barrett said. “It became very clear that pregnancy was an additional risk factor.”
Dr. Deborah Money, a professor of obstetrics and gynaecology at the University of British Columbia, told CTV News that doctors are finding that “pregnant women have more chance of hospitalization and ICU admission than […] the non-pregnant women of the same age group.”
Because of the lack of data surrounding vaccines and pregnant people, caution ruled the day at first. Initially, pregnant people were not recommended to receive the vaccine.
While the rules have shifted, and pregnant people are encouraged to receive the vaccine, and have been earmarked for prioritization in Ontario’s phase two of the rollout, the public perception may not have shifted, doctors fear.
“I think there’s a lot of concern in general with pregnant women […] about picking any medication or taking any vaccine,” Money said. “We’ve hopefully been moving that dial with the common advice around [the] vaccine and pregnancy.”
Pfizer announced earlier this year that they would be running clinical trials of their vaccine in pregnant women. Canadian guidelines suggest pregnant women consider vaccination in the second and third trimester, with Megan’s story an apt warning.
“We hope that women are realizing that that vaccine in pregnancy is actually a benefit to them and in many cases of benefit to their infant,” Money told CTV News.
“I think these kind of personal stories make it seem more real to people.”
Megan made it safely through her labour, with baby Jonah eventually being delivered through C-section. But the experience was traumatizing.
“They put him to my face for literally a split second,” she said. “And took him away, and I wasn’t able to see him for another 10 days after he was born. That was a whole other level of trauma.”
She had to be treated aggressively with steroids to help her recover from the birth without going on ventilation. But after another week at the hospital, she was finally able to go home with her baby, where she remains on the mend.
“I still have residual symptoms from COVID that I’m working through, but I’m far better off than I was last week,” she said.
She’s still taking blood thinners to prevent blood clots, and has a lingering cough. She said if she had been eligible to take the vaccine before this ordeal, it could have changed things.
“Because I wasn’t patient-facing, I wasn’t in the eligible category yet,” she said. “And because I was so close to delivery, some of my doctors said, ‘just hold off, your risk level is low.’ And I literally had like one more day to go into the hospital for work, and in that time I got it.”
She wants other pregnant women to know that if they have the chance to receive a vaccine, they should not hold back out of fear — because getting COVID-19 while pregnant is an experience she would not repeat.
“I would not hesitate to take it pregnant,” she said. “And I wouldn’t even question it. Any of the vaccines are approved, I encourage all pregnant women, son’t think about it, take the vaccine, it’s safe. It’ll help [so] you don’t go through what I went through.”
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