Lagos, Nigeria (Minority Africa) — At 30 weeks pregnant, Esther Adamu is terrified of visiting the hospital for her regular antenatal care. She is also skeptical about having her baby in the hospital as the health facility which should be a safe place might no longer be so.
Her fears are not far-fetched, a number of private hospitals in Lagos, Nigeria have been shut down as a result of exposure to the COVID-19 infection. Other health facilities that are not exposed have shut their doors to patients in a bid to avoid contracting the virus, while they respond to only emergency cases.
Conceivably, Adamu has had to think up an alternative. In this case, maintaining contact with her doctor over the phone.
“My expected delivery date is roughly a month away and I have been in touch with my doctor,” she says. “He has been reassuring me that I have nothing to fear and the baby will be fine.”
For how peculiar this seems, Adamu is, however, not alone. Many pregnant women feel greatly pressured by the uncertainty the coronavirus pandemic has created in its wake.
A lockdown that was announced by Nigeria’s government more than a month ago to curb the spread of COVID-19 in different parts of the country, including Lagos, the epicenter, has amplified the difficulties involved in seeing a doctor even for the periodic medical checkups.
“I have not been going to antenatal clinic since the lockdown started because I am afraid of possible infection, coronavirus no dey show for face,” says Cynthia Nwosu, another pregnant woman who is in the early stage of her second trimester.
“I am just taking my drugs and maintaining personal hygiene because it is better to be safe than sorry.”
As of publication time, Nigeria has reported 4151 confirmed cases of COVID-19 and 128 deaths. While it is one of the countries in Africa with the highest number of COVID-19 cases, its figures pale in comparison to other countries outside of the continent.
Yet for many Nigerians, this global context has done nothing to minimize their fears.
Like Adamu, Nwosu has adopted remote consultation too, but not using phone calls. Nwosu instead communicates with her doctor through the messaging platform, WhatsApp.
“If there is anything I observe, I send a message to [my doctor] right away and he responds to all my questions,” she says.
Maternal health and COVID-19
According to Dr. Adeniyi Afolalu who is a specialist in Family Medicine, there is currently no evidence to show that pregnant women who get COVID-19 are more at risk than other adults.
“Pregnant women are not in any particular danger because of their condition,” he says. “[We] enforce the use of PPE such as masks and gloves by health care workers attending to them [and] we strongly emphasize social distancing between health workers and the women.”
A Harvard Health study of nine pregnant women who were infected with COVID-19 and had symptoms showed that none of their babies was affected by the virus and the virus was not present in the amniotic fluid or breast milk.
In April, a pregnant COVID-19 patient was delivered of a baby by a team of Nigerian doctors at the Lagos University Teaching Hospital (LUTH). The hospital said in a tweet that the “40-year-old mother and 3.3kg baby are doing fine.”
Nigeria has a maternal mortality ratio of about 814 per 100,000 live births and in 2015, the West African country with 58,000 deaths accounted for 19% of global maternal deaths.
Some experts like Dr. Adeolu Olusodo who is a General Practitioner at New Bambo Hospital in Lagos, believes that the fear of COVID-19 shouldn’t supersede the need for vital maternal care.
“It is not advisable for pregnant women to stay away from the hospital because antenatal checkups help to identify and reduce potential risks to you and the baby,” he says.
Dr. Olusodo advises pregnant women to continue to show up for antenatal but employ protective measures including the use of masks and washing their hands.
Others like Dr. Afolalu are instead offering remote care to patients who are afraid to show up at the hospital.
“My personal and hospital numbers are available to my patients,” he tells Minority Africa. “I also have a number of my patients on WhatsApp who can message me whenever the need arises. I try to make myself accessible to my clients so that they can reach me easily.”
“I felt alone”
Nigeria’s government announced the “phased and gradual” lifting of the month-long coronavirus lockdown in its capital, Abuja, and the economic nerve center of the country, Lagos from May 4th.
The President also ordered new nationwide measures against COVID-19, including a night-time curfew and mandatory face masks to allow some economic activities to resume while a ban on social and religious gatherings remains in place.
The news of easing the lockdown has been received with mixed reactions. While a number of people are hopeful that economic activities will gradually kick-off, others worry that lifting the lockdown is premature.
For Nwosu and many other pregnant women, returning to the hospital is still not an option despite the limitations of remote consultation.
“[WhatsApp] cannot be compared to going for the antenatal clinic where the development of the baby will be checked to ensure there is no problem,” she tells Minority Africa.
Adamu equally acknowledges some challenges with phone consultation.
“The downside of consulting with the doctor over the phone is the delay in responding to me,” she says. “His responses are not in real-time.”
Her concerns mirror some of the fears experts have about the growth of telemedicine in Nigeria where weak internet connectivity and high costs of data remain a stumbling block.
Nonetheless, Nigeria’s pregnant women are turning to technology in other ways during the pandemic. Several support groups across WhatsApp and Telegram are helping them stay connected with each other and also offering advice and tips on best practices to stay safe.
Bolatito Idakula is the Founder of Pregnant and Free, a Telegram support group for pregnant women which she describes as, “a safe place for [them] to speak openly about their journeys and encourage each other.”
“Pregnancy has always been a personal challenge for me,” Idakula says referring to her previous pregnancies. “I felt alone and didn’t have others to speak to.”
“I finally decided to do something about it when I got pregnant [again] as I had fears and anxiety I was struggling with at the beginning of the pregnancy,” she adds.
Idakula’s response was to start the group which now has over a hundred members.
She says, “I knew a solution was to create a community where no one felt isolated in their pregnancy.”
This seems to have worked so far. Damilola Phillips, a member of the Pregnant and Free group on Telegram, says the online group has been greatly resourceful.
“I am a first-time mum and I was struggling with fear and anxiety concerning my pregnancy,” Philips says. “My major concern was COVID-19, then I discovered the group. The pregnancy tips and advice shared by other members have been reassuring.”
While Philips says messages on the group can sometimes be overwhelming and correspondingly hard to keep track of, she adds, “It is an exciting place to be and I am grateful for the community.”
This story was published in collaboration with Maternal Figures.
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