Welcome to the world baby, coronavirus and all

Crushing, mind numbing pain. That is how Julia Nduati would describe what her body was going through at the time. The pain in her pelvis area was excruciating. And at that moment, Julia could have killed to have her sister or her husband with her; if for nothing else to wipe off the beads of sweat on her forehead. Or to rub her back. Heck, she wouldn’t have minded even her worst enemy in the room. She was experiencing the worst pain of her life and she was alone.

Julia was going through labour pains. Her first time going through a natural delivery because with her first child, she had a caesarean section.

When she had checked in at Kenyatta National Hospital, it was with a strong sense of fear.

“I had been going for clinics there but when the coronavirus pandemic struck, we were asked to limit our visits to the hospital antenatal clinics, unless it was an emergency case.”

She was entering the hub where they were fighting one of the worst pandemics of our times. Would she and her baby survive it? She had missed her last few antenatal checks because the doctors had told her to stay away. But here she was. Ready or not, her baby was checking in on that day; April 17th.

As soon as she walked in, she was separated from other patients and a coronavirus test administered. The medics had then ushered her into a room with some instructions. She was not to remove her face mask, leave the room or interact with other patients. She was after all in a medical facility, where many wards away, another group of medics were battling the highly contagious coronavirus.

“There were frequent check-ins by nurses and doctors just to ensure everything was going on smoothly. That did reassure me and put me at ease.”

Later at night, she welcomed her baby girl Davina, and thus began the battle to keep the delicate newborn safe from the chaos surrounding her.

“I still wore my mask. The ward was cleaned about four times a day by cleaners who were all geared to the nines. Even the guys who delivered our meals were in protective gear. New mothers were not allowed to mingle. We all had separate rooms and the place was extremely clean!” she adds.

The baby was kept away from everyone except Julia and the medics who monitored her for the time they were in there. Save for an excessive bleeding complication that was quickly resolved by doctors, things ran with a practised efficiency.

Julia stayed in the hospital for four days and while there, many precautions were taken.

“No one was allowed to visit me and the baby, even my husband. At some point, my husband came by to drop off some items but I did not see him, I just got the package later,” she recalls.

And when it was time to leave the hospital, her husband had to undergo many checks in order to be allowed into the designated waiting spot.

“He needed a gate pass from the security personnel to allow him to come in. He also got temperature checks and went through a disinfection booth,” she says.

It has now been two weeks since Julia left the hospital. She, and her new born are doing great.

When the mother has coronavirus... 

For Patience Muema* things were a lot more complicated. In her last stages of pregnancy, she came into contact with someone who tested positive for the virus. And this worried her to no end.

On admission at KNH, her samples were taken for testing to ascertain her Covid-19 status, but she soon went into labour before the test results were out. It was the baby's time to make its entrance.

In full personal protective equipment, the midwives and the doctors guided her complication-free delivery. But some not so great news was waiting for her. Her test results were positive for coronavirus.

The next challenge was on how to prevent mother to child transmission of the virus while breastfeeding. She was reluctant to breastfeed the baby, fearing that she would infect it but doctors encouraged her to, advising her on the precautions to take to avoid contamination and minimise unnecessary contact.

Breastfeeding precautions needed between positive mum and negative baby

Doctors recommend that mothers confirmed to have the virus should always wear an N95 mask to minimise chances of transmitting the virus to their child while breastfeeding. This is in addition to hand hygiene measures at every point of handling the baby. Health workers attending to pregnant women are also supplied with full PPEs, including N95 face masks for safety, as per WHO guidelines in preventing contact and spread of the virus.

Patience was thereafter transferred to Kenyatta University Teaching and Referral Hospital (KUTRH) to continue with her isolation until the point when she tests negative to be discharged home. 

“We admitted her in her own room to also protect the baby from picking up other infections in the hospital,” said a medic. “Though the baby is fine, the mum is worried about handling, at times in fear of holding the baby because she has the virus.” 

The baby hasn’t yet been tested because it is too young for the kind of swabs available. And they risked getting injured in the process of obtaining samples.

“Mother and baby so far have been stable and doing well, although we are yet to get a negative sample from the mother.”

According to Grace Wang’ombe, the midwife in-charge at the Kenyatta National Hospital these are the three things to expect.

Separation

From the moment a woman going to deliver enters a triage, we cut off the mums from the other patients. This is to ensure they and their unborn children are not exposed to any risks especially now that we are at the forefront of fighting Covid-19.

Fewer vaginal examinations

Midwives do fewer checks to reduce exposure to infections.

We have been trained and we are not afraid. We have a lot at stake on our end because two lives are in our hands, and we have to do what it takes to ensure we protect them.

Limited hospital visits

The hospital has also limited hospital visits by relatives intending to check on their loved ones. We are just being extra cautious and therefore we are not taking any chances when it comes to protecting the babies whose immunity at birth is low. ?