This country has a long history of treating pregnant women and girls appallingly; the pandemic should not be an excuse to continue to do the same, writes Seána Glennon.
IN A SHOCK announcement at the National Public Health Emergency Team (NPHET) briefing on Thursday evening, the Deputy Chief Medical Officer Dr Ronan Glynn reported the occurrence of a cluster of four recent stillbirths in Ireland among pregnant women with Covid-19.1
Inquests and further investigations have yet to occur. Health officials were clear that these were preliminary reports that the stillbirths could potentially be associated with a Covid-19 complication known as Covid Placentitis.
This sad news prompts us to take a step back and look carefully at how pregnant people have been treated in this country since the advent of the pandemic.
For most of last year, partners of pregnant women were excluded from attending hospital appointments due to the Covid-19 restrictions. Hundreds of expectant parents wrote to the Minister for Health to protest the inhumanity of this set of circumstances, many describing their experiences of learning of a miscarriage alone or their fears of being forced to go through labour with no support.
In response to this outcry, the HSE conceded that partners of pregnant women would be permitted to attend their 20-week scan, as well as surgical interventions.
In January, however, some maternity hospitals including the Coombe, the Rotunda, Cork University Maternity Hospital and University Maternity Hospital Limerick have reintroduced these same restrictions, again barring partners from important scans.
The draconian nature of these restrictions, and the ad hoc manner by which they are enforced in some hospitals and not others, is a source of great anxiety for expectant parents, women especially.
Early pregnancy is something that we do not talk about widely in our society.
Even where a pregnancy is planned, it can be a lonely and difficult time for women who are experiencing huge physical changes and worrying about the possibility of losing the pregnancy.
The convention is that most women do not tell their families, friends and colleagues about their pregnancy until after 12 weeks, at least, when the risk of miscarriage has reduced.
This means that there is little in the way of a support network for many people at this early stage, other than their partners. For partners, then, to be excluded from important early scans and appointments, is a grave measure.
I am currently in my 12th week of pregnancy. Like many women in the first trimester, I am experiencing extreme fatigue and often debilitating nausea. I attended my first scan alone, in the National Maternity Hospital, with my husband sitting in the car outside.
I am very grateful that my scan showed a strong foetal heartbeat and a healthy pregnancy; I wish that I had not had to experience the dread of attending the appointment alone and I cannot imagine how it would have felt to receive bad news, on my own, that day.
Many women throughout the pandemic have had that very experience. Of course, the country is experiencing a surge in the virus, and restrictions are necessary.
The restrictions imposed on pregnant women, however, are disproportionate and unfair, and it is unclear whether concrete evidence exists that the exclusion of partners from these very important hospital appointments is a proportionate and necessary measure to curb transmission. This is especially the case given that most healthcare workers have now been vaccinated.
Surely it is time for a consistent and proportionate policy to be implemented across all the country’s maternity hospitals, so that pregnant women know what to expect and can plan accordingly?
Meanwhile, pregnant women languish at the end of the vaccine list.
On Friday, the master of the Rotunda Professor Fergal Malone said that “putting them at the end of the queue is not a good thing”.
There are international studies showing that pregnant women with Covid-19 may be at higher risk of serious complications, hospitalisation and death from the virus than non-pregnant women of the same age.
The HSE has in recent weeks issued guidelines to state that pregnant women with certain medical conditions or working in the healthcare sector may be included in those respective groups in the roll-out order.
All other pregnant women, who are not frontline healthcare workers or high risk for another medical reason, remain in the last category, despite arguably constituting a high risk group by virtue of being pregnant.
The latest news makes that position all the more stark.
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The alerts issued by the HSE and NPHET warning of Covid Placentitis have not been accompanied by any undertaking to reassess the priority to be afforded to pregnant women in the vaccine roll-out.
The allocation of last place for pregnant women, coupled with the lack of any promise to reassess this in light of this news, is evidence of this category of citizen being considered as an afterthought throughout the pandemic.
Pregnant women are not a static group and given the gender disparity in the Dáil, they often appear to be overlooked.
It is unsurprising that the perspectives of women in this context fail to be meaningfully taken into account in circumstances where, for instance, there is no female representation on the Cabinet Covid-19 Committee or the Cabinet Health Committee.
Gender inclusion in these decision-making forums matters; our life experience impacts how we perceive the world, and women’s experience of these issues inevitably differs to men’s.
In short: the vaccine roll-out order must be re-examined. The restrictions on partner support at hospital appointments at which potentially devastating news may be received need to be reassessed. Finally, changes need to be made in the key decision-making bodies, including the Cabinet Covid Committee, to ensure that women are properly represented and have their interests taken into account.
This country has a long history of treating pregnant women and girls appallingly; the pandemic should not be an excuse to continue to do the same.
It is clear that those within the key (male-dominated) decision-making forums are not going to speak up for the rights and interests of pregnant people; as such, it is incumbent upon us to do so ourselves, and to demand to be listened to.
Seána Glennon is a PhD candidate at the School of Law in UCD, recipient of the 2019 UCD Sutherland School of Law doctoral scholarship and an Irish and English qualified solicitor.