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Pregnant & on the Coronavirus Frontline
Frontline NHS doctor Meenal Viz reflects on a momentous year – in which she gave birth to her first child and took on the Government over its lack of protection for healthcare workers during the COVID-19 pandemic
“If it gets worse, I’ll have to take you in with me.”
My husband, then a doctor in obstetrics, was very much au fait with patients like myself. My first pregnancy was already far rougher than I had anticipated. The vomiting was excruciating, to the extent that I would often have to pull over on my drive to work. As a doctor, I was reluctant to ever take time off work. I didn’t want my pregnancy to make me appear weaker. But, after having been sent home during a ward round, I realised I was in for a tough time.
So I convalesced at home, as my bump began to show. I had plenty of time to mull over my future. I had visions of our first visit with my husband to the sonographer to find out whether we’d be having a boy or a girl. I had visions of my own mother being a birthing partner and being able to share in the joy of seeing her first grandchild. I was entertaining thoughts of a baby shower. I was in a state of constant pre-embarrassment, knowing that my goofy husband would joke around during antenatal classes.
As I waited for my nausea to improve while just about hydrating on an unpalatable cocktail of ginger juice and anti-sickness pills, I imagined returning to work with a visibly bigger bump. I imagined how I might be of use in emergency situations, knowing that my pace would have slowed right down. I was worried that I would be far too exhausted.
Towards the end of January, my sickness subsided and I returned to work. Cabin fever had overtaken nausea as my primary concern and I was desperate to help my patients and see my brilliant colleagues once again.
I was blissful to the fact that I would soon be at the eye of a storm.
The Virus Arrives
Was that a kick? I definitely felt the kick. As I placed my hand over my tummy, the kicks became stronger; rhythmical punches and kicks which would wake me through the night, a constant reminder that I was now host to a baby for whom I was totally responsible. Every time there was a jolt of momentary discomfort, I felt like my baby was checking in to tell me she was okay.
As I continued working into February, my husband would return from his own night shifts and tell me stories of unusual cases in Accident & Emergency, where he was now stationed. The Coronavirus had hit China hard, but it still felt like another world away. I was trying to arrange a gazebo and catering for my baby shower and felt that nothing could ever happen to me. Not in this country, not on these shores.
As a precaution, I had asked for a risk assessment from my hospital. I was worried that I would be put into a high-risk situation with an unknown virus and wanted reassurance that I would be protected. At the same time, my pregnant colleagues started to take sick leave due to stress, deeply concerned about the potential ramifications of coming into contact with COVID-19.
As March arrived, I started to see a steady stream of patients with presumed Coronavirus. I was six months pregnant and working 12-hour shifts, in a hyper-anxious state, with variable access to masks. There was a general state of denial throughout the hospital but, as the tsunami crossed Asia and hit Italy, then Spain, then France, it seemed inevitable that we would be impacted. Worryingly, there was no data and little guidance regarding pregnant women, until Boris Johnson announced on 16 March that we should be ‘shielding’.
He would receive menacing phone calls from communications managers at his hospital – who were monitoring his Twitter account during a pandemic.
But there was no guidance at all for pregnant healthcare workers, and so our fate was left to the discretion of our managers. Responses were variable throughout the country – some pregnant healthcare workers were given the chance to carry out research from home, whereas other frontline pregnant workers were arm-twisted into continuing in their existing roles.
I was deeply concerned to learn of these disparities and that there was no uniform guidance for pregnant workers already in a state of anxiety. It resulted in many of these women taking indefinite sick leave due to stress.
It became apparent that my antenatal classes would never happen. My husband would escort me to the maternity building at his hospital, I would wear my mask, he would kiss me on the cheek, point at my belly, shrug his shoulders and dutifully wait outside. When the sonographer did my scan, I looked to my side and my husband wasn’t there to share my joy with me. It’s impossible to describe the emotion of seeing your baby during an ultrasound scan. It should be a tender, lifelong memory shared by the mother and her partner.
All the while, the situation with personal protective equipment (PPE) was scandalous for those of us working on the frontline – and this only raised more issues for pregnant workers. There was so little data available that it seemed sensible to apply the precautionary principle and keep us in relatively safe environments. I had repeatedly attempted to escalate my own concerns, but I was not heard.
Taking A Stand
When Mary Agyapong, a 27-year-old nurse, died of the Coronavirus shortly after delivering her baby, I was distraught. She worked and died at the same hospital that I was planning to deliver my baby. She lived down the road from us. I later learnt that black pregnant women are five times more likely to die during childbirth in this country, and that black and ethnic minority healthcare workers were more likely to contract and then die from COVID-19.
I started to reflect on the reasons for these disparities, pondering why issues such as structural racism weren’t being acknowledged, let alone addressed. I decided to take my one-woman protest to Downing Street – a decision that turned my quiet and calm life definitively in the opposite direction.
On a Sunday morning in April, I waddled down Whitehall, carrying my sign, and planted myself in front of the Downing Street gates. My knees tired, but every time I thought about calling it a day, I felt a timely kick to spur me on. In my XXL scrub top, it was hard to tell that I was heavily pregnant as I held a silent vigil outside to honour the memory of Nurse Mary.
We later felt it important to attend her funeral, which was held in a socially distant manner. Everyone was wearing a mask. The sharing of grief is part of the healing process, but this was different. Nobody could even attempt to console the grieving family of a young nurse with a hug or an arm around the shoulder.
A few weeks earlier, my husband had spoken up about the lack of protection our Government had provided and he was concerned about losing his job as a hospital doctor. On the rare occasion we had a day to ourselves, he would receive menacing phone calls from communications managers at his hospital – who were monitoring his Twitter account during a pandemic. They were dangerously and wilfully detached from reality, actively trying to harm those of us who were trying to help. While it felt like the public were supporting healthcare workers, there was certainly a movement within the NHS to suppress us.
We remained undeterred. This meant that rather than spending our evenings going through our baby checklist, we would plan how we could financially secure our future with a newborn along the way. We were planning for either, or both of us, to be sacked from our jobs.
Radhika Arrives
As my due date neared, I was considering taking early maternity leave as I remained deeply concerned about the lack of protection for pregnant healthcare workers. Eventually, through extensive campaigning and lobbying, the Government belatedly recommended that all pregnant women in their final trimester should work from home where possible.
Due to infection control precautions, I had been told that, if I were to proceed with a natural birth, I would only be allowed support from a birthing partner if I went into “deep labour”. Due to ambiguity on this – and coupled with my concerns over Mary’s death and black and ethnic minority disparities – I was deeply worried that I would be left alone, in pain. As a result, I opted for a caesarean birth at the last minute.
The day itself was bizarre. My husband dropped me off to hospital for pre-operation checks and I was in a room full of fellow women who were all in various stages of labour. Most of us were alone, without a birthing partner.
My husband was then allowed to come and see me just as I was to enter the operating theatre. He was wearing a mask throughout the operation, so I couldn’t read his expression at all. No matter how brilliant the hospital staff were, it felt tense and sterile. I just wanted the baby out, so I could hug her, hold her and never let go.
Thankfully, the operation was quick and smooth, and the staff were truly brilliant – the midwives, nurses and obstetricians. We joked that it was entirely appropriate that our baby Radhika was born on Bastille Day. My husband was allowed to stay with me for exactly one hour after the birth and escorted me to the recovery ward, but he wasn’t allowed inside. He kissed our daughter goodbye and tried to reassure me that we’d be together again soon.
The two midwives both shed a tear, to which my husband deadpanned: “What, haven’t you ever seen a baby before?”
I was in the recovery ward for two days, receiving excellent care, but alone with my daughter. Radhika’s grandparents wouldn’t see her until much later on. My husband would have to wait another two days to see us again. But, I’m one of the lucky ones.
As a doctor, I feel like I had some degree of knowledge about how to navigate the hospital. But, my fellow patients in the recovery ward were not in the same position – many of them did not speak or understand much English and so I served as a makeshift, socially distant translator. They had no agency and were terrified. They needed someone familiar by their side.
Months later, I still suffer from a sense of survivor’s guilt, knowing that I made it and that Mary didn’t. I carry her memory with me everywhere I go and remain determined to seek justice for Mary, her husband and her two children.