In late August, a 38-year-old woman with COVID-19 in Okinawa Prefecture gave birth prematurely, just 24 weeks into pregnancy — a 29.3-centimeter baby weighing only 580 grams.
“I’m sorry for giving birth to such a tiny you,” the woman, who asked not to be named, repeatedly murmured into a smartphone. She could only see her baby through the device, as the newborn was being treated in a neonatal intensive care unit.
When an expectant mother is infected with the coronavirus, the risk of having the baby prematurely increases. And with more pregnant women contracting the virus in Okinawa Prefecture, the woman hopes none of them will ever experience what she went through.
It was just after 10 a.m. on Aug. 28 when she felt something wrong in her abdomen. She felt a cramp and what appeared to be contractions, just like when she had her first child.
But her due date was in mid-December. “It’s too early,” she thought, scared.
Around 3 p.m., she contacted her physician after her water broke and was rushed to University of the Ryukyus Hospital. She cried in the ambulance, thinking of the worst-case scenario.
At 7:30 p.m, the baby was born, surviving the labor, but did not cry. Four hours later, she met her baby boy — hooked up to many machines — for the first time, via smartphone.
“He was so shockingly tiny that I couldn’t look at him. I was filled with regret and had no words to describe it,” she said.
Keiko Mekaru, a doctor who treated the woman at the University of Ryukyus Hospital, said they wouldn’t have been save the baby if the mother had come the hospital much later.
How did it all come about?
Rewinding several weeks, it was a string of incidents that led to the ordeal, which occurred against a backdrop of rising COVID-19 cases in Okinawa Prefecture.
When her husband developed a fever on the night of Aug. 13, he called several hospital emergency rooms, only to be told that he needed to call the public health center first. When he did call the public health center, he was told he couldn’t get tested for COVID-19 if he had not been in close contact with a person who had tested positive.
The man’s employer told him to pay from his own pocket for an antigen test, which came back negative — twice. He was prescribed antibiotics by a local clinic on Aug. 16 but he still had a fever of 40 degrees Celsius.
Suspecting that her husband had COVID-19, the woman, who wasn’t vaccinated yet, tried to stay away from him as much as possible at home.
“I had to take care of my husband while being worried that I might get infected,” she recalled.
When her husband finally tested positive at a local clinic, it was six days after he first developed a fever, on Aug. 19. But even then, he was forced to recuperate at home instead of being admitted to a hospital or repurposed hotel.
Even when their teenage son tested positive on Aug. 23, the public health center told the family to self-isolate for two weeks at home. The woman was told to skip regular health checkups for expecting mothers for the time being.
It was about two weeks after her husband developed a fever that the woman’s water broke. She tested positive on the way to the hospital with a 38-degree fever.
After she gave birth, the doctor in charge told her there was a chance that her child was born prematurely because she was infected with the virus. “But I can’t say for certain,” the doctor said.
For 10 days, she was not able to meet her family and had to recover alone in a coronavirus ward. Her doctor told her that her son may have complications and it was unclear whether he would survive the coming three months.
“We’ll go through this together, one day at a time,” the doctor said.
She was mentally devastated and experienced hyperventilation because she was crying all the time by herself in the hospital. Her newborn son was able to take in 3 milliliters of breast milk at each feeding time, but she was only able to pump out 1 to 2 ml at a time.
In August, headlines were made when an expecting mother infected with the virus gave birth to a baby prematurely at home — at 29 weeks — because hospital beds were not immediately available. The baby later died.
The woman in Okinawa Prefecture is grateful that she was admitted to a hospital, which saved the life of her son, who was small enough to fit in her palm. But she can’t erase the feeling that this all could have been avoided.
“If my husband had been tested earlier, if he was able to be quarantined somewhere else, if women who have had close contact with a COVID-19 patient were allowed to get the health checkups for pregnant women,” she said. “If there wasn’t a coronavirus pandemic.”
Her thoughts go round in circles. But in the end, she blames herself.
“If I had done more to prevent the virus from spreading at home,” she said, tears streaming down her cheek. “I blame myself over and over, apologizing to my baby son.”
After the latest incident, obstetricians and gynecologists in Okinawa Prefecture held an online conference on how to prevent a recurrence, such as by sharing information. For expecting mothers, they agreed to cooperate with each other so that patients can be treated in larger hospitals in the future.
The prefectural branch of the Japan Association of Obstetricians and Gynecologists has been sharing information on expecting mothers infected with COVID-19 and other high-risk pregnant women to ensure they are treated in cases of emergency. But with hospitals overwhelmed with patients in August, the association did not have information regarding pregnant women who had had a close contact with an infected person.
“Pregnant women have a risk of giving birth prematurely if they get infected,” said Mekaru. “Even if they can’t get checkups at local clinics, we want to make sure they can get checked at hospitals where virus measures are in place.”
This section features topics and issues from Okinawa covered by The Okinawa Times, a major newspaper in the prefecture. The original article was published Sept. 12.
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