Dr Nighat Firdous, one of the senior-most gynaecologists in Kashmir, is the Head of the Department, Gynaecology and Obstetrics at the women-exclusive Lala Ded Hospital. In an interview with Syed Samreen, she urges pregnant women to visit hospitals only when it’s necessary and calls for seeking help on phone.
KASHMIR LIFE(KL): How can Covid-19 positive pregnant women take care of themselves? What measures should be taken by females to avoid contracting the virus?
DR NIGHAT FIRDOUS (DNF): As far as antenatal care (pregnancy care) in Covid-19 positive women is concerned it is just like any other normal pregnancy. There is no difference unless there are extreme cases where ICU admission is needed. The patient should be cared for and taken care of like a normal pregnant female.
Suppose a patient is asymptomatic, the only additional thing that can be done is that if there is some suspicion, the Covid-19 test should be carried out immediately. That is very important.
Second, comes the counselling part, where the pregnant woman needs to be told that there’s nothing serious about testing positive, there is nothing to worry and we should try to break the stigma to her.
Once a pregnant woman turns out positive, she has to isolate herself from others. But that won’t stop her from receiving the same care and treatment Covid-19 negative pregnant females have. The isolation is important so that she doesn’t transmit her infection to other family members or the people around her.
However, there are categories: say an asymptomatic patient gets tested and turns out positive. She simply has to isolate, take a good diet, plenty of fluids as a pregnant woman’s immune system is already compromised.
But if a woman starts getting symptoms, say milder symptoms, it is recommended for her to not travel all the way long from her native village to Srinagar. Unnecessary travel should be avoided. Instead, she should visit the nearest facility available where she will be taken care of.
Rather than coming all the way from her native place – infecting all other people in the journey – to Srinagar for the treatment of mild symptoms, the pregnant lady should go to a primary/district health centre and get symptomatic treatment there.
If God forbid a pregnant woman experiences severe symptoms and needs tertiary care, then she needs to report to a Covid facility.
With respect to deliveries, there’s nothing different. The mode of delivery is also the same. Except that the diet has to be nutritious and protein-rich followed by reporting all the symptoms experienced by them like fever, cough et al to the hospital. The mode of delivery remains institutional for them.
I advise all the pregnant women to not go from one hospital to the other unnecessarily, go for testing and ultrasound unnecessarily and overall not moving around much.
For many months I’ve now been seeing patients on WhatsApp. I see their tests and assure them. This way both the doctor and the patient are not exposed to one another.
In a pandemic, we can delay the monthly examinations. There’s no harm if we do the examination, say 15 days later. This will prevent the patient from getting exposed at many places in the process of seeing a doctor, getting a test done, receiving the test result and then revisiting the gynaecologist.
One more additional responsibility that the family members of the pregnant woman should take is to stay aloof from her if they’re moving around too much and exposed to the outside world, keeping in view that her immunity is already weak.
KL: When a Covid-19 positive woman recovers, what protocol should she follow?
DNF: When a pregnant woman tests positive and has very mild symptoms, we send her home and ask her to isolate herself.
It is not important for her to get tested again because sometimes the test turns out positive even on the 14th day, which is because dead viruses also show up positive. This will add to her panic if she does so.
Once she’s negative, since she already has formed antibodies, she doesn’t need to worry.
Once negative, the woman should still take care because as we have seen people have retested positive even after six months of the infection or for that matter even after the vaccination of normal people.
KL: What about post-delivery care for pregnant women?
DNF: Again, the post-delivery care also remains the same. Be it normal delivery or caesarean, the care remains the same for Covid-19 recovered females.
As far as breastfeeding is concerned, there is absolutely no problem with that. A Covid-19 positive mother can lactate her newborn by covering her face and wearing proper masks. (In severe infection cases, artificial feeding should be done). Also, post-delivery vaccinations can also be carried out.
KL: There have been many rumours making rounds on social media regarding infertility caused by the vaccination. What do you have to say about that?
DNF: Most of it is a myth. No issues with infertility have been seen. Studies abroad have been carried out and women have been taken on trials and fertility issues haven’t been seen as such. The explanation for it is that whenever someone is vaccinated, what happens is antibodies are formed. If a person as such is getting a Covid-19 infection, what happens there? The same antibodies are formed by the time he recovers.
KL: Does that mean none of the Covid-19 recovered females will ever conceive?
DNF: Scientifically, in both cases, antibodies are formed. So all these rumours shouldn’t be given heed to. They are all myths.
KL: What about the vaccination of pregnant women? Has Kashmir started the process?
DNF: As far as vaccination for pregnant women is concerned, there have been studies in the US, Australia etc. They’ve started giving vaccinations routinely.
But in India, the federation of gynaecological societies of India, from where we receive recommendations, has recommended vaccination for pregnant women. But the recommendations have to be put in letter and spirit by the ministry of family welfare, which hasn’t happened yet but will start, in some time.
According to the recommendations, risk vs benefits has been drafted out.
In many studies that were carried out in pregnant vaccinated women, it was seen that antibodies were found out in the umbilical cord of the baby, which is protective for both the mother and the baby.
Once the ministry gives a nod, vaccinations will start after the recommendations are put into letter and spirit.