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World Indian mothers-to-be living in fear of Covid

03:50  02 june  2021
03:50  02 june  2021 Source:   bbc.com

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By then, India had begun vaccination against Covid but that was not an option for Jagriti. It still isn't because the jab has not been approved for pregnant women in the country. The government recently cleared it for nursing mothers , but there is no word on what pregnant women should expect Doctors now fear that they will still be at a disadvantage as delays and prohibitive costs prevent most Indians from getting a jab. Those who can afford it are looking for alternatives - the BBC spoke to one family in Delhi who say they went to the US to get the woman vaccinated because they couldn't wait endlessly.

COVID -19: India 's infections slow but deaths mount. Mazumdar added that authorities were creating a new category of orphans by announcing a financial package that is available only to children who have been affected by the virus. " Are they more vulnerable than any of the other children who have been orphaned due to a different cause?" he said. Meanwhile, Shivani Bhaskar of Save the Children called for "public awareness through mass media and social media campaigns" regarding legal processes on adoption.

When Jagriti Eadala found out she was pregnant in February, she and her husband celebrated by going on a holiday. It coincided with their anniversary and Covid appeared to be on the wane in India.

a person standing next to a train © Getty Images

But within a month, the 29-year-old found herself cloistered in a room, scared to step out. The virus had returned with alarming ferocity. Her husband had to continue going to work, so she isolated herself from everyone in the house.

By then, India had begun vaccination against Covid but that was not an option for Jagriti. It still isn't because the jab has not been approved for pregnant women in the country. The government recently cleared it for nursing mothers, but there is no word on what pregnant women should expect, leaving them anxious and scared.

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He was administered steroids, a life-saving treatment for severe and critically ill Covid -19 patients. But experts say the drug also reduces immunity and pushes up blood sugar levels in patients. After a prolonged stay in the ICU, the patient had recovered and was ready to go home when doctors found he was "We are seeing an increased number of patients with the infection during the second wave of Covid -19. There are a lot of sick people in the ICUs and many of them are on high steroid doses. That could be the reason," Dr Om Srivastava, a Mumbai-based infectious diseases specialist, said.

On Tuesday, India ’s seven-day average case count for Covid -19 reached a record high of 390,995 as the World Health Organization labeled the Indian strain of the virus a “variant of concern.” With hospitals already at breaking point and oxygen supplies being rationed, doctors have reiterated their warning against alternative treatments and preventative measures which have become popular across India . The practice of applying a cow dung and urine mixture to one’s skin and waiting for it to dry, before washing it off with milk or buttermilk, is particularly concerning to doctors.

"I had Covid in November and I have good antibody levels, but my doctor said I need to be very careful. I am pretty paranoid," Jagriti says, adding that she knows of someone who was nine months pregnant when she tested positive for Covid. The baby was born by C-section but the mother had to go on a ventilator. She survived but, Jagriti says, stories like this frighten her.

There are many such stories, too often with a heartbreaking end. A 35-year-old man in Delhi lost his wife to Covid, two weeks after she delivered a baby girl. He says he is still in shock, unable to fathom how he is going to parent his three children - he has two young daughters - without the "wonder woman" by his side. "Don't take corona lightly," a young Covid positive doctor said, struggling to speak in a video that was shared after she died of the infection. She was seven months pregnant but the baby had died in her womb the day before.

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She was taken to a hospital emergency room on 16 April after her oxygen saturation level dropped. Her CT scan showed that she had developed severe pneumonia. But without her Covid report the hospital refused to admit her. She spent around 36 hours in the emergency room on oxygen support in the northern Indian district of Robertsganj. Heartbreaking stories such as this are coming in from across India as a second Covid wave wreaks havoc. Data suggests that this wave is proving to be more infectious and deadlier in some states, although India 's death rate from the virus is still relatively low.

The variant is being studied to establish whether it is responsible for a deadly surge in India , which is currently overwhelming hospitals and crematoriums. India reported 366,161 new infections and 3,754 deaths on Monday, down from record peaks. Experts say the actual figures could be far higher than reported. media captionWhy do new variants of Covid -19 keep appearing? Laura Foster explains. Surging cases have meant that oxygen shortages continue to be a problem and have spread beyond the capital, Delhi. Local media in the southern state of Andhra Pradesh reported that 11 Covid

Studies have shown that Covid positive pregnant women, compared to non-pregnant women, are at higher risk of dying from the virus. They are also more likely to be admitted to the ICU, hooked to an invasive ventilator, develop dangerous pregnancy complications or deliver prematurely.

Hundreds of pregnant women have reportedly died of the virus in India but there is no official data. The situation is likely far worse in rural areas, where poor surveillance, delayed testing and spotty access to critical care has led to a high death toll from the virus.

a man standing next to a truck: Families weeping outside hospitals has become a familiar sight in India's deadly second wave © Getty Images Families weeping outside hospitals has become a familiar sight in India's deadly second wave

Could the vaccine have saved them?

"In my opinion, the vaccines were developed quickly for the right reasons - but it usually takes 10 years before most vaccines are declared safe for pregnant women. The government is trying to play safe. But there is no decision yet and millions of pregnant women are very vulnerable. We hope to get a positive response from the government soon," says Dr Meenakshi Ahuja, head of obstetrics and gynaecology in Delhi's Fortis La Femme hospital.

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India 's government has instructed social media companies to remove any content that refers to the " Indian variant" of Covid -19. The IT ministry said the World Health Organization (WHO) listed the variant as B.1.617 and any reference to " Indian " was false. Geographical terms have been used to describe The country has been hit hard by the new variant since late March and is now second only to the US in terms of overall infections, at more than 26 million, according to Johns Hopkins University research. Covid -related deaths are close to 300,000, behind only the US and Brazil, although some

Up to 15,000 first dose jabs are being made available for those in the local area who have not yet been vaccinated, PA Media reports. The event - called Let’s Tackle Covid - aims to increase the number of vaccinations as cases of the Indian coronavirus variant surge in Hounslow, west London. At present up to three-quarters of new Covid cases in the UK are thought to be caused by the India variant. There have also been signs of a slight rise in hospitalisations. The situation has led some scientists to warn that the country is now in the early stages of a third wave of coronavirus which, despite the

India's federation of gynaecologists too has recommended that pregnant women be allowed to consult with their doctors and decide.

Immunity is generally compromised during pregnancy but Dr Ahuja says Covid positive pregnant women are especially vulnerable in the third trimester. The growing uterus pushes against the diaphragm, compressing the lungs and making it harder to breathe in a normal amount of air.

"So the first thing we try to do is to deliver the baby even if it's premature," Dr Ahuja says. "That is one reason why we have seen a rise in neonatal deaths."

a group of people sitting in chairs in front of a crowd: India's vaccine drive has now opened up to everyone above the age of 18 © Getty Images India's vaccine drive has now opened up to everyone above the age of 18

The other concern is the delivery itself.

"A vaginal delivery requires the woman to lie down on her back. Lying down straight pushes the diaphragm and the lungs further up, lung capacity reduces and her oxygen levels are likely to drop," says Ruma Satwik, an obstetrician at Delhi's Sir Ganga Ram hospital.

She adds that pregnant women with mild or no symptoms need not panic - but among the "smaller subset" who are admitted with a moderate to serious infection, the "mortality rates appear to be higher than what it would be in pre-Covid figures".

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"We hadn't seen a single mortality the first time around [the first wave]. This time it's been much worse."

a couple of people that are looking at the camera: Israel allowed pregnant women to be vaccinated as early as January © Getty Images Israel allowed pregnant women to be vaccinated as early as January

Dr Satwik says she is still unsure of recommending the vaccine to her patients in the absence of any clear data or studies - she points to the fact that Covishield and Covaxin, the two jabs that India is currently administering, have not been tested on pregnant women.

Last month, Brazil suspended Covishield for pregnant women after a woman who had taken the shot died. Some countries have also stopped giving it amid increasing reports that it was linked to blood clots.

This is also a fear among gynaecologists because pregnant women are at higher risk of developing blood clots, Dr Ahuja says.

The countries that are vaccinating pregnant women - US, UK, EU, Australia - are giving the Pfizer or Moderna vaccines, both of which have been deemed safe by a major new retrospective study.

But in the absence of vaccines, critics say, India's federal government appears to have no strategy for treating pregnant women - only a handful of hospitals in big cities are even admitting them if they are Covid positive. The government failed to prioritise pregnant women - who number in the millions each year - as a high-risk category early on. Doctors now fear that they will still be at a disadvantage as delays and prohibitive costs prevent most Indians from getting a jab.

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Those who can afford it are looking for alternatives - the BBC spoke to one family in Delhi who say they went to the US to get the woman vaccinated because they couldn't wait endlessly.

"To be very frank, there is no protection for pregnant women or lactating mothers," says 29-year-old Avni Reddy.

She and her four-month-old baby were diagnosed with Covid in April. They recovered after mild symptoms, but Ms Reddy says she was just given a pain killer because she couldn't take anything stronger while breastfeeding.

"I was lucky because the infection was mild, But what if I had a severe infection?"

Read more of our Covid coverage:

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  • How India's vaccine drive went horribly wrong
  • The newsroom counting the uncounted deaths
  • Do reinfections pose a challenge to vaccines?

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