SINGAPORE, Sept 17 — She was about nine months into her pregnancy when she discovered that she contracted Covid-19, and bank executive Vanessa Rickard became the first woman to deliver in an isolation ward at the Singapore General Hospital (SGH) on Aug 24.
After the mental anguish that she went through, the 36-year-old Filipina has a strong message for other pregnant women: Get vaccinated.
She was physically separated from her baby for two-and-a-half weeks after birth and could not have family with her during or after labour.
She was not vaccinated at all at the time.
SGH, Singapore's main public hospital, is now seeing a worrying rise in the number of pregnant women who have Covid-19 being admitted to its isolation wards.
It had not seen such patients in all of last year and this year until August, and more than 10 cases have been recorded since. A number of the women needed oxygen support to breathe, and one is now in its intensive care unit.
None of these women were fully vaccinated and “very few” were partially vaccinated, the hospital said.
Speaking to reporters in an interview facilitated by SGH on Thursday (Sept 16), Rickard said that she was hesitant to get vaccinated against Covid-19 during her pregnancy.
She got pregnant in December last year and was halfway through her pregnancy when studies emerged in May this year to affirm the messenger ribonucleic acid (mRNA) vaccines’ safety for pregnant women. These were the vaccines approved for the national voluntary vaccination exercise even then.
“I was weighing the risks involved and I just decided that maybe I'll wait until after I give birth because I wasn't sure as well what the effect would be on my baby,” Rickard said.
Now, it is clear to her that the benefits of the vaccine far outweigh the risks. Her doctors at SGH said that the benefits include lowered risk of dangerous complications such as pre-term birth, stillbirth, and other adverse pregnancy outcomes such as miscarriage.
Furthermore, babies born to mothers with Covid-19 were more likely to require neonatal care facilities, and studies have shown that pregnant women are more prone to serious illness from the coronavirus, needing intensive care or ventilators to help them breathe in some cases.
For Rickard, who is now a mother of two, the hardest part was being isolated with no family members or visitors, and being anxious and uncertain of what was going to happen to her and her baby. Her older child is two-and-a-half years old.
She was given a choice to be in the same room with her baby boy, but she decided to be separated from him instead as she was still testing positive. She only caught glimpses of the baby through video calls facilitated by the nurses.
The day after she gave birth, Rickard found out that her whole family — her husband, older son and their domestic worker — also got the infection.
“(The vaccine) might not prevent (pregnant women) from getting the virus, but the benefits of the vaccine definitely outweigh the risks,” she said.
“Definitely, all pregnant women should get vaccinated as soon as they can.”
She is now waiting until November to get her first jab, because her doctor has advised her to get the vaccine at least three months after recovering from the disease. Her husband and domestic worker are both fully vaccinated.
KKH sees similar trend
SGH said that three babies have been delivered to infected mothers so far, but none of the infants contracted the virus.
The babies have to be tested for Covid-19 twice in the first three days and once before discharge if they were issued a quarantine order.
The babies get even more tests if they stay in the hospital for 14 days or more for various reasons.
Given the increase in the number of Covid-19 cases in the wider community, the hospital is concerned that pregnant women remain hesitant to take mRNA vaccines despite growing evidence about the safety and effectiveness of vaccination during pregnancy, it said.
KK Women’s and Children’s Hospital (KKH), the largest hospital specialising in healthcare for women and children in Singapore, separately told TODAY that it has also seen a “recent increase” in the number of pregnant women who were infected with Covid-19.
The majority of them were not vaccinated.
Professor Tan Hak Koon, chairman of the division of obstetrics and gynaecology there, said that KKH saw “about a doubling” of such cases in five months, from May this year to date.
Although the majority of these pregnant women experienced mild symptoms, a few developed complications and required oxygen support, so they had to be monitored closely at the inpatient wards, to prevent or treat complications such as pneumonia or thrombosis (blood clots), Prof Tan said.
The average length of stay for these pregnant women is about two to three weeks, if unvaccinated, he added.
“What is most worrying is that the majority of the pregnant women infected with Covid-19 in KKH are not vaccinated. Worldwide, there is an increasing number of pregnant women being infected with Covid-19 and dying from it.”
He stressed that pregnant women are at higher risk of severe complications if they are infected with the virus, compared to the non-pregnant population.
They also double the risk of pre-term birth if they have infection symptoms, and their babies may require intensive care, he added.
TODAY has asked the Ministry of Health (MOH) for the number of pregnant women in Singapore who had tested positive for Covid-19 so far.
‘One dose is better than nothing’
Doctors at both hospitals said evidence has established that Covid-19 vaccination is safe and protects the mother and baby, with SGH’s doctors recommending that all pregnant women should get vaccinated, as long as they are eligible.
Dr Tan Wei Ching, a senior consultant at SGH’s department of obstetrics and gynaecology, said that pregnant women can have the vaccination after 12 weeks of pregnancy, as stated in MOH’s guidelines.
“We are just being cautious here, because that’s when so-called foetal formation is complete. Over in Europe and the United States, they give vaccination at any stage of pregnancy, so any time after four weeks, we encourage them to consider getting vaccinated,” she said.
She added that it does not matter what stage of pregnancy it is.
“Whether it is 20 weeks, 30 weeks or 37 weeks, one dose is better than nothing. Some protection is better than none.”
Addressing the main reservations pregnant women have about getting vaccinated, Dr Tan said data from the US have shown that the risk of miscarriage in vaccinated patients is not higher than unvaccinated ones.
The same goes for the risk of premature labour and having small, growth-retarded babies as well.
“We will (tell the mothers) that, no, it does not increase the risk of having a miscarriage. In fact, it is Covid itself that would cause more pregnancy-related complications, whether it is miscarriages, pre-term labour, as well as even stillbirth of the baby if the mother gets very sick,” she added.
Prof Tan of KKH said that the mRNA vaccines have been shown to generate antibody production in pregnant women and these antibodies are transferred passively to the baby before birth.
“As Singapore moves towards being a Covid-resilient nation, we strongly recommend that all pregnant women, or women intending to conceive, to receive the Covid-19 vaccination as well,” he added.
In a written parliamentary reply on Monday, Health Minister Ong Ye Kung said that the Health Sciences Authority (HSA) has received a small number of non-serious “adverse event” reports with the Pfizer-BioNTech or Comirnaty vaccine in pregnant women.
These include rash, syncope (fainting), dizziness and one report of Bell’s palsy (temporary weakness of the facial muscles).
However, he pointed out that these adverse events are similar to those reported in the general population.
“There is currently no evidence of safety concerns when mRNA vaccines are used in pregnant women, based on real-world clinical data. MOH (Ministry of Health) and HSA (Health Sciences Authority) will continue to monitor both the local and international safety data,” he added. — TODAY
