Baby Keith Forbes made an early arrival late last month, which his 25-year-old mother describes as the scariest thing that's ever happened to her.
Alexa Forbes's water broke in the middle of a meeting at work — six weeks ahead of schedule.
When she arrived at the hospital, she tested positive for COVID-19, making her one of about 400 pregnant people in Manitoba to contract the illness so far, according to provincial data.
"I'm like, 'Impossible! I have no symptoms,'" she said.
Those symptoms appeared a couple of days later, including a bad cough, muscle aches and a high fever.
"I was just a mess," Forbes said.
She huffed in and out through a mask during 36 hours of contractions, made even more difficult due to her respiratory symptoms. Her oxygen levels dropped and her baby's blood pressure shot up to a crisis-level range.
Keith was born on March 20, weighing in at five pounds and four ounces— and without COVID.
"That would've been a huge issue," said Forbes. "We lucked out."
Even so, Keith spent the next 10 days in the neonatal intensive care unit, separated from mom and dad.
"I was just a wreck," says Forbes. "It was very stressful. They plopped him on my chest for maybe a minute … and then immediately the NICU team rushed him away."
Forbes's doctor COVID-19 was responsible for her situation. She is sharing her story in hopes of encouraging Manitobans to get vaccinated as soon as possible, and to take the ongoing threat posed by COVID-19 seriously amid the province's third wave.
Prioritizing pregnant people for vaccine
Dr. Nathalie Auger, a physician epidemiologist at the University of Montreal Hospital Research Centre, said Forbes's overall experience with COVID-19 makes sense given what's known now about the disease.
It's associated with a higher risk of preterm, stillbirth and pre-eclampsia — which involves high blood pressure and possible organ damage — according to a broad review of the research by Auger and others published in the Canadian Medical Association Journal in January.
Those risks are why a growing number of experts are calling for pregnant people to be prioritized for COVID-19 vaccination.
Pregnancy itself is a risk factor for more serious COVID-19 outcomes, and early signs suggest coronavirus variants seem to result in even more severe effects, says pediatrician and infectious diseases specialist Dr. Anna Banerji.
Some pregnant patients have concerns about the AstraZeneca-Oxford vaccine, she says. There's about a one in 250,000 chance of developing a rare but serious blood clot associated with that vaccine, according to recent research. Clotting in Europe happened primarily in young women.
But an Oxford study suggests people are eight to 10 times more likely to develop a clot after contracting COVID-19 than from a vaccine. Banerji said the overall risk of dying of COVID-19 in Canada works out to around one in 1,500.
"It seems to be safer to get the vaccine, even if it's AstraZeneca," she said.
Health Canada approved AstraZeneca's use for anyone aged 18 and up in February, and several provinces just expanded eligibility to those 40 and up.
Pregnant people with COVID-19 are at increased risk of hospitalization and ending up in intensive care or on a ventilator, said Dr. Vanessa Poliquin, an obstetrician gynecologist and reproductive infectious diseases expert in Winnipeg.
Poliquin is co-chair of the infectious disease committee for the Society of Obstetricians and Gynaecologists of Canada, which recently called for pregnant people to be prioritized for vaccines.
"There have been no signals of adverse impact of COVID vaccines on pregnancy, so I am of the opinion that every pregnant woman should be eligible for a COVID vaccine, given that we're entering a third wave," said Poliquin.
The National Advisory Committee on Immunization advises health professionals to do a risk assessment and inform patients there isn't much data yet on pregnancy and COVID-19 vaccination, but still suggests the benefits outweigh the risks of the illness.
This week, Forbes was hospitalized with a blood clot in her leg. Doctors told her blood clots are a risk post-pregnancy, and that she was at higher risk because she had COVID.
She's still in hospital right now and she'll have to inject herself with blood thinners twice a day for the next three months.
She has the same attitude she did before: She would've "loved" to be vaccinated while pregnant, if she'd been eligible.
Forbes wants others to get vaccinated when they can.
"It's not about you. It's about other people like me with low immune systems because we're pregnant. It's about your grandparents. It's about anybody with an immunocompromised system," she said.
"You have more chances of getting blood clots from something else than you do from these vaccines."
ABOUT THE AUTHOR
Bryce Hoye is an award-winning journalist and science writer with a background in wildlife biology and interests in courts, climate, health and more. He recently finished up a stint as a producer for CBC's Quirks & Quarks. He is the Prairie rep for OutCBC. Story idea? Email firstname.lastname@example.org.
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