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How have options for pregnant women in Japan changed amid fifth wave of coronavirus?

A newborn baby is seen in Tokyo in this unrelated photo. Due to the coronavirus pandemic, various restrictions are being placed on birth methods, visits and other aspects of hospitalization. (Mainichi)

TOKYO -- A baby recently died prematurely in a home birth in the city of Kashiwa, Chiba Prefecture, after her mother, who had tested positive for the coronavirus, was unable to find a hospital that would admit her -- exposing the lack of support for infected pregnant women.

    Based on the advice of an expert and one woman who gave birth to a baby safely despite having the coronavirus, this Mainichi Shimbun reporter considered what pregnant women should do now.

    In February, a Tokyo woman in her 30s who was 37 weeks pregnant felt something was wrong. Her husband, who she lives with, was confirmed to be infected with the coronavirus. She also had a mild sore throat, a cough and issues with her sense of smell.

    She tested positive in a polymerase chain reaction (PCR) test and was admitted to the general COVID-19 patient ward of a Tokyo hospital that also has an obstetrics and gynecology department.

    Every day, nurses asked the woman if she felt any abnormalities in her health. However, the obstetrician only asked about her physical health twice during hospitalization.

    After two weeks in hospital, the woman gave birth naturally at 39 weeks. The roughly two-week recuperation period for COVID-19 patients with mild cases had passed, but the hospital treated her cautiously as a "coronavirus-infected person" for four weeks from the day symptoms developed. As a result, the doctor, nurses, and midwives attended the birth in protective clothing.

    "As soon as my baby was born, they were taken to a separate room so I could only see their face, but not hold them," she recalled.

    The end of the four weeks she spent as a "coronavirus patient" came five days after the birth, meaning the mother and child were separated for the first four days. As she held her baby for the first time, she said, "Finally, finally, we've been able to meet. I'm sorry it had to be like this. I'm glad I can hold you safely. Thank you for being so healthy."

    Looking back, she was worried not only about the coronavirus infection, but also that she couldn't get a doctor to check on her baby for about a month during her pregnancy.

    This photo shows Kaori Ichikawa, associate professor of nursing at the Tokyo University of Information Sciences. (Photo courtesy of Kaori Ichikawa)

    "There were hearings every day to check for any abnormalities (in my body), but no weekly prenatal checkups, and I was worried there might be something wrong that I couldn't detect," she said.

    But what should pregnant women who are feeling anxious do now?

    Kaori Ichikawa, associate professor of nursing at Tokyo University of Information Sciences and an expert in prenatal and postnatal care for pregnant and nursing mothers, said, "It is important to take measures on a daily basis to prevent infections. Avoid meeting with friends and spend time only with those you have regular contact with."

    If you have a mild case of COVID-19, you will recuperate at home, making it necessary to stockpile food and daily necessities. It is also important to think about who you can turn to in an emergency. "In addition to specialists such as doctors and midwives, I recommend you prepare a list of family members, friends and others you can talk to," Ichikawa said.

    Information such as that on "free phone consultations with midwives" is available in notices from the local government distributed with the maternal health handbook. A midwife can be contacted by phone or online. They will listen to the person, give advice and contact the public health center on their behalf.

    "The first thing to do when calling a public health center is tell them you are pregnant. Even if you are diagnosed with a minor case, two lives are involved, so you should be aware that even slight changes can lead to an emergency," Ichikawa advised.

    On Aug. 14, three organizations, the Japan Society of Obstetrics and Gynecology, the Japan Association of Obstetricians and Gynecologists, and the Japan Society for Infectious Diseases in Obstetrics and Gynecology, issued a joint statement on coronavirus vaccinations of pregnant women, recommending vaccination regardless of the time of pregnancy.

    Among the reasons given for vaccination are that infections in late pregnancy are more likely to become serious, that pregnant women's adverse reactions to vaccination are no different from other people's, and that there is no difference in the frequency of miscarriages or premature births among people who aren't and are inoculated.

    They also urge those in close contact with pregnant women to get vaccinated. About 80% of all infections in mothers-to-be come from their husbands or partners.

    (Japanese original by Tomoko Kagawa, Tokyo Regional News Department)

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