To a doctor, some demands can be confronting. In particular, the expectations of women around pregnancy and birth have a built-in resistance to medicines, vaccines and even routine preventative testing. With this history, it’s little wonder that our community has a very reluctant uptake and acceptance of the need for the COVID vaccine. Pregnant women are caught in an urgent dilemma – to vaccinate or not to vaccinate?
My adult son told me of his friends who are expecting, or thinking about pregnancy, and are concerned about getting vaccinated. This news did not greatly surprise me because natural pregnancy and birth have long been part of our Byron and Mullum culture.
In all the hurly-burly about vaccination, I haven’t noticed much attention given to this cohort. But it seems that many women in the reproductive stage of their lives harbour deep reservations and are steering clear of vaccines altogether. But what of medical advice? Some nurses say ‘you should talk it over with your doctor’ but that is no guarantee of consistent counsel.
Looking overseas to places with more in-your-face experience of this modern scourge, the English College of Obstetricians recommends COVID-19 vaccination for pregnant women.
Closer to home, Dr Vijay Roach, President of the Australian and NZ College of Obstetricians, has said, ‘We want to reassure pregnant women that COVID vaccines are safe and effective. The risk of severe outcomes from COVID-19 is significantly higher for pregnant women and their unborn babies. It’s critical that pregnant women, their midwives and doctors, are aware of this clear advice and that pregnant women have access to a vaccine’.
The advice is consistent across borders, but suspicions linger among some people as to whether they can trust the word of conservative organisations that have been historically unsupportive of natural methods, such as water birth.
My informants in and outside the health system say that a sizeable cohort of pregnant and breastfeeding women generally consider the vaccine risk too significant. Also, those women considering pregnancy fear that a COVID vaccine may increase the risk of infertility or miscarriage. According to the College, the numbers of vaccinated pregnant women are still worryingly low, at around 15 per cent.
This doctor has moved out of orbit, and can’t give up-to-date pregnancy advice, but still cares for you across a generation of time. Someone currently in the game is Dr Jenny Dowd, an obstetrician with 30 years of experience. She wrote in The Guardian, a paper you can trust, ‘Vaccination has made me reassess my advice to pregnant patients. Usually known for my forthright opinion, I have altered my approach to spend time trying to understand my patients’ vaccine fears’.
The science is still developing, and that goes with rapidly changing advice. Political purposes compound the confusion. But let’s be real. Less than two years has not given science much time to amass sufficient data, so vax hesitation persisting in women of reproductive age is very understandable.
However, the current figures relating to SARS-Cov-2 infection are pretty alarming. One in six critically ill COVID-19 patients is an unvaccinated pregnant woman. Of twenty pregnant women requiring invasive intensive care, 19 were not double vaccinated. Something to understand clearly, intensive care for COVID-19 is a medical treatment you wouldn’t wish on anybody, especially a pregnant woman.
Affect on fertility
The scientific consensus, at present, is that the COVID-19 vaccines do not affect fertility or the chance of a normal pregnancy and does not cause miscarriage. It is safe for breastfeeding women and can be given at any stage of pregnancy. It may provide some immunity to the unborn as well, and reduces the chance of premature birth.
All that a reproductive woman can reasonably do is balance the small risks and more significant benefits of the vaccine against the known risks that go with serious illness.
Last but not least, severe COVID-19 infection is known to increase the risk of premature labour. Our Byron bubble has been largely untouched by the spread of COVID owing to public health order restrictions and luck. But that karma may change very soon as the locks come off and contagious people travel here from far and wide.
Once this virus takes hold in the body, it’s too late to change your mind. The vaccine is not a treatment but a preventative medicine. It can only work ahead of that time.
Dr Who has written previously for The Echo and has had their credentials checked to confirm the expertise of opinion.