Spike of unvaccinated pregnant women in COVID-19 ICUs concerning, says Calgary doctor

An unvaccinated pregnant Alberta woman died from a COVID-related infection following admission into intensive care units, sources familiar with the death say.

CBC News granted confidentiality because our sources were not authorized to speak, but understands the woman’s baby was delivered and survived. The woman will not be named, nor the community where she died.

At a press conference Thursday, Dr. Deena Hinshaw, Alberta’s chief medical officer of health, said pregnant people are at high risk of very serious illness and are urging them to get their COVID-19 vaccinations.

“Not only has COVID had severe impacts on the parents health, but also the child’s. Five preterm births occurred as early as 29 weeks. If you are pregnant, trying to become pregnant or have recently delivered, please get both doses of the COVID-19 vaccine as soon as possible.” 

Dr. Eliana Castillo says the proportion of unvaccinated pregnant women in Alberta admitted into the ICU is rising dramatically as the pandemic surges.

Castillo, along with Dr. Verena Kuret, co-leads a national team studying COVID-19 in pregnant women, funded by the Public Health Agency of Canada and the Canadian Institutes for Health Research.

“Since the variants of concern emerge we have seen a change in the magnitude and the severity of COVID-19 infections in pregnancy, and certainly what we are seeing with the delta wave is unprecedented,” said Castillo, a clinical associate professor with the departments of Obstetrics and Gynecology and Medicine at the University of Calgary.

Worsening waves

During the first thirteen months of the pandemic —  March 2020 to April 30, 2021 — Castillo says based on her data, there were about seven unvaccinated pregnant women admitted into Alberta ICU’s due to COVID-19.

In the third wave, between May and July 31, 2021, Castillio says six unvaccinated pregnant women were admitted into ICUs as a result of the disease.

This is nearly the same number as the first and second waves combined, but in a quarter of the time.

Dr. Eliana Castillo says a larger proportion of unvaccinated pregnant women are ending up in the ICU during the fourth wave and she says their life-threatening illnesses are preventable with vaccination. (Lisa Enman Photography)

And as the fourth wave hits Albertans, the doctor says the outcomes are even worse.

In August, doctors admitted six unvaccinated pregnant women into the ICU, which is the same number of admissions as previous waves but in a much shorter time period.

As a result, Castillo says some of these women who are fighting COVID-19, can’t properly support their pregnancy. She says the risk of preterm babies is nearly double that of the baseline population which means some babies can be left struggling with developmental issues.

Front line experience

Dr. Darren Markland, an ICU specialist in Edmonton, stresses it’s well known that pregnant women are at higher risk for complications with respect to viral pneumonias such as H1N1.

He says health care professionals didn’t see as many severe cases during previous waves, but that’s changed in recent weeks.

“This time we’re seeing much more disease in pregnant women and we’re seeing more women in the ICU with complications from severe respiratory insufficiency,” said Markland.

He adds that in some cases, COVID-positive pregnant women end up having urgent C-sections to try to help their baby in distress.

But Dr. Markland says there are other consequences to consider besides the impact to the health of the baby or mother.

“A lot of these women who have been so sick in our ICU are unable to connect with their child meaningfully,” said Markland.

Paradigm shift

Castillo says some women who are pregnant ,or who are trying to get pregnant, have heightened concerns about what they put into their bodies to ensure a healthy delivery — which rightly so, she says, since that’s what they’ve been told by the medical community for years.

But she says in the era of pandemics, that paradigm needs to shift.

“The best way to actually protect our babies is to put something into our bodies so babies are born … loaded with protection right until they can get their own vaccines,” said Castillo.

Calgariain Heather Francisco is pregnant with her second child and is unvaccinated.

Calgarian Heather Francisco says she hasn’t gotten the vaccine during her pregnancy and ended up with a mild case of COVID-19. (White Apple photography)

She says she considers herself vaccine hesitant and wanting to wait and see how people react to the vaccine before rolling up her sleeve — especially with being pregnant.

She’s had doctors both encourage her to get vaccinated, she says, as well as hold off until after the baby is born since she’s already contracted the virus, providing some natural immunity.

“I’m not a crazy person who thinks it’s population control.… There’s just some hesitancies without knowing long term effects,” said Francisco.

Still, Francisco contracted COVID-19 in May when she was 13 weeks pregnant. She says she suffered from flu-like symptoms but they weren’t severe enough to require hospitalization. She considers herself lucky.

Unfounded fears

Castillo says there’s growing research that proves vaccines don’t cause infertility, or other problems for their fetuses.

“We can confidently say that COVID-19 vaccines do not increase the risk of birth defects or miscarriages,” says Castillo. 

She says while the vaccines do not cross the placenta, the protection antibodies produced by the mothers do and that they’ve been shown to be better quality and in greater quantity than those produced by an infection.

Even so, Castillo says it’s important to sympathize with mothers who are considering a vaccination because she says they are bombarded with fear mongering on social media, and sometimes, even their health care providers.

And she says from what she’s heard, mothers would like to see more peer-to-peer, or mom-to-mom counselling.

“I’m 46, my children are in university … do I know what it feels to be pregnant right now and get myself a COVID-19 shot with everything else going around? No, but other moms who have done it maybe can help other moms struggling with vaccination decisions.”

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