Vigor Liu at her place in Beijing. She is 20 weeks pregnant, and worried about going out, going to the hospital and going back to work because of the coronavirus. Photo / Giulia Marchi, New York Times
Pregnant women describe a lonely, sometimes terrifying experience navigating the country's overburdened health care system during the outbreak.
The hospital waiting room was filled with dozens of women wearing homemade hazmat suits. Their hair was tucked tightly under shower caps. Their rain ponchos zipped taut over winter coats. All of the women, anxious and pregnant during the coronavirus outbreak, had been waiting hours to see the same doctor.
"I don't feel at ease," said Vigor Liu, who is five months pregnant with her first child. After waiting for three hours, Liu finally saw the doctor for a brief 10-minute conversation. His advice: stop reading the news.
As China deals with the vicious epidemic that has sickened nearly 80,000 people and killed more than 2,600, pregnant women say the country's already overburdened health care system has started to leave them behind.
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Maternity nurses and doctors have been pulled from their ordinary duties and shipped off to crisis centers and more than a thousand hospitals newly designated for coronavirus patients. Smaller community hospitals that offer obstetrics and gynaecological services are temporarily closed because of staff shortages.
The swift diversion of resources has left many soon-to-be mothers struggling to get access to the basic prenatal care usually provided in these facilities, often a pregnant woman's first and only stop for medical attention in China. Reports in state media of infected mothers giving birth have heightened fears of passing on the virus to newborns, even though there is no clear indication that this has happened.
Women who have given birth since the outbreak also describe a lonely and sometimes terrifying experience of limited medical assistance in understaffed hospitals. New mothers cannot get vaccinations for their newborn babies because entire cities and provinces have shut down clinics. Well baby checkups are being postponed.
Experts say the situation is undercutting the major political effort in recent years to prod Chinese women to have more children amid historically low birthrates and a looming demographic crisis.
In the city of Wuhan, the center of the outbreak, pregnant women have faced the daunting prospect of figuring out where to give birth. Their community hospitals are closed, the city's public transport is shut down and no one is allowed to leave because of quarantine rules.
Without volunteer drivers, the women would not even be able to attend their scheduled doctor's appointments.
One network of volunteers in Wuhan is trying to help women find hospitals that still offer prenatal and postpartum care. The group — which includes psychological workers and drivers — is working with more than 600 pregnant women and new mothers in and around the city, and offers 24-hour service to help deal with emergencies.
Jane Huang was recently connected with the volunteers. The 40-year-old mother of one is 17 weeks pregnant, but the district hospital where she is registered is no longer open to pregnant women. Huang worries that if she does not find a hospital soon, neither she nor her baby will survive because of her hypertension and fragile kidney.
"I worry every day about whether my child will die in my belly. I worry if there is an early delivery, it will not be able to survive," Huang said by phone. "I worry about the financial burdens if I have to do dialysis or even change my kidney, I worry that if my child has an abnormality, should I bring it into to the world."
"I think about a lot of things every day," she said.
Even in normal times, the array of bureaucratic detail that Chinese women have to deal with before giving birth can be challenging.
There is no functioning primary care system in China, where coverage can be limited and there is already a shortage of doctors. Pregnant women must find a hospital that offers maternity services and register to give birth there. Some pregnant women have registered at hospitals that have since been turned into virus centers. Those who can afford it consider shelling out thousands of dollars to give birth in a private hospital instead.
Those who cannot afford it are at the mercy of public hospitals, most of which are severely understaffed.
"Peoples' anxiety is up in general and if you are pregnant then you have a whole other set of anxieties," said Roberta Lipson, chief executive officer of United Family Healthcare, a chain of private hospitals in several Chinese cities.
Lipson said that United has seen a surge in women who had previously planned to give birth in a public hospital in China switch, or inquire about switching, to a private one.
Some 1,774 hospitals have been designated for pregnant women who are infected with the coronavirus. These are the same hospitals that pregnant women who are not sick want to avoid.
China's National Health Commission has told hospitals that if pregnant women are registered to give birth at a newly designated virus treatment center they must "make reasonable arrangements as soon as possible" for those women. But many pregnant women say they are not sure what that means for their situation: Will they be forced to give birth at a hospital designated for coronavirus patients? Will they be transferred elsewhere? Will they be turned away?
"A difficulty is that different hospitals use different platforms to broadcast their information," said Bin Tu, a volunteer in Wuhan. "For pregnant women, finding information on each hospital, one by one, would be complicated."
And finding information on the virus itself can sometimes feel impossible.
There is emerging evidence that the coronavirus does not transfer from a sick mother to an unborn baby, but the limited data and unanswered questions have left many pregnant women in China apprehensive.
In early February, Chinese state media reported a case of a newborn in Wuhan who had been diagnosed with the virus. The mother had been infected, but it was not clear if she transmitted the virus during her pregnancy or if the baby was infected immediately after it had been born.
As authorities continue to try and contain the outbreak, details about the virus have become even more sparse. Citizen journalists have been silenced. Medical workers have been told not to talk to the media.
In this environment, these women have turned to informal channels like chat groups and other online forums to find out what their options are and the latest details on transmission. Some seek advice on missed appointments, others wonder out loud about the virus flying through an open window. Tips and recommendations are posted on Weibo and WeChat, two of China's most popular social media platforms.
These forums have become the kind of community that women like Liu and Huang say they now depend on. And yet some women who have given birth in recent weeks have little consolation to offer these anxious mothers-to-be.
Zhang Chong delivered her second child, a boy, on February 1 at a public hospital in Beijing. The hospital was understaffed, in part because some workers were still stuck in their hometowns following citywide quarantines.
Zhang's scheduled C-section surgery was delayed by a day because of the staffing shortage. None of her family members were allowed into the room during or after the surgery. Zhang was then placed in a ward with 40 new mothers and babies and just two nurses and two assistants.
Family was only allowed to visit for an hour a day, a drastic change to normal rules which allow one family member to always be by the side of the new mother.
On the first night following the surgery, Zhang said she could barely move her body. Her baby was crying and wanted to be fed, but no one was around to help her. For four nights, Zhang said she was almost entirely alone.
"There were 100 times a day that I felt like crying," she said
Her husband, desperate to help, tried unsuccessfully to bribe a security guard so he could stay with her longer.
Written by: Alexandra Stevenson
Photographs by: Giulia Marchi
© 2020 THE NEW YORK TIMES
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