Pregnant nurse concerned about risk of COVID-19

A pregnant nurse in Regina is raising concerns about the risk of being exposed to COVID-19 on the job and what she feels is a lack of accommodations to protect her.

The woman requested her identity be kept confidential because she is worried about retribution from her managers or employer. For the purposes of this story, she will be called ‘Anne.’

In line with the official guidelines from the Society of Obstetricians and Gynaecologists of Canada, Anne’s midwife told her pregnant women are not considered to be at any higher risk from COVID-19 than anyone else. Pregnant women who work in essential services, including frontline health-care workers, can continue to work during the pandemic and would not require any additional personal protective equipment beyond that worn by other frontline workers.

From Anne’s perspective, there is still too much uncertainty and lack of medical research to make her feel safe. Her family doctor agreed and suggested she try to find a way to work outside of direct patient care.

“The studies that we have are so tiny and they’re studying such a small group of people. It’s reassuring that they’re saying, ‘You’re probably okay,’ but if the tables were turned and this was a new medication as opposed to an illness that was spreading, pregnant women would be told that, ‘We don’t have enough research to support that it’s safe for you, so please, by all means, avoid it,’” Anne told 980 CJME.

“Because (COVID-19) is an illness, we’re being told that, ‘We have a little bit of research that says it’s probably okay so you should go and expose yourself and hopefully you’ll be okay. Hopefully, your unborn child will be okay.’”

The Center for Disease Controls reports that babies born to women who test positive for COVID-19 do not catch it from their mothers in utero or through labour and are generally born healthy. In some cases, babies have been born premature but close to full term, and those cases depend on the severity of the respiratory infection in mothers.

For Anne, that’s not good enough. She has taken note of what other jurisdictions are offering around the world and across Canada and she doesn’t feel Saskatchewan is doing enough to protect pregnant women on the frontlines of health care.

Nurses unions in B.C. and Quebec have asked health-care employers to reassign pregnant health-care workers outside of patient care or allow them to stay home. In Alberta, Manitoba and Saskatchewan pregnant health-care workers including nurses are still expected to work while taking the same precautions for infection control including personal protective equipment (PPE) as anyone else.

Anne said she has asked her union and managers about accommodations to limit her exposure to patients, but she has been told to continue working.

“The only thing they kind of singled out pregnant nurses for is they should not be involved in patient care during aerosolizing procedures,” Anne said, explaining those procedures include intubations which are a regular part of her job.

PPE poses a problem for Anne. She said N95 masks required for those procedures cannot be reliably fit-tested on pregnant women, particularly in the later stages of pregnancy because hormones and weight gain can change the shape of their faces.

“I pretty much can’t use an N95 mask at all because I can’t know that it’s working any more than a simple mask would,” Anne explained. “So they try to keep us out of rooms that we would otherwise need an N95 mask for.”

Saskatchewan Union of Nurses president Tracy Zambory confirmed the union has no overarching policy on accommodations for pregnant or immunocompromised nurses working in frontline patient care specific to the COVID-19 pandemic.

“When it comes to those kinds of things, nurses that are pregnant or immunosuppressed or older and maybe not as healthy, that’s all dealt with on a case-by-case basis,” Zambory said.

However, she noted general accommodations for workplace safety already fall under legislation for the right to refuse dangerous work.

“If someone is expecting and they feel that their vulnerability is heightened or their exposure is heightened because the information or the research and evidence is not as strong, certainly we would support them to do whatever it is they feel that they need to do to be safe and to keep their pregnancy safe,” Zambory said.

The Saskatchewan Health Authority (SHA) responded to a query on its policy for pregnant frontline health-care workers by email and stated that safety is a top priority for all employees.

“For their own protection, all frontline health-care staff members, including those who are pregnant, are required to use personal protective equipment (PPE) when working with patients who have presumptive or confirmed COVID-19,” an SHA communications official wrote.

The email went on to say the SHA follows guidelines for PPE developed by the Public Health Agency of Canada.

“The current guidelines for PPE used in routine care of patients with confirmed or suspected COVID-19 include gloves, gown, facial protection and a procedure/surgical mask. During specific procedures, there is a requirement for an N95 mask. Many pregnant frontline health-care employees are able to and are continuing to use PPE as recommended by IPAC (Infection Prevention and Control).”

The SHA response suggested any employee who is unable to completely follow the guidelines should not care for any patient who is being tested or has a confirmed or presumptive case of COVID-19. The SHA said the human resource department can work with managers to review individual situations on a case-by-case basis and “if appropriate” can work with the employee to make “alternate arrangements” including redeployment, working from home or paid leave.

Anne would like to see a more consistent policy from the union and health authority.

“I hope that at least there will be some guidelines from somewhere higher up that can pretty much give us permission to step away from our patient care positions because right now the only way I can get out of working at the hospital is to go on mat leave early, which is not always an option for everyone,” Anne said.

To protect herself and her baby from COVID-19, Anne would prefer to have the option of a temporary work placement outside of patient care. She doesn’t feel it would be unreasonable to reassign a few pregnant health-care workers to other duties during this time.