Mariam Mufti: Snapshot of a Pregnancy

Photos: Alexis Blondin

I spoke with Mariam during the seventh month of her pregnancy to get a sense of what it was like to be expecting a child during the pandemic. Since then, she has given birth to her baby and both mum and baby are doing well.  

How are you feeling about your upcoming delivery?

Mariam Mufti: Well what has happened to me is that my GP is on maternity leave so I have been dealing with my GP’s substitute. Then that substitute became pregnant and went on mat leave. And then a third doctor came on the scene, and that doctor treated me for a month and a half and then I was transferred to a forth doctor and that is my OB/GYN. At the end of the day, who knows who it will be delivering my baby. The way the hospital is organized, they have doctors on rotation, so it will depend on whatever day the baby comes. There's no guarantee that I would have my OB/GYN. So there's no point in my my developing a rapport with her or caring about what she's like, because she might not be the one.

Do you have a midwife?

MM: No. I could have opted for it, but I figured what was I going to do with the midwife during this time? Midwives during the pandemic have actually just been driving by your house, sitting in your driveway, chatting through a window and then going on with their business. It’s not like I would have gotten the extra care or attention of a midwife, that stranger cannot come into my home. I wonder if a mother who has had a midwife during this time would think differently?

I was 100 percent certain that I wanted a hospital birth. Given my advanced age, I was like, okay, I need someone who knows how to perform surgery, knows how to deliver a baby and knows how to handle whatever situation might arise. And then I'm only allowed one support person. So who do I want to be in the room at the time? Do I want a doula or a midwife or my partner Alexis?

And what about prenatal classes? Have you been taking them virtually?

MM: The region of Waterloo has e-classes for birth—so pregnancy, labour, breast feeding and taking care of the baby postpartum. They had this module e-course that was available, and I looked that up because I was like how am I ever going to lean anything at all? So I did that e-course two or three months into the pregnancy because I thought this is nuts I know nothing. And I was going to make Alexis do those e-courses as well, but then when I went to the OB/GYN she told me that there were two nurses from the hospital where I was registered that had just restarted given pre-natal classes when the Covid restrictions were lifted across Ontario. I thought the class was great because we could ask the nurses anything we wanted. We were the only couple there, so we lucked out we had a private session. But, typically, in non-pandemic times I should be able to do a tour of the hospital and see what is going to happen to me. But I can’t do that these days. Everything is closed.

Asking all the questions that I had was great. And then there was the benefit of Alexis getting a concentrated six-hour lesson on everything. So now he is completely up to date with everything that I wanted him to know, and know about the baby. I think that opportunity was great for the two of us. But it was also a racket, because what these nurses do is that they take that same videos that the regional e-course was offering and play those videos and stop and start in different places and give some of their own input. It was not a hands-on class. It was not like they were teaching us actual labour techniques, how to breath, anything like that that. They didn’t make Alexis practice any support techniques on me. They just made us watch the video.

But if you learn kinesthetically, that's not going to help.

MM: Exactly. They did send us home with a book. But tell me, when I am in the throws of labour am I going to be sitting there reading a book? And I think maybe one of the reasons they don’t teach these techniques is because every labouring mum is so different—her needs are different—so why bother teaching all of these techniques that may not come in handy. I think that is the Canadian mindset—why worry about stuff that may or may not happen? Just worry about the things that you know 100 percent will happen. The baby has to come out one way or another, so let’s just focus on that.  

So stepping back a little bit, what did you think initially when you found out you were pregnant during the pandemic?

MM: Well my last period was March 27th. So then I was expecting my next period in late April, but the date came and went and I began fasting because Ramadan started. So I started fasting, and I was going along my merry way thinking okay, I have never been irregular so this is odd. And then I mentioned it to Alexis and he was the one who took it seriously and was like Mariam do a pregnancy test.

“THE AVERAGE CANADIAN WOMAN MAY NOT HAVE ACCESS TO RESOURCES. WHAT IF SHE DOES NOT NECESSARILY SPEAK ENGLISH WELL? WHAT IF SHE DOES NOT HAVE AN E-MAIL ACCOUNT? WHAT IF SHE DOES NOT HAVE A SMARTPHONE?”

 And I very unwillingly took a pregnancy test because I was 100 percent certain that this would not have happened. We do the pregnancy test and we get the results and the two of us were just like uhhh.. I think we were shell shocked more than anything else, me more so than Alexis—Alexis was like this is excellent and I was just like what? That was pretty much our reaction. And then our first call was to Alexis’s mum and the second call was to my mum. And my mum said Mariam you don’t know what you are talking about this could very much be a false positive because it is too soon to say, because obviously I told my mother the dates as well. My mum was like you are not that late, this could be a false positive, you don’t know what is happening here. Alexis’s mum's reaction was like, okay these are early days, wait and take the test again in two or three days and if that is also positive then, of course, you guys should take it to the doctor. So we waited 48 hours and took the test again, and the test came back positive. So now at this point, I thought we cannot have two false positives. There is something here.

 I called up my doctor and I said, listen, I've had these two pregnancy tests that are positive. Can I come in for an appointment? No, you cannot come in for an appointment, we are in pandemic times. We will have a telephone conversation with you. Now a telephone conversation doesn't prove a damn thing. I would have thought that at this point they would have said listen, go for a blood test and find out what's going on.

Anyway, she scheduled a telephone conversation with me—and maybe that's how they do it, maybe that's the procedure. The doctor spoke to my briefly and said okay I am sending you the requisitions for a blood test, go and get it done and that will tell us whether or not you are pregnant.

 Now, most women will not be able to tell you the last date of their period, most women don’t remember this. It is just because I had my Fitbit tracking every single period and every single thing that Alexis and I were doing that I could tell these people exact dates and times. Anyway, so she sends me requisition slip. Great. I go and I get the test done. And I find out finally on May 21st, Alexis and I had known that you were pregnant since April 27th.

Now let me give you the Covid implications of all of this. What if between the phone call with my doctor and May 21st , when I had the blood test, I had gotten a fever or something? What if I came down with—I don't know—a 38 or 39 Celsius fever, nothing major, but a fever nonetheless. I would not have been able to go for the blood test, because no lab would allow me to come in, they are covid screening everywhere. What if at this point in time I did not have a printer at home and I wasn't able to print out my requisition slip and go to Life Labs by myself?

I'm just saying that the average Canadian woman may not have access to resources. What if she does not necessarily speak English well? What if she does not have an e-mail account? What if she does not have a smartphone? What if she cannot speak to the doctor freely from home because she's being domestically abused? What if? What if? What if?

Those are very valid points.

MM: You see, my doctor’s position was that everyone is doing telehealth for good reasons as we are in a pandemic. She wanted to have a conversation with me to ask me all of these questions—are you having nausea symptoms etc. But what if I was being domestically abused and I didn't want to have these conversations openly at home with my husband listening? What if there's only a landline in the house? It's worth thinking about, right?

It is. And I think people have been thinking about it—the domestic abuse situation during covid has been a major point of concern in Canada.

MM: Of course, and there are all of these things that they now have advertised, for example people can make that hand symbol that I need help or am in danger. But this was not a teleconference. This was having a phone call with me on my cell phone. She cannot see my face, or my hands.

And I just want to add again, if I wasn't the nutcase that I am and had already read a lot of pregnancy material, I wouldn't have started folic acid on my own. My point being, that I found out April 27th, I called up by my doctor. My doctor didn't speak to me till May 12th. During those critical two weeks—which is basically the sixth and seventh week of my pregnancy—if I hadn't been taking folic acid, what would have happened to the neurological development of my child?

If I hadn't known that folic acid is a thing, what would have happened? The major assumption is that all women who are getting pregnant are having planned pregnancies. So therefore, they've been taking folic acid for the last one year of their lives, before their planned pregnancy. We are such an educated society; we are making the assumption that everybody knows everything.

How did it feel abruptly having to do all this telehealth? Were you concerned about being reliant on these emergency systems of communication?

MM: I wasn't concerned, only because I am educated and I have enough of a support system around me—like Alexis’s mum, my mum, my sister, other people—I knew that I would be fine.

Plus, pregnancy is one of those things that millions of women do around the world without having access to excellent healthcare. My only thing was that I'm in Canada right? I have a GP right? I have to have these phone conversations with my GP—as it is when I go into the clinic my GP doesn't make eye contact with me and is more concerned about typing up notes on the computer—but maybe by having a phone call with me my GP has to answer my questions, because I'm not putting the phone down and they cannot put the phone down on me. Do you see what I'm saying? I have a captive audience for once in my life—which is great—because when I go into the clinic, I don't have a captive audience in the clinic. They treat you like you’re some sort of garbage that has walked in to wast their time

So the phone calls were almost better than when I was there in person, but then again not every woman is like me. I used to have a list of questions written down for the GP, and I would go through all of those questions to make sure that I got the most out of the telephone conversation. But a woman who is not thinking about all those things because maybe she has four other kids probably wouldn't have questions waiting like that, neither would a woman who is completely unaware,  or one who is new to Canada, is new to these systems. How do you figure all this out?

“IT IS VERY DIFFICULT FOR HIM TO HANDLE THAT HE HASN'T HEARD THE BABY'S HEARTBEAT, EVEN ONCE. THE BABY DID NOT FEEL REAL TO HIM UNTIL AT LEAST THE 27TH WEEK WHEN THE BABY STARTED KICKING.”

I just want to give you the experience of my first Life Labs (blood testing services) appointment. She (my GP) sends me the requisition by email. I did not have a printer at home, so I could not print out the requisition. So an hour before my appointment, by chance, it occurred to me that I should phone up the doctor's office and ask them to fax the requisition to Life Labs. But if Life Labs had not received that requisition faxed, they wouldn't have let me come in for the appointment. And they wouldn't have looked at the requisition slip on my phone. They need a paper copy.

So now look, both you and I have been living in Canada for so long, would you have thought to do this? No. Not unless someone mentioned oh by the way they need a paper copy of this form.

What else has been complicated for you about this experience?

MM: Well Alexis has found some things difficult. There have been differences between the care I have received here in Canada and the care of his sister when she was pregnant in France. And then of course there are the restrictions due to Covid. It is very difficult for him to handle that he hasn't heard the baby's heartbeat, even once. The baby did not feel real to him until at least the 27th week when the baby started kicking. Because he's not been in any of the ultrasounds. He cannot go to the ultrasound clinic with me. I cannot have a support person with me going in everywhere. Alexis cannot go into the Life Labs with me for bloodwork, he cannot go with me to the GP’s office. So he hasn’t heard the baby’s heartbeat during this whole time, which has been hard for him. He hasn't seen a single ultrasound. At the ultrasound clinic for the anatomy scan, I did ask them if I could video call with him, and they said I could, as long as I didn’t record anything, so he was virtually present for that. And the ultrasound clinic will print images, but they are not photographers—that is not their job—and sometimes the images they print are not the best ones, they are not the ones you really want to share.

This has been a relatively smooth pregnancy, but there is another side to all of this in that it has been much more complicated by the pandemic.

And you are due in two and a half months?

MM: Yes, and the hospital I am registered with to give birth could change it rules depending on Covid case numbers. I know other women who have had babies during the pandemic have had to labour wearing a mask. I will also have to labour wearing a mask—something that is not comfortable at all—labour is bad enough without having to wear a bloody mask. You do not need to have that extra humidity on your face while you are going through the worst experience of your life. Only one support person is allowed, that I think is a good thing. Frankly speaking, you don't have to have a circus in your delivery room. People have often four to five people. People have a videographer. People have all kinds of different things when they're giving birth. So that's restricted now. But other regulations could come. What if the of hospital at some point says once the baby's born, the baby has to quarantine for 14 days? It's possible. Things are changing all the time.

You see anything can happen; it’s a moving target. And I think it can be difficult for a lot of people who are pregnant right now. People don't know what you're going through. Your friends don't know what you're going through. I didn't even bother to tell most people until they called me for my birthday in September.

One experience that I will take away is the isolation. I think this time has been an isolating one for pregnant woman. It's been an experience that you haven't been able to share in the same way that you would have if there hadn't been a pandemic.