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PERSPECTIVE: On Sep. 14, 34-year-old Tan Yi Fang tested positive for Covid-19 while she was 35 weeks pregnant.

Tan shares what she went through in a 21-day ordeal — being put on oxygen support, nearly dying, and eventually delivering her baby without her husband by her side. 

As told to Matthias Ang by Tan Yi Fang

Felt unwell on the night of Sep. 13

I'm not a very young mother at the age of 34, and I was going into my third trimester with my first child.

I had taken MC on Sep. 13 for my routine check-up with my gynaecologist at Mount Elizabeth Novena Hospital. I was fine in the morning for my check-up.

Later in the evening, I started feeling cold and feverish. I tried sleeping early, and took Panadol as my temperature rose to 38 degrees in the night.

In the morning of Sep. 14, I still did not feel right and so I decided to take a Covid-19 test with the ART kit.

I thought my eyes were playing tricks on me as I also saw a very faint line at the T portion on the test kit. I did not know what to do at first, except put on a mask, while my husband decided to do his own test as well.

When he tested negative, I broke down as I questioned how this could happen to me.

We took precautions as I was not vaccinated

We made a trip to the nearest clinic where I did both a PCR and ART test. The results for both were positive.

When the doctor asked why I did not get vaccinated, I explained that it was not because I did not want to get vaccinated — if I was not pregnant, I would have gone for the vaccination.

I had a few considerations.

Both my husband and my mother were also worried for me as my husband had a pretty strong reaction to the Moderna vaccine.

As I felt like I did not know enough about the vaccines at that time, I decided not to get vaccinated as I was afraid of the reactions I would get, and whether it would harm my baby.

[Editor's note: Pregnant women have been invited to book vaccination appointments in Singapore from June 4, following a review of  clinical data of vaccination in this group.

On Sep. 13, the Ministry of Health also published a written answer to a Parliamentary question, saying that there is currently "no evidence of safety concerns when mRNA vaccines are used in pregnant women, based on real-world clinical data".

The  Health Sciences Authority (HSA) received a small number of non-serious adverse event (AE) reports with the Pfizer-BioNTech/Comirnaty vaccine in pregnant women. These AEs are similar to those reported in the general population.]

Isolating at home

As I was working from home, I hardly went out on weekdays, and I only ran errands on the weekend. Everyone around me, including my husband, was vaccinated, so I thought I will be safe as long as I am careful.

When I received my positive results from the clinic, I cried as I thought of all the risks that could happen and whether I was going to endanger my baby.

I was given a three-day Stay-Home Notice from the clinic and told to wait for a call from the Ministry of Health.

From Sep. 14 to Sep. 16, my husband and I tried to isolate ourselves, with my husband staying in the living room while I stayed in the master bedroom. During this time, my fever fluctuated and I also had a blocked nose, which affected my taste. I would put on my mask if I had to leave the room.

On Sep. 15, I received a call from MOH's contact tracing team and another call from a lady who said that an ambulance would be arranged to send me to the hospital as I was pregnant. However, she could not promise when exactly the ambulance would come, saying that it would come either on the 15th or the morning of Sep. 16, latest.

By Sep. 16, there was no word of the ambulance to be sent by MOH, so I called 995 before noon.

[Editor's note: It was announced on Sep. 10 that home recovery will be the default protocol for fully vaccinated Covid-19 patients from Sep. 18 onwards, provided that they fulfil certain conditions. Vulnerable groups, such as pregnant women, were ineligible for home recovery.]

Rejected from KKH, sent to TTSH, spent seven hours in holding area

Sep. 16 was a terrible, terrible nightmare.

I was told by the paramedics that I would be sent to KK Women's and Children's Hospital (KKH).

However, when we reached the entrance of KKH, I was told the hospital would not accept me as I was not having contractions.

SCDF took me to the next nearest hospital, Tan Tock Seng Hospital (TTSH), which was accepting Covid-19 patients.

By the time I reached TTSH, it was 12:45pm. I waited for seven hours on a stretcher, in a makeshift non-air conditioned holding area within a carpark, with other patients. I didn't know if these were Covid-19 positive patients or not.

It was stuffy and humid and I was feeling more breathless than ever.

At first, a nurse told me not to worry — even though TTSH did not have baby monitors, they said that they could liaise with KKH. They also said that they had helped with deliveries before as a gynaecologist could travel over.

I was eventually told by a doctor that I could not be admitted to TTSH as I was already in my third trimester and the hospital did not have the facilities for me — they would not be able to help me deliver should I need to deliver early. So I had to stay at the holding area to wait for further instructions.

When the doctor apologised and asked me to bear with it, I asked how I could do so especially since I had been admitted to the hospital for breathlessness.

I couldn't understand why the hospital management was taking so long to decide on my case, or why they couldn't tell me what was going on.

Finally admitted into NUH, had to be placed on oxygen support

Eventually, TTSH had me transferred to NUH on the night of Sep. 16, where I was admitted to a single room at their isolation ward.

My symptoms began to worsen the next few days, from Sep. 17 to 21.

I could not taste the food and drink at my meals, nor could I smell the shower foam and shampoo that I used.

On Sep. 21, every time I went to the toilet, I started coughing severely to the point of breathlessness. I also felt like I wanted to vomit, which never happened before throughout the course of my pregnancy, even in the first trimester.

At night, the nurse who came in to check on me every four hours was shocked as my oxygen level had dipped below 90.

Normal oxygen levels are at least 95, so mine was in the danger zone.

A doctor conducted an X-ray on me and told me that my lungs looked hazy. I had no idea what that meant, except that I had to be sent to the ICU that night and placed on oxygen support.

The doctor also told me to wear a diaper as I would cough heavily if I removed the support to go to the toilet.

Had to deliver the baby via C-section

In the morning, an Obstetrics and Gynaecology (O&G) team came outside my ICU room at about 10am, and told me via a microphone that they had to deliver my child that very day in the afternoon as my lowered oxygen levels were potentially a danger to both myself and my daughter.

They mentioned that as my baby was already fully developed at 36 weeks, it would be the best decision to deliver as soon as possible so that they can concentrate on treating me after that without worrying about complications and side effects to the baby.

I asked if I could deliver naturally, as originally intended with my gynaecologist, however, as my baby’s head was not engaged yet, we could not afford to wait for another few days. Delivery via C-section would be the best choice.

The first thing that came to my mind was: "My husband is not going to be beside me when I deliver. Was I really going to deliver today?"

I called my husband, mother and gynaecologist. My gynaecologist told me to agree to the delivery, reiterating what the NUH staff said.

I was in a daze but I eventually realised that I had to go through it, without my husband.

Did not hold or see my daughter in person until I was discharged from the hospital on Oct. 3

On this note, I want to express my heartfelt thanks to my anaesthetist, Dr Bryan Ng, and the doctor who helped me to deliver, Dr Citra Mattar, for being so supportive during a tough time.

My anaesthetist assured me during the whole labour process and saying,"Don't worry, I'll be your husband for this process." He even helped to capture the first moments of my daughter, Leia, in pictures when she was delivered.

But there was no skin-to-skin contact. I could not see Leia or hold her until I was discharged, more than one and a half weeks later on Oct. 3.

I only saw her in the photos and video that were taken, and through the video calls arranged by the hospital's neonatal department in the morning and evening.

My husband also could not see Leia in person. Leia had to undergo many tests, including three PCR tests over the course of the next few days to ensure that she was fine.

She was finally allowed to go home on Sep. 27 with my husband.

Still needed oxygen support after delivery

Unfortunately, I still needed oxygen support after my delivery, although my reliance came down and I was shifted to a lower tier of support.

I also had to wear a binder, be on a catheter and use a commode as I was not allowed to walk to a toilet.

And I still needed to try and express breast milk every three hours. I felt helpless. How was I going to do it when I was still in ICU, on a catheter and commode?

The catheter was removed about one to two days later and I was shifted to a general ward with five other Covid-19 patients on Sep. 26, the 14th day of my symptoms.

I was still on oxygen support but at least I could move around and try to express breast milk.

I was told by a doctor that the issue now was oxygen, not Covid-19 — they could not discharge me if I could not stay off oxygen support at rest.

Doctor revealed that I had been at risk of dying with my child

By Sep. 29, it was 17 days since my symptoms first started but my oxygen level was still below 95.

The doctor also told me more about my X-ray results from Sep. 21: half of my right lung had been infected. There was a risk that I could die together with my baby, as my organs could have failed with the dipping oxygen levels.

They did not tell me this before, probably because they were scared that this would affect me.

Ultimately, I spent 18 days in NUH and was discharged on Oct. 3, 21 days after the onset of my symptoms.

I didn't realise that there would be such a vast difference in the symptoms for the vaccinated and the unvaccinated. I don't want anyone to go through what I did, so I hope this story shares what could possibly happen to unvaccinated pregnant women.

That being said, I am glad that Leia is feeding and sleeping well.

I have to count my blessings as things could have been much worse.

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