Health |

Of the COVID-19 pregnancy cases reported in Illinois, Black and Latina women make up over 70%

At around 25 weeks pregnant with her first child, a 21-year-old Hispanic woman became infected with COVID-19.

The young woman’s doctors at St. Anthony Hospital in Little Village were just learning more about the coronavirus as it hit Illinois in the spring, and they wanted to monitor the baby’s growth.

But her insurance did not initially approve the growth ultrasound, her doctors said. So they had to wait to schedule a scan to check her baby. This delayed their ability to assess the pregnancy and created extra stress.

“There were a lot of barriers for her,” said Margarita Flores, a St. Anthony midwife who helped treat her.

When she delivered in June, she was diagnosed with preeclampsia — high blood pressure in pregnancy that can lead to serious, or even fatal, complications for both mom and baby. The baby was born small.

The mom and her baby, whose names were not shared for privacy reasons, are doing well now, said Flores and her doctors.

The coronavirus has amplified the challenges pregnant women face. And even more so for Black and Latina women, who might be disproportionately affected by COVID-19, according to recent Centers for Disease Control and Prevention data, and who experience extra burdens of not only implicit racism within the health care industry, but also socioeconomic factors that can impact their ability to access care.

“Patients, especially in our area, are very high risk,” said Michele Bucciero, medical director of perinatal services at St. Anthony. The hospital is located in a predominantly Latino neighborhood.

At least 1,089 women in Illinois have had COVID-19 while pregnant, and of those cases, five have died, according to Illinois Department of Public Health data received Thursday. Nearly half of them, 43%, were hospitalized, although the department can’t confirm whether it was related to their pregnancy or fighting the virus.

Among these women, 49% were Hispanic and 23% were Black. Melaney Arnold, a Health Department spokesperson, said the reporting likely underestimates pregnant cases by about 30% because for much of the data, pregnancy status is unknown.

“COVID-19 brought its own set of issues around disparities, but also highlights issues that have been there all along,” said Ann Borders, an OB-GYN in the NorthShore University Health System and executive director of the Illinois Perinatal Quality Collaborative. The latest data, she said, confirms concerns doctors like her have always had about pregnant women’s vulnerability. It also confirms the need to be extra vigilant, she said.

Unique Clay, a Black postal carrier who tested positive for the coronavirus, died a week after giving birth to her third child in May, according to a news report. Her 11-year-old daughter found her dead at home. In April, Eli Solano, a Latina mom, passed away after her battle with COVID-19 shortly after giving birth to a baby boy, according to a fundraiser from her family. The state Health Department recently investigated Roseland Community Hospital after a 31-year-old pregnant woman died from the virus there in May. The report does not list a name, but Cook County medical examiner’s office records of coronavirus deaths show a 31-year-old Black woman named Lolita Davis, who was pregnant, died May 15.

The American College of Obstetricians and Gynecologists (ACOG) cautioned that researchers are still learning about how COVID-19 impacts pregnancies, and noted pregnant women did not appear to be at more risk of death than nonpregnant women.

Doctors should speak with women about their household situations, whether they live with people who are essential workers, for example, and the need to quarantine and take precautions.

“A lot of it’s risk reduction, rather than completely being able to avoid risk,” Borders said. “Not everyone has the luxury of being able to socially distance or stay at home.”

Bucciero says it’s always a balancing act for many of St. Anthony’s patients. “A lot of (our patients) are essential workers that live in multigenerational households,” she said. “They use a lot of public transportation, they rely on their kids being in school, they rely on the programs for meals for their kids.”

Mary Calderon is a doula at New Moms, a nonprofit that works with young mothers, often young Black and Latina women. Many of her clients live with multiple family members, including those who are essential workers and thus must leave the house often, elevating exposure to the virus.

“The issues that our community faces are just being exacerbated and brought to light during the pandemic. They have been issues for a long time,” Calderon said. “When a woman is experiencing chronic stress from scarcity, not having enough food, not knowing where she’s going to live, being unemployed, chronic stress from racism, that seeps in on a cellular level.”

She and the pregnant moms she speaks to — now over videoconferencing — talk about finding healthy food and the impact that can have on their babies. She tells them about the importance of prenatal care and meeting with doctors. She encourages them to speak up at appointments.

“Arming them with information about their options just helps them advocate for themselves,” she said.

Paris Brown remembers being glued to the TV in March. In her second trimester, she watched as the state of Illinois shut down, worrying about what it meant for her second daughter due in late July.

“I would wake up at 3, 4 in the morning and wouldn’t even go back to sleep,” she said. While she hasn’t tested positive for the virus, the pandemic has added stress to her pregnancy.

During each ultrasound, she uses so much hand sanitizer that her doctor told her, “Clearly, you’re very cautious.”

She attended all appointments in person, balancing concerns about being in a hospital with wanting to hear her baby’s heartbeat. Doctors stress that in-person visits are often crucial, depending on each patient’s pregnancy, and that it is safe to attend them.

“Obviously I have to put the baby’s health first,” Brown said.

The CDC report found that pregnant women with COVID-19 are more at risk for hospitalization, although it could not detail whether hospitalizations were because of pregnancy or the virus, and noted that any barriers for pregnant women to protect themselves from the virus should be addressed.

“With COVID-19 it’s like, OK, now we’re really seeing the challenges to providing good health care to African American women,” said Joy West, an OB-GYN at Roseland.

She noted the closing of OB units, which made it harder for women to receive care close to home, and the disparities in telehealth. Not everyone has a computer or internet service. And when doctors try to assess vitals and weight, not every patient has a blood pressure monitor, thermometer and scale at home. High blood pressure in pregnancy, for example, can signal serious complications.

“We know that high blood pressure in pregnancy is one of the No. 1 reasons why there is an increase in maternal mortality in African American communities,” West said. “Preeclampsia, or high blood pressure, is devastating, and it’s very common in African American women.”

Black women are six times more likely to die from pregnancy-related conditions in Illinois. They are more at risk from dying from cardiovascular disease, a disparity that ACOG attributed in part to racial bias and racism in the health care system.

As doctors seek to learn more about the coronavirus and its impact, hospitals have been adding precautions, such as testing women who arrive to deliver. And moms who test positive are separated from their newborns — while a precaution, it has added extra stress and heartbreak.

In normal times, pregnancy is a challenge with women at risk for a variety of potential complications.

At St. Anthony Hospital, the doctors often huddle to assess cases.

Now, they are waiting and watching as women who became infected with COVID-19 in March and April prepare to deliver later this summer.

“It’s just a matter of time,” Bucciero said. “They’re going through their third trimester now.”

abowen@chicagotribune.com