If you are pregnant, the greater your chances of being vulnerable to serious Covid-19 illness.



A September 2020 report by the US Centers for Disease Control and Prevention (CDC) stated: “Pregnant women with Covid-19 were found to be more likely to be hospitalized and require ICU admission than non-pregnant women.”



According to South Africa’s Department of Health, pregnancy is a time when the immune system changes so pregnant women “should continue with standard precautionary measures such as avoiding crowded places, limiting the use of public transport where possible, washing their hands regularly with soap and water, and avoiding touching their face”.



Already in Africa, the World Health Organization (WHO) has stated that maternal health – or the health of women during pregnancy, childbirth, and the postpartum period, and their reproductive health – is a human rights issue.



Sandra Orta, General Manager for South Africa &amp; Sub-Saharan Africa at Roche, a global partner in pharmaceuticals and diagnostics, agrees.



<blockquote class="wp-block-quote is-style-default is-layout-flow wp-block-quote-is-layout-flow">“Antenatal is not taken seriously enough, and it is a serious problem. However, it is a millennial goal to ensure that there is better access to antenatal care.”<cite><meta charset="utf-8">Sandra Orta</cite></blockquote>



Orta says that there are considerable gaps in maternal health interventions like antenatal care. Or the fact that WHO also reported that every day, approximately 830 women die from preventable causes related to pregnancy and childbirth; and 99% of all maternal deaths occur in developing countries.



Maternal mortality is higher in women living in rural areas and among poorer communities.



“The poorer the area, the more the area is affected,” Orta says to FORBES AFRICA. “And now with Covid-19, we don’t have exact numbers because it is still too early but what we have seen is that patients have been going less to see their doctors or having to postpone their appointments because maybe there are restrictions or no public transport.”



And what is also not looked into, Orta adds, is how antenatal care brings emotional support to the mother.



“What we need to remember is knowing that the baby is ok and healthy; that brings you less anxiety and moms need to be supported. Everything that we feel, the baby feels as well.”



The biggest challenge in South Africa, according to Professor Koleka Mlisana, Executive Manager: Academic Affairs, Research and Quality Assurance at the National Health Laboratory Service (NHLS) and also co-chair of the Ministerial Advisory Committee (MAC), is that there is no data that specifically looks at pregnant women.



“So the burden of Covid-19 among pregnant women would just come from admission surveillance work that is done by the NICD (The National Institute for Communicable Diseases),” Mlisana said, in an interview with FORBES AFRICA in June.



“There is a serious lack of data because we don’t know how many pregnant women we have in [the] country at any point of time.”



“That is a sign that there is no good or not enough antenatal care,” Orta adds, “Antenatal is not taken seriously enough, and it is a serious problem. However, it is a millennial goal to ensure that there is better access to antenatal care.”



But the data that is available point to the fact that 10% of Covid cases are made up of pregnant women.



“What surveillance work is showing is that pregnant women have a higher risk of hospitalization compared to [other] women, even though they are in hospital.”



In South Africa’s initial vaccine rollout phase, only pregnant women with comorbidities or at higher risk of infection could receive Covid-19 vaccinations, but now, with vaccines encompassing the younger generation, women of childbearing age are all included.



“Women are key pillars for our communities, for families and it is very important that we look after them,” Orta says.

SRI LANKA-HEALTH-VIRUS-VACCINE

Pregnant Women And Covid-19: Risks And Reports

In recent years, surrogacy has become increasingly popular among single women and gay couples. For heterosexual single men, it’s still a rather unusual path to follow but that is changing.



BY PAULA SLIER



SOUTH AFRICAN MEN ARE MAKING HISTORY, choosing to become single fathers by choice. In March, Wesley Hayes, a 35-year-old divorce attorney won a year-long battle to legally register his daughter, Justine Filly – her second name reflects Hayes’ love of horses. 



Andrew Martin, a fertility lawyer who heads his own firm in Cape Town, has successfully registered a number of babies for single fathers through surrogacy over the past decade. One of Martin’s clients is a 46-year-old Johannesburg business consultant, Gavin Phillips*. 



Since November 2019, Phillips has undergone three unsuccessful IVF journeys and is now about to begin his fourth. 



“I’ve always wanted children and after I lost my father to Alzheimer’s in 2017, the need to extend my family, and have a legacy, became more intense,” he says. 



<div class="wp-block-media-text is-stacked-on-mobile" style="grid-template-columns:21% auto"><figure class="wp-block-media-text__media"><img loading="lazy" decoding="async" width="612" height="1024" src="https://cms.forbesafrica.com/wp-content/uploads/2021/06/Dr-Tasneem-612x1024.jpg" alt="" class="wp-image-51482 size-full" srcset="https://cms.forbesafrica.com/wp-content/uploads/2021/06/Dr-Tasneem-612x1024.jpg 612w, https://cms.forbesafrica.com/wp-content/uploads/2021/06/Dr-Tasneem-179x300.jpg 179w, https://cms.forbesafrica.com/wp-content/uploads/2021/06/Dr-Tasneem-768x1286.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2021/06/Dr-Tasneem-917x1536.jpg 917w, https://cms.forbesafrica.com/wp-content/uploads/2021/06/Dr-Tasneem-1223x2048.jpg 1223w, https://cms.forbesafrica.com/wp-content/uploads/2021/06/Dr-Tasneem-scaled.jpg 1529w" sizes="(max-width: 612px) 100vw, 612px" /></figure><div class="wp-block-media-text__content">
<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow">It’s exciting and I hope it’s something we see more of. We have the technology to do these things and there are definitely men who would make good parents and if we can help them, it’s a lovely thing for us to be able to do. – Dr Tasneem Mohame</blockquote>
</div></div>



Phillips was married and unfortunately despite efforts to have a child, those efforts did not bear fruits. “After we got divorced, I considered adopting a child, and then I started to research surrogacy.” Traditionally, it’s heterosexual couples who go this route. Globally, one in six such couples struggle to conceive, regardless of whether they come from low-, middle- or highincome countries. But in recent years, surrogacy has become increasingly popular among single women and gay couples. 



For heterosexual single men, it is still a rather unusual path to follow. Dr Tasneem Mohamed, an obstetrician gynecologist practising at the BioART Fertility Centre in Johannesburg, has dealt with only two requests in the last two years from single men wanting to have babies. 



“I think maybe a lot of men out there don’t know it’s an option for them,” she says. “And probably a lot of them who’ve thought about it just get shut down by their families. It’s a lot of responsibility raising a child on your own, but maybe once single men know it’s possible, we could see more of them coming forward. 



“It’s exciting and I hope it’s something we see more of. We have the technology to do these things and there are definitely men who would make good parents and if we can help them, it’s a lovely thing for us to be able to do.” South African law stipulates that those seeking surrogacy as well as the surrogate herself must be South African or resident in South Africa. 



“This is to protect local South Africans from being taken advantage of by foreigners coming and using them as surrogates,” explains Dr Yossi Unterslak, a gynecologist and reproductive medicine specialist at Vitalab Fertility Clinic in Johannesburg. 



“There’s no restriction on the egg or sperm donor. But if it’s a single man seeking surrogacy, it has to be his sperm.” 



<div class="wp-block-media-text is-stacked-on-mobile" style="grid-template-columns:34% auto"><figure class="wp-block-media-text__media"><img loading="lazy" decoding="async" width="1024" height="1024" src="https://cms.forbesafrica.com/wp-content/uploads/2021/06/Dr-Yossi-Unterslak-1024x1024.jpg" alt="" class="wp-image-51483 size-full" srcset="https://cms.forbesafrica.com/wp-content/uploads/2021/06/Dr-Yossi-Unterslak-1024x1024.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2021/06/Dr-Yossi-Unterslak-300x300.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2021/06/Dr-Yossi-Unterslak-150x150.jpg 150w, https://cms.forbesafrica.com/wp-content/uploads/2021/06/Dr-Yossi-Unterslak-768x768.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2021/06/Dr-Yossi-Unterslak-1536x1536.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2021/06/Dr-Yossi-Unterslak-2048x2048.jpg 2048w" sizes="(max-width: 1024px) 100vw, 1024px" /></figure><div class="wp-block-media-text__content">
<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow">Shop around and find a clinic that is close, affordable and offers treatment but also be careful. – Dr Yossi Unterslak</blockquote>
</div></div>



As much as 40% of patients seeking fertility treatments at Vitalab come from abroad – the vast majority from countries in Africa where such treatments are inferior in quality. 



“Shop around and find a clinic that is close, affordable and offers treatment but also be careful,” warns Dr Unterslak. 



“There are countries that allow cross-border surrogacy like Ukraine and India, which are quite popular.&#8221;



“Look at the law to make sure you are not going to go through the expensive process of generating embryos and then after the baby’s born, there’s an issue getting the child back into your country.” 



Surrogacy does not come cheap. Success rate the first time around is around 67% which means the bills can add up. Phillips estimates he’s already spent nearly a quarter of a million rands (about $17,000). 



“There’s the buying of eggs, the fertility clinic, lawyer fees and treatment cycles. Legally, the surrogate can’t earn money from doing this and so I also contribute towards costs of her pregnancy, her medical aid and life insurance. There is a provision in the agreement that says that she is required to try at least three times. The fact that we are on our fourth shows you that these surrogates care and commit to these surrogacy journeys with deep empathy and altruism.” 



But the process can be laborious. The first step is choosing a donor. 



“You get to see their health records, family history, whether they smoke, take meds, drink, how much they exercise,” says Phillips. “You get to find out their eye color, hair color, height. You get an idea of their academic ability, their sporting ability, whether they’re introverted or not and you get pictures of them up until the age of 11 because of anonymity concerns.” 



Out of 27 possibilities, Phillips eventually found a donor he was happy with. He donated his sperm to fertilize her eggs. Once the fertilization had taken place, mature embryos (blastocysts) were then frozen until the surrogate had been prepared through various stimulation treatments to receive a blastocyst transfer (IVF). Unfortunately, after three attempts, and although the surrogate fell pregnant each time, the pregnancies did not progress, resulting in miscarriages.



Phllips, then, in an effort to give the surrogacy route another try, decided to change donors and also underwent personal genetic testing to determine if there were any chromosomal abnormalities (of which there were none).



“I’m hopeful, my new donor has got good qualities in terms of what I would like for a child, but genetics can go back six generations. So, you might see something from your great, great, great, great grandfather come out in your child. Not everything is a guarantee but what you want is really healthy eggs from a successful donor (a donor that has donated eggs in the past that has resulted in a pregnancy).”



Phillips has also sent the embryos he has available from this fertilization cycle for additional genetic testing called Preimplantation Genetic Testing for Aneuploidy (PGT-A). This helps mitigate any risks around implanting embryos that could present with chromosomal abnormalities, prior to commencing with the next round of IVF. If all is normal in the results, a fourth round of IVF will proceed.



Says Phillips: “I feel I have given myself the best chance available for success. I know that 50% of the success is in the hands of science and the rest is in the hands of a higher power – if the stars align, I could be a father in 10 months’ time. Sadly, there’s still a stigma attached to single men having children on their own and the argument that a child allegedly needs a mom. I’ll be the mom and the dad, and I’ll protect and nurture my child with everything I have. I also won’t give up until I have completed this beautiful journey. My child/children will know how much love went into conceiving them,” he says.



Both Phillips and Hayes feel that the concept of a nuclear family is changing. No longer does it mean two point four children and a husband and wife. 



Families today come in all shapes and sizes – single mom, two moms, two dads, single dad.



“Relationships are not my forte,” admits Hayes. “I’m very independent and I don’t necessarily find myself best suited to living with somebody and having to make joint decisions about a child. I’ve done enough divorces to know that it’s an unpleasant business and in a number of cases, the children are used as a pawn in the divorce proceedings. As a single parent, I don’t have to concede to anyone. It sounds very selfish, but I don’t have to take anybody else’s opinion into consideration.”



But the process can be quite invasive. “I had to undergo psychometric testing and a psychological evaluation. The social worker looked into my circumstances and interviewed my family and friends to see what my environment was. I also had to prove that financially I am able to look after a child. I’m not saying it’s a bad thing, but it is invasive.”



But it was all worth it the moment he saw Justine for the first time. 



“I wasn’t there for the actual birth itself and arrived moments after she was born. I found her in a little incubator and I just recognized her. I immediately saw small bits of myself looking back at me,” he smiles.



“Africa is by and large a patriarchal society so I can’t see why being seen as the head of a family and being seen as the father of a child without a mother is an issue. There are many single fathers who’ve lost their wives for various reasons.



“Nobody can say that my daughter is unwanted. She was absolutely 110% planned and a 150% wanted and is unimaginably loved. Just as thousands of children don’t have fathers, I think it’s going to become more commonplace that children don’t have mothers.”

Wesley Hayes and daughter3

Daddy Cool: How More Single Straight Men Are Considering Surrogacy

TOPLINE Visits for postpartum mental health treatment spiked 30% during the pandemic, according to a study of more than 137,000 women in Ontario published Monday, adding to the many other emerging mental health effects of the pandemic.



<h4 class="wp-block-heading" id="h-key-facts">KEY FACTS</h4>



Visits for anxiety and depressive disorders by new mothers were as much as 39% higher from March to November 2020 compared to pre-pandemic levels, while visits for substance use disorders also rose, according to a study of more than 137,000 postpartum women in Ontario published in the Canadian Medical Association Journal.



Increases in less-densely populated portions of the province saw returns to pre-pandemic levels of postpartum mental health visits beginning in the summer, which may be because fewer Covid-19 cases allowed in-person school, in-person dining and other hallmarks of normalcy.



The smaller increases in mental health visits among low-income women may be because they can’t take time off of work or don’t have wifi and a phone that can handle telehealth appointments, said Dr. Simone Vigod, lead author of the study and head of psychiatry at the University of Toronto-affiliated Women’s College Hospital.&nbsp;&nbsp;&nbsp;



<h4 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h4>



“Postpartum mental health issues are very treatable,” but without access to healthcare they can become a long-term problem affecting a woman’s wellbeing, said Vigod. Postpartum anxiety and depression has also been linked to social and emotional problems for children, she said. “There can be long-term implications across generations.”



<h4 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h4>



The pandemic shut down many of the social supports that new parents rely on, including help from family, parent groups and public health nurses, said Vigod. Mental health problems have broadly increased during the pandemic in the U.S. as well. In 2019, slightly more than one in 10 adults reported symptoms of anxiety or depressive disorders to the CDC. In 2020, the agency’s surveys regularly found&nbsp;<a href="https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm" target="_blank" rel="noreferrer noopener">more than one-quarter of adults</a>&nbsp;said they had symptoms of anxiety or depression—and sometimes more than one in three adults said they were struggling with those issues.&nbsp;



<h4 class="wp-block-heading" id="h-further-reading">FURTHER READING</h4>



<a href="https://www.cmaj.ca/content/193/23/E835" target="_blank" rel="noreferrer noopener">Postpartum mental illness during the COVID-19 pandemic</a>&nbsp;(Canadian Medical Association Journal)



<a href="https://www.forbes.com/sites/mishagajewski/2020/06/19/moms-are-not-okay-coronavirus-pandemic-triples-anxiety-and-depression-in-new-mothers/">Moms Are Not Okay: Pandemic Triples Anxiety And Depression Symptoms In New Mothers</a> (Forbes)



By Graison Dangor, Forbes Staff

Tag: pandemic pregnancy

FORBES AFRICA SOCIAL MEDIA

Pregnant Women And Covid-19: Risks And Reports

Daddy Cool: How More Single Straight Men Are Considering Surrogacy

Postpartum Mental Health Visits Spike 30% During Pandemic, Study Finds