When Mili América Antelo woke up, she couldn’t remember a thing; nothing about her 11 days in an intensive care unit (ICU) due to Covid-19, and nothing about her pregnancy or the delivery of her twin daughters, Ayma and Ayla, who were put directly into incubators in the neonatal unit at Vall d’Hebron hospital in Barcelona.
“Four doctors came and asked, ‘Do you know you have given birth?’ But I didn’t know anything. I couldn’t remember being pregnant or giving birth,” explains Mili, 40.
When she opened her eyes and found herself alone in a room, she had no idea where she was. She tried to get up, but she was too weak to even sit on the bed. Nurses in personal protective equipment (PPE) came and went from time to time. Mili was confused and wondered where her husband was and why he wasn’t with her. “All I could think was that my husband didn’t want to see me,” says Mili. “I asked him why he wasn’t with me and he said he wasn’t allowed because of Covid-19. But I didn’t understand anything.”
The last thing she remembers was her husband coming back from a trip on March 13. They chatted while he unpacked, and then nothing – her mind went blank. From what she has been told, she knows that a few days later she started to have contractions and went to the emergency ward, which turned out to be a false alarm. The next day, she experienced breathing problems and was back in the ward again. It was March 27 – the height of the pandemic; she was diagnosed with Covid-19-related pneumonia and admitted to Vall d’Hebron hospital. The next day, she was transferred to the hospital’s pediatric intensive care unit, which had been allocated to pregnant women with the virus.
Mili’s condition was deteriorating by the day. “She was in a terrible way, with severe respiratory failure, and had to have a cesarean section at week 28,” explains Felix Castillo, the head of the hospital’s neonatal unit. Ayma and Ayla were born on March 29 weighing just one kilogram each. Mili and her daughters were all intubated – Mili to help her fight the virus that was attacking her lungs, and the premature babies to help them fight for their lives outside their mother’s womb.
Mili was taken off intubation a week after her daughters were born and moved, on April 8, to a room on the ward where she was told what had happened to her. “They explained that I had had a stroke; that they had had to bring the birth forward, but that the girls were fine,” she says, adding that her response was: What birth? What girls?
“It’s the result of being sedated for 21 days, with very powerful drugs,” says Castillo. “She has become disoriented and has no short-term memory.”
According to Joan Balcells, head of the pediatric ICU where Mili was treated, “a period of disorientation is common after the sedation wears off. Between 25% and 30% of patients suffer from it but it improves after a few days. What is more striking is the amnesia prior to admission. A small lesion was detected on the magnetic resonance which was classified as a possible stroke, but I’m not sure that this could interfere with memory.”
Mili hung a picture of her babies lying in their incubator in her room. “It really affected me when I saw photos of them – the girls being so small, intubated, with the oxygen,” she says.
It was a month before she could see them in person. “She wasn’t able to do kangaroo care [a method involving breastfeeding and skin-to-skin contact for low birth weight babies] until she herself tested negative,” says Castillo. “She went in when the twins were one month old and the encounter was spectacular.”
The twins have tested negative for Covid-19 four times – on the day of their birth, after 24 hours, after five days and after two weeks. Mili has since beaten the disease and her husband, after an obligatory spell in quarantine, has been able to return to the hospital to be with her and his daughters.
Ayla and Ayma still have a few days left in the incubator and four or five weeks in the hospital before they can go home. Mili visits them every day for skin-to-skin contact, which was done by nurses and auxiliary staff in her absence. “It’s better if the mother does it,” says Castillo. “It is far more calming for the babies.”
The hospital has had to bring forward the deliveries of five pregnant women with Covid-19 while another 20 have reached full term. “If the mother’s condition is such that the baby may be suffering and there is danger, we have to get the child out sooner,” says Castillo.
Mili, meanwhile, is still recovering from her ordeal. She was discharged on April 21, almost a month after being admitted to the hospital, but she is still feeling the after-effects. “It’s like being in a haze,” she says. “I struggle, I forget things.”
English version by Heather Galloway.