The first shock came after her COVID-19 test, required ahead of admission to the University Hospital of the West Indies (UHWI) maternity ward, came back positive. She had no symptoms and no clue she had the coronavirus.

The second shock came six weeks later when she reportedly had to endure an almost three-hour-long tussle with a Registrar General’s Department (RGD) representative at UHWI before her child was finally registered.

“I know COVID is a special set of circumstances but it is here and we’re having to live with it. We need proper procedures in place so that children don’t go unregistered and mothers are not subjected to the nightmare that I was,” said the young woman who asked not to be identified by name.

“The big issue for me is that I should not have gone through a three-hour ordeal to register my child. I should not have to be begging people to go and beseech the RGD representative at the University Hospital to register my child when there is a record of me delivering a healthy baby [there]. It was a complete mess. And I suspect I’m not the only person that has encountered that issue. I don’t know what the other mothers’ experience has been, I don’t know what it’s like in other hospitals but I believe that there are gaps that need to be addressed. Nobody should have to go through this.”

After her positive test, the expectant mother was placed on an isolation ward as protocol requires. She said she accepted that because she was COVID-19 positive there would be changes in the RGD’s usual approach of registering the child at the mother’s bedside.

However, she was puzzled when no attempt was made to follow up with her about registering the birth long after she and her child were discharged from the hospital.

Things took a turn for the worse when she attempted to do the registration at UHWI while there to have her baby immunised. The RGD representative, she said, told her that she needed to get a letter from the hospital to say that she was able to register the child or able to conduct duties.

“A person’s COVID status should have nothing to do with whether or not they can register a child. And in my case, the two-week period would have passed a long time ago. What it displayed is that the RGD, at least the representative that I interacted with, she either doesn’t have a clear understanding, or wasn’t able to use her discretion to ensure that the registration took place,” said the mother.

Medical staff explained to her that the required letter could only be provided by the municipal authorities responsible for tracking COVID-19 cases. They had done an exit interview with her after her two-week quarantine, she said, but had not given her anything in writing.

With no letter in hand, she then tried to reason with the RGD rep, pointing out that her two-week quarantine period had long expired. She was then told that the registration could not be done because her name was not in the passport hospital nurses had provided for her child ahead of discharging her. She alleged that the RGD rep made no effort to check hospital records to verify that she had given birth there.

Determined not to leave without having her child’s birth recorded, the young mother enlisted the help of hospital staff.

“Everybody was trying to speak to the RGD on my behalf because they were being resistant to facilitating the registration of the child. The public health nurse went back to her and talked to her. The supervisor decided to reach out to the RGD ward representative, and she literally had to have a 15-minute conversation with the woman to say to her, ‘You need to register this lady’s child’.

“The conversation went as far as her saying to the lady, ‘this is a direct instruction for you to register the child’. Because the woman was not yielding in terms of her insistence that she should not register this child,” said the mother.

According to the RGD website, “the registration officer is responsible for registering all births occurring in hospitals and birthing centres daily, based on the information provided to them by the parent(s) in the hospital”. It also says the RGD has trained officers stationed at hospitals across the island to do bedside registrations and “this has led to significant improvements in the recording of these vital events”.

In responding to queries from the Jamaica Observer, the RGD provided an outline of protocols, dated in March, put in place for cases where mothers are COVID-19 positive.

There is no mention of a letter saying the mother is COVID free, but it does say measures are in place to ensure that staff approved for these duties are free from “underlying medical conditions that might place him/her at increased risk in case of COVID-19 infection”.

The RGD also explained that one significant change was that its staff have no face-to-face interaction with COVID-19 positive mothers.

According to the UHWI’s attorney Dr Peter Glegg, the hospital’s approach is that births are now registered when the mother takes the child in for immunisation.

“Pre-COVID, the RGD staff would have gone to the labour ward every day to look in the log book and they would do the registration based on the names in the log book,” Glegg told the Observer.

“Post-COVID surge, what has been happening is that when the mother comes in for a six weeks review where the immunisation and other checks are done, at that stage, that is when we are doing registration in order to [minimise] exposure to the staff, especially the RGD staff.”

But the young mother was unaware births were only being registered at the six-week mark.

“So this is where the big muck-up happens now. There are three institutions at play here — the RGD, UHWI and I think it’s the municipal authorities who are tracking the COVID cases — and none of them have a seamless process to ensure that mothers are able to register their babies after testing positive for COVID,” she said.

“The three organisations are not talking [to each other]. It seems the RGD just does not have a protocol any at all, and the municipal authorities are not thorough in terms of ensuring that persons are able to smoothly conduct business,” she added. “They’re quarantining people and then not doing follow-up in the end. The hospital’s [shortcoming] is an issue of communication; I don’t think it is necessarily a protocol issue. They are not sitting at the table to talk and say when we have [COVID-19 positive] mothers this is the protocol that is supposed to be in place.”