text: For many pregnant mothers, the hospital seemed like the scariest place of all. Tali Bogler is a physician and the chair of family medicine obstetrics at St. Michael's Hospital in Toronto. In March, her twin daughters were not quite three years old; she didn't have to reach back to remember her own pregnancy anxiety. And that was in normal times. When the pandemic was declared, it felt to Bogler like a huge, invisible switch had flipped. Even though she hadn't closed her practice, her phone began ringing cancellation after cancellation. Pregnant women left her office with tears pelting down their faces. Others phoned ahead to ask if they should come into their appointment, shocked and unsure of what to do. Every common worry had ballooned in size, and then burst. Bogler understood their pop! pop! pop! of fear. Her first thought when the WHO declared the pandemic was, How am I going to support women during this time?
  
  But she, like everyone else, had few answers about how hazardous the virus was to pregnant people. Her mind went to the Zika virus, which the WHO named a global health emergency in 2016. At the time, the health agency warned pregnant women, or those who might become pregnant, not to travel to nearly one hundred countries and regions. If a child-bearing person became infected, the virus could damage the fetal nervous system, even if said person didn't develop symptoms. If that damage did occur, the baby could develop congenital Zika syndrome, which has five key markers, including brain damage. The Canadian federal government had lifted travel warnings related to Zika only a few months earlier. Initially, Bogler had no way of knowing if COVID-19 would pose a similar threat or become something even worse. Viruses in general tended to attack the immunocompromised, and both pregnant people and newborns fit into that category. (It's worth noting that, six months into the pandemic, information on how the virus affects pregnant people and newborns remained distressingly deficient; some early data has shown that pregnant people are more at risk and are 70 per cent more likely to need respirators if they do get the virus, but a Grand Canyon of questions has persisted.)
  
  Even if the new coronavirus spared them, Bogler knew that the mass shutdown of services would affect her patients in other, detrimental ways. "It was such a shock for pregnant women, because you do everything you can to have a healthy pregnancy," she said. You eat the right foods, sign up for the right classes, avoid all the risks. "And then this was something completely out of control for them." Women who had the resources for prenatal classes were abruptly left with nothing. Grandparents who had intended to be present for the baby's birth or to provide support in the postpartum period were forced to stay home. Community supports were nullified. Women who were already facing higher risks only saw them skyrocket. Add to all that the absolute paralyzing fear of not knowing if your newborn could catch COVID-19, or what it would do to them if they did. And add to that the destabilizing uncertainty of bringing a new life into a world throttled by a pandemic. A world that nobody thought would ever be the same again. There was no "ultimate guide" for that.
  
  Within days of receiving the lockdown orders, Bogler and other providers she worked with began to brainstorm new ways they could reassure—and reach—their patients. They landed on a simple, but highly effective, solution: Instagram. Not only was it free and easily accessible, but they knew that many pregnant people fit into the platform's demographic. In early April, they launched an account under the name Pandemic Pregnancy Guide, and gave the page a cheeky description: "What to expect when you're expecting…during a pandemic." The colour scheme is a checkerboard of Insta-calm, all rich teal and blush pink. The tone of each post exhibits the same calm; captions are evidence-based, competent, clear. Early posts talked about whether patients in labour were wearing masks; how prenatal care might change; the likelihood of hospitals reducing the "one support person" rule to zero, a controversial and panic-producing move that would force people to give birth alone. Comments were both anxious and thankful, vacillating between posters who expressed general alarm and those who, in typical Insta fashion, thanked organizers, left heart emojis, and said things like "bless."
  
  Bogler and the other founders expected their followers would include their immediate patients, and maybe their friends. Instead, the page quickly gained more than ten thousand followers. As their numbers and profile grew, the team started to receive sponsorship offers. Bogler turned them all down. It was important for her that the information remain free from influence and bias; the information is strictly medical and that's it. By September 2020, the page had hosted dozens of live expert sessions, on everything from optimal birth positions to going to the ER during the initial outbreak surge. As the country began to reopen schools, the account also addressed the extra anxieties of families with school-aged kids. They hosted a Pride-themed prenatal and postpartum workout, and they discussed intimate partner violence. They talked about Black maternal health, diversified their experts, and even tackled post-pregnancy sex. In a time particularly rife with social media and "I heard that…" misinformation, Bogler and her colleagues worked hard to quell uncertainty and provide good information. They listened to feedback about the platform and got better at all the tech stuff and savvy branding. "None of us are influencers on Instagram," said Bogler. "We're all learning things as we go."