Pregnant mothers, newborns threatened by healthcare strains during pandemic: UNICEF

Global containment measures such as lockdowns and overwhelmed health centres during the coronavirus pandemic threaten to put millions of expecting mothers and newborn babies at risk, according to the United Nations Children's Fund or UNICEF.

The rampant spread of the coronavirus has resulted in supply and equipment shortages and a lack of sufficient skilled birth attendants as health workers, including midwives, are redeployed to treat COVID-19 patients, the agency noted.

With 116 million expected births in the approximately 9 months since the COVID pandemic was recognised, UNICEF called on governments and donors to maintain life-saving services for pregnant women and newborns

In Bangladesh, an estimated 2.4 million babies will be born under the shadow of the COVID-19 pandemic. Globally, the number is 116 million. These babies are projected to be born up to 40 weeks after COVID-19 – currently straining health systems and medical supply chains all over the world – was recognised as a pandemic on March 11, UNICEF said in a statement.

“Millions of mothers all over the world embarked on a journey of parenthood in the world as it was. They now must prepare to bring a life into the world as it has become – a world where expecting mothers are afraid to go to health centres for fear of getting infected, or missing out on emergency care due to strained health services and lockdowns,” said UNICEF Executive Director Henrietta Fore.

“It is hard to imagine how much the coronavirus pandemic has recast motherhood.”

Ahead of Mother’s Day, recognised in May in over 128 countries, UNICEF warns that COVID-19 containment measures can disrupt life-saving health services such as childbirth care, putting millions of pregnant mothers and their babies at great risk.

Countries with the expected highest numbers of births for the period of 9 months from the date of the pandemic declaration (11 March) are: India (20.1 million), China (13.5 million), Nigeria (6.4 million), Pakistan (5 million) and Indonesia (4 million). Most of these countries had high neonatal mortality rates even before the pandemic and may see these levels increase with COVID-19 conditions.

Even wealthier countries are affected by this crisis. US is the sixth highest country in terms of the expected number of births.

In Bangladesh, an estimated 2.4 million babies will be born under the shadow of the COVID-19 pandemic. The country ranks at number 9 in terms of the highest expected number of births for the period of 9 months from the date of the pandemic declaration on 11 March.

Even though there is no significant change in the maternal mortality ratio and neonatal mortality rate, an analysis of data in the Directorate General of Health Services dashboard shows that since the beginning of the COVID-19 crisis, there is a significant reduction in the uptake of maternal and newborn health services from the health facilities.

Only 33 district hospitals in Bangladesh are performing all key functions of emergency obstetric care out of 63.

“Despite the pressure on the health system due to COVID-19 situation, routine lifesaving services for the pregnant mothers and newborn babies need to continue with proper infection prevention and control measures. UNICEF is working with the Government of Bangladesh to save lives by ensuring that pregnant mothers and sick newborn babies receive the required care in the months to come,” said Tomoo Hozumi, UNICEF country representative in Bangladesh.

UNICEF is supporting the government to maintain maternal, newborn and child health services during the pandemic through guidelines and training for doctors, nurses and midwives in the area of infection prevention and control.

This helps prevent the spreading of the virus, and protects health workers and patients. It includes triage (separating COVID-19 patients from non-COVID-19 patients), handwashing and other hygiene measures, and rational use of personal protection equipment.

Globally, UNICEF warns that although evidence suggests that pregnant mothers are not more affected by COVID-19 than others, countries need to ensure they still have access to antenatal, delivery and postnatal services.

Likewise, sick newborns need emergency services as they are at high risk of death. New families require support to start breastfeeding, and to get medicines, vaccines and nutrition to keep their babies healthy.

On behalf of mothers worldwide, UNICEF is issuing an urgent appeal to governments and health care providers to save lives in the coming months by:

>> Helping pregnant women to receive antenatal checkups, skilled delivery care, postnatal care services, and care related to COVID-19 as needed;

>> Ensuring health workers are provided with the necessary personal protective equipment and get priority testing and vaccination once a COVID-19 vaccine becomes available so that they can deliver high-quality care to all pregnant women and newborn babies during the pandemic;

>> Guaranteeing that all infection prevention and control measures are in place in health facilities during childbirth and immediately after;

>> Allowing health care workers to reach pregnant women and new mothers through home visits, encouraging women living in remote areas to use maternal waiting homes, and by using mobile health strategies for teleconsultations;

>> Training, protecting and equipping health workers with clean birth kits to attend home births where health facilities are closed;

>> Allocating resources to lifesaving services and supplies for maternal and child health.

While it is not yet known whether the virus is transmitted from a mother to her baby during pregnancy and delivery, UNICEF recommends that all pregnant women follow precautions to protect themselves from exposure to the virus, closely monitor themselves for symptoms of COVID-19 and seek advice from the nearest designated facility if they have concerns or experience symptoms.

They must also take the same precautions to avoid COVID -19 infection as other people by practising physical distancing, avoid physical gatherings and use online health services, according to UNICEF.

Pregnant women should also seek medical care early on if they live in affected or at-risk areas and have fever, cough or difficulty breathing and continue breastfeeding their baby even if they are infected or suspect being infected as the virus has not been found in samples of breastmilk.

Mothers with COVID-19 should wear a mask when feeding their baby, wash hands before and after touching the baby, and routinely clean and disinfect surfaces while continuing to hold the newborn and performing skin-to-skin care.

They should also ask their midwife or doctor where they feel is the safest place to give birth and have a birth plan in place to reduce anxiety and to ensure they get to the place on time.

Medical support, including routine immunisations, must be continued after the baby is born.

Even before the COVID-19 pandemic, an estimated 2.8 million pregnant women and newborns died every year, or 1 every 11 seconds, mostly of preventable causes.

UNICEF calls for immediate investment in health workers with the right training, who are equipped with the right medicines and protective measures to ensure every mother and newborn is cared for by a safe pair of hands to prevent and treat complications during pregnancy, delivery and birth.