Pregnant mothers and babies born during COVID-19 pandemic threatened by strained health systems and disruptions in services

New Delhi: An estimated 116million babies will be born under the shadow of the COVID-19 pandemic, UNICEF said today ahead of Mother’s Day. 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 recognized as a pandemic on March 11.

New mothers and newborns will be greeted by harsh realities, UNICEF said, including global containment measures such as lockdowns and curfews; health centres overwhelmed with response efforts; supply and equipment shortages; and a lack of sufficient skilled birth attendants as health workers, including midwives, are redeployed to treat COVID-19 patients.

“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 mothersare afraid to go to health centers for fear of getting infected, or missing out on emergency care due to strained health services and lockdowns,” said Henrietta Fore, UNICEF Executive Director. “It is hard to imagine how much the coronavirus pandemic has recast motherhood.”

Ahead of Mother’s Day, recognized in May in over 128 countries, UNICEF is warning 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 in the 9 months since the pandemic declaration 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. In the US, the sixth highest country in terms of expected number of births, over 3.3 million babies are projected to be born between March 11 and December 16. In New York, authorities are looking into alternative birthing centers as many pregnant women are worried about giving birth in hospitals.

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;

· Take the same precautions to avoid COVID -19 infection as other people: practice physical distancing, avoid physical gatherings and use online health services;

· Seek medical care early in if they live in affected or at-risk areas and have fever, cough or difficulty breathing;

· 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;

· Continue to hold the newborn and perform skin-to-skin care;

· 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;

· Continue medical support, including routine immunizations, 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 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.

“This is a particularly poignant Mother’s Day, as many families have been forced apart during the coronavirus pandemic,” Fore said. “But it is also a time for unity, a time to bring everyone together in solidarity. We can help save lives by making sure that every pregnant mother receives the support she needs to give birth safely in the months to come.”

An estimated 20.1 million mothers and newborn will receive pregnancy and newborn care in India in the nine-month following declaration of the COVID pandemic. Ministry of Health and Family Welfare, Government of India has prioritized maternal and newborn service continuity as a critical component of the overall COVID response. National guidelines on ensuring service continuity were released to the States and districts to ensure that State and district COVID response plans will ensure integration of Reproductive, Maternal, Neonatal and Child Health and Adolescents (RMNCHA) continuity within their plans. Referral systems as well as service delivery across the country is being reorganized and reoriented to ensure that maternal and newborn emergency services will continue parallel to expansion of COVID services with due attention to infection prevention and care of COVID infected mothers and children

Dr Yasmin Haque, UNICEF Representative to India said, “With the COVID 19 pandemic situation rapidly evolving, the health systems at all levels will be under increasing pressure. It is critical that we continue to work together closely and collaboratively, especially in supporting the adaptation and continuity of essential health and nutrition services for pregnant women, children, and the elderly. Now, even more than before we must focus on the most vulnerable — including people with special needs, and those who live in the most marginalized and high-risk communities.”