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Friday, 25 September 2020

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Lifesaving services must be maintained for pregnant mothers and babies

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An estimated 116 million babies globally and 643,000 in the UK, will be born up to the 40 weeks after the coronavirus was declared a pandemic on March 11- UNICEF has said this week. These babies are projected to be born a time when the coronavirus pandemic is causing a strain on health systems and medical supply chains all over the world.

New mothers and newborns will be greeted by harsh realities, including 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 coronavirus patients.

Anna Kettley, Director of Programmes at Unicef UK said:

“In the UK, where about 643,000 babies are due to be born during the first nine months of the coronavirus pandemic, our maternity services are coping as well as they can – but are also under considerable strain. This is a worrying time for everyone, especially so for pregnant women and new parents who can find having a baby isolating at the best of times.

“During this pandemic, we need to consider the needs of babies and their families and protect and support the services that work with them. Maternity and health services need clear guidance on how they can swiftly and safely return to offering high-quality face to face support to new and expecting mums. This includes how additional support can be put in place to mitigate the impacts of social distancing, particularly on the most vulnerable families, such as more personal protective equipment for midwives and health visitors, increased testing and technology to support remote visits.”

UNICEF is warning that coronavirus 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 coronavirus conditions.

Even wealthier countries are affected by this crisis. In the US, the sixth-highest country in terms of the 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 centres 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 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 coronavirus and seek advice from the nearest designated facility if they have concerns or experience symptoms;
  • Take the same precautions to avoid coronavirus 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 coronavirus 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 immunisations, after the baby is born.

Even before the coronavirus 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.

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