Maternal health and COVID-19. The COVID-19 pandemic has placed extraordinary strain on health systems across the globe and disrupted essential maternal services. For too many women, access to potential life saving perinatal and postnatal care is a challenge as countries redirect health resources to tackle COVID-19.
The impact of the pandemic on women in developing countries is compounded: they are often poor, they often live in remote communities distanced from medical resources and they are women. The implementation of lockdowns and travel restrictions, coupled with the closure or repurposing of public health facilities to slow transmission, further distances women from already difficult to access maternal services. Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa, states “Women are disproportionately affected by lockdowns and this is resulting in a reduced access to health services.” Accordingly, perinatal and postnatal care are considered by the WHO as essential medical services that must be maintained during a pandemic to support women’s health.
Although the WHO considers adverse health effects of unattended births outweigh the risk of COVID-19, fear of contracting the virus from health centres is deterring more women from travelling to open facilities to receive medical support from skilled clinical personnel. Reduced access and utilization of essential maternal health services translates into an increased likelihood of obstetric fistula injuries and maternal deaths.
The WHO interim guidelines for COVID-19 estimate a 10% decline in facility based births could result in an additional 28,000 maternal deaths. Many African countries are reporting a gradual decline in deliveries by medical personnel, with assisted births down by 9% in Ethiopia alone.
The UNFPA’s Executive Director Natalia Kanem commented to The Lancet Journal “We’re at a point where people are avoiding health systems for fear of COVID-19, so the role of the midwife, the role of the community health worker… is absolutely essential.”
In 2020, the International Year of the Nurse and Midwife, these frontline workers are more important than ever. Midwives are trusted companions of expectant mothers, performing a dual role to achieve safe childbirths and deliver maternal care. They are essential to creating a positive pregnancy experience. Amidst the challenges of COVID-19 midwives are risking their health to deliver care and emotional support to women.
At Hamlin Fistula Ethiopia, Hamlin Midwives are the cornerstone of our vision, to ensure women in rural Ethiopia continue to access quality maternal health care, especially during COVID-19. In communities where there is a Hamlin Midwife, the Hamlin team is determined to ensure that there is not a spike in obstetric fistula cases or maternal death due to lack of skilled medical care. At the same time, Hamlin Midwives and Hamlin’s outreach officers have been supporting the Ethiopian Government’s initiative for community health workers to raise awareness about how to prevent COVID-19 infection. Our midwives are particularly well placed to support this as they speak different regional languages, and the trust the Hamlin team has built up over the years is helping them engage with their communities.
Hamlin Fistula Ethiopia is committed to the protection and care of patients during this challenging time. Although “the pandemic has definitely affected the flow of fistula victims to our hospitals”, according to Sister Konjit, the number of women suffering obstetric fistula has likely risen. Our work today is as essential as ever, with the threat of COVID-19 disproportionately affecting women - that’s why Hamlin Fistula Ethiopia is dedicated to providing essential maternal care and restoring dignity to Ethiopian women.
Even in the most difficult of times, our students, midwives and entire Hamlin clinical team are working harder than ever. Because of them, obstetric fistula as well as countless maternal and neo-natal deaths are being prevented.
We won’t stop until fistula is eradicated. Forever.
If you would like to support the work of Hamlin Fistula Ethiopia, click here. Your support is needed now, more than ever. Together we can create hope and lasting change for women.
Further reading on maternal health and COVID-19:
By Aimee Barac-Dunn, intern at the Catherine Hamlin Fistula Foundation