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Childbirth in a pandemic: Expectant mothers’ concerns mount amid COVID-19 outbreak

Unlike many expectant mothers, Reem Salama was not anxious about childbirth. Even though this is her first baby, she had been calm about the whole process. That is until the COVID-19 outbreak made its way to Egypt.

“I wasn’t worried about going into labor, or concerned about which hospital I chose,” she says, “but now everything changed.”

Reem had selected a hospital to have her baby, but now with her baby due in May, she is saying her plans shifted given the COVID-19 outbreak.

“Coronavirus ruined all my plans,” she laments, “now I have to be careful which hospital I choose and make sure no cases were reported there.”

Reem is yet to decide on a hospital to have her baby, but is keen on having a safe delivery.

“I want a natural birth and I want the baby to be healthy,” she says.

The 27-year-old says the clinic where she was following up with her doctor is located in a village where two people were reportedly being treated for COVID-19, so she stopped going for her checkups and only follows up with her doctor over the phone.

Reem is one of many expectant mothers whose concerns mounted after the World Health Organization declared the COVID-19 a global pandemic.

She has been abiding by the guidelines outlined by the WHO; she rarely leaves her house and makes sure she washes her hands thoroughly.

She follows several online platforms on social media, where other pregnant women ask questions, share tips and exchange information on safe pregnancies and deliveries in Egypt.

“Can someone tell me how I can raise my immunity during pregnancy?” one woman asked, “I am scared and I don’t know what to do.”

“I am pregnant and I need to have some tests done, is it safe to go the lab?” asked another.

Maryam Mokhtar, who is expecting her baby in June, was also reluctant to head down to a lab to have some tests done.

“I didn’t want to risk it and it was just a blood sugar test,” she says.

UNFPA recommends that maternity services should continue to be prioritized as an essential core health service, among other sexual and reproductive health care.

There is currently no scientific evidence that pregnant women are at higher risk of severe illness than the general population, according to the WHO. However, due to changes in their bodies and immune systems, pregnant women can be badly affected by some respiratory infections. It is therefore important that they take precautions to protect themselves against COVID-19.

The precautions are aligned with the general precautions taken by the general public including frequent hand washing, social distancing, and avoiding touching eyes, nose and mouth.

There is also no evidence yet that pregnant women with COVID-19 can pass the virus to their fetus or baby during pregnancy or delivery. To date, the virus has not been found in samples of amniotic fluid or breastmilk, according to the WHO.

Dr. Mohamed Mourad, Obstetrician and Gynecologist, says what while most expectant mothers are panicking given the current circumstances, doctors like himself work to calm them down and quell their concerns.

He explains the measures he tells pregnant women to abide by are the same as everyone else’s. He highlights, however, the importance of regular follow up visits, and says that special precautions are taken to maintain social distancing.

Dr. Mohamed explains that specific schedules should be put in place to ensure fewer people in the clinics’ waiting rooms. He also says expectant mothers should stick to “one-step clinics,” where they follow up, get their sonograms and have any tests needed so it is all done in a single visit.

He adds that some follow up visits are alternatively done through video conferencing.

According to Dr. Mohamed, the main safety measures to be taken during delivery are to be taken by the maternity care providers. He highlights the importance of wearing personal protective equipment while caring for mothers in labor to ensure safe delivery.

On her part, Reem is taking her own precautionary measures in preparation for her delivery at the hospital.

Along with packing her and her newborn’s necessities, Reem is also taking sanitizers, masks and gloves. She will also pack her own sheets and towels.

While Maryam says she trusts her doctor, she also paid a visit to the hospital where she is supposed to have her baby to get an idea on the facility.

“I was looking for cleanliness, responsiveness of the staff and the availability of information,” she says, adding that she was reassured by the medical staff’s transparency and knowledge.

UNFPA is working with the Egyptian Ministry of Health and Population to  strengthen health systems and protect maternity care providers, and provide safe and effective maternity care to women.