Millions of pregnant mothers and babies born during COVID-19 pandemic threatened by strained health systems and disruptions in services - UNICEF

KATHMANDU, 7 May 2020 – Globally, an estimated 116 million babies will be born under the shadow of the COVID-19 pandemic and almost a quarter of them—approximately 29 million—will be born in South Asia, UNICEF said today. These babies are projected to be born up to 40 weeks after the COVID-19 pandemic—which is currently straining health systems and medical supply chains all over the world and is generating concern for mothers’ health and that of their newborns. 

Countries in South Asia with the expected highest numbers of births in the nine months since the COVID-19 pandemic declaration are: India (20 million), Pakistan (5 million), Bangladesh (2.4 million) and Afghanistan (1 million). The continuing rapid spread of COVID-19 across South Asia means new mothers and newborns will be greeted by harsh realities, including global containment measures such as lockdowns and curfews; health centers 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. 

While COVID-19 containment measures are essential, UNICEF is warning that it can disrupt life-saving health services such as childbirth care, putting millions of pregnant mothers and their babies at great risk. UNICEF cautions 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 care to ensure the health and well-being of mothers, support to start breastfeeding, and to get medicines, vaccines and nutrition to keep their babies healthy. 

On behalf of mothers everywhere, 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 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.

UNICEF calls for immediate investment in health workers - including Community 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.

“The life threating situation of millions of women and adolescent girls, as well as newborns, in South Asia cannot be ignored. The COVID-19 outbreak has instilled fear among mothers to seek health services due to the fear of getting infected. At the same time, many now unfortunately are being deprived of emergency care due to strained health services and lockdowns. Critical workers such as community health workers and midwives need full support. In this time of crisis, we all must work together to make sure every pregnant mother receives the support she needs to give birth safely, and that women who want to delay or space pregnancies have the supplies and information to do so,” says Jean Gough, Director of UNICEF Regional Office for South Asia.

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Notes to Editors:

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The analysis was based on data from World Population Prospects 2019 of the UN Population Division. An average full-term pregnancy typically lasts a complete 9 months, or 39 to 40 weeks. For the purposes of this estimate, the number of births for a 40-week period in 2020 was calculated. The 40-week period of March 11 to December 16 is used in this estimate based upon the WHO’s March 11 assessment that COVID-19 can be characterized as a pandemic.

For new guidance on treating pregnant women and newborns, visit: https://www.unicef.org/coronavirus/covid-19-resources-practitioners