‘COVID-19 led to rise in maternal deaths, stillbirths’

The impact on pregnancy outcomes high on poorer countries, says study

The failure of the health system to cope with COVID-19 pandemic resulted in an increase in maternal deaths and stillbirths, according to a study published in The Lancet Global Health Journal.

Overall, there was a 28% increase in the odds of stillbirth, and the risk of mothers dying during pregnancy or childbirth increased by about one-third. There was also a rise in maternal depression. COVID-19 impact on pregnancy outcomes was disproportionately high on poorer countries, according to the study published on March 31.

The report is an analysis of 40 studies across 17 countries including Brazil, Mexico, the U.S., Canada, the U.K., Denmark, Netherlands, Italy, India, China and Nepal.

“The disruption caused by the COVID-19 pandemic has led to avoidable deaths of both mothers and babies. Policy makers and healthcare leaders must urgently investigate robust strategies for preserving safe and respectful maternity care, even during the ongoing global emergency. Immediate action is required to avoid rolling back decades of investment in reducing mother and infant mortality in low-resource settings,” the authors urge.

The study attributes the worsening trend to the failure of the “inefficiency of the healthcare system and their inability to cope with the pandemic” instead of strict lockdown measures. This resulted in reduced access to care.

In the Indian context, an analysis of HMIS data by Population Foundation of India shows that during the months of national lockdown last year between April and June, compared to the same period in 2019, there was a 27% drop in pregnant women receiving four or more ante-natal check-ups, a 28% decline in institutional deliveries and 22% decline in prenatal services.

The impact was high among the marginalised across various settings such as in Nepal where hospital deliveries decreased most markedly among disadvantaged groups; and in the U.K., where 88% of pregnant women, who died during the first wave of the pandemic, were from black and minority ethnic groups, the study states.

The authors recommend that personnel for maternity services not be redeployed for other critical and medical care during the pandemic and in response to future health system shocks.

Further, wider societal changes could have also led to deterioration in maternal health including intimate-partner violence, loss of employment and additional care-responsibilities because of closure of schools.

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