COVID-19: Are Pregnant Women At Increased Risk?

As the COVID-19 continues to wreak havoc around the world, most groups of people are vulnerable to the virus and there are questions regarding the safety of pregnant women. Below we reproduce a recent article by the United Nations Population Fund (UNFPA).

COVID-19: Are Pregnant Women At Increased Risk?

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Pregnant and recently pregnant women who have recovered from COVID-19 should be enabled and encouraged to access routine antenatal, delivery, safe abortion and postpartum, or post-abortion care to the full extent of the law.

UNFPA is also concerned about the risks pregnant women may experience as health systems grapple with the pandemic. During public health emergencies, human and financial resources are often diverted from various health programs to respond to the infectious disease outbreak.

Quality maternal health services must remain available, even as health resources are increasingly diverted to deal with COVID-19.

What should pregnant women be doing to stay safe?

Pregnant women should take the same preventive actions recommended for all adults, such as avoiding close contact with anyone who is coughing and sneezing, washing hands often with soap and water or alcohol-based hand rub, covering their mouth and nose with a tissue or elbow when coughing and sneezing.

All recommended actions are available on the WHO website.

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Should new mothers exhibiting COVID-19 symptoms breastfeed their new-borns?

There is no evidence to show that respiratory viruses can be transmitted through breast milk, according to UNICEF.

Symptomatic mothers well enough to breastfeed should wear a mask when near a child (including during feeding), wash hands before and after contact with the child (including feeding), and disinfect contaminated surfaces.

If a mother is too ill to breastfeed, she should be encouraged to express milk that can be given to the child via a clean cup and/or spoon – while wearing a mask, washing hands before and after contact with the child, and cleaning/disinfecting contaminated surfaces.

Is the COVID-19 epidemic affecting women disproportionately?

 How so? Accurate, reliable sex-disaggregated data on COVID-19 infection and mortality rates are still needed.

But it is known that disease outbreaks affect women and men differently. Evidence from prior epidemics shows that existing inequalities for women and girls, and discrimination of other marginalized groups such as persons with disabilities and those in extreme poverty, worsen in these times.

Women and girls face higher risk of domestic violence, as well as other forms of gender-based violence including sexual exploitation and abuse.

Women are less likely than men to have decision-making power during an outbreak, and as a consequence their general and sexual and reproductive health needs may go largely unmet.

There is also an inadequate level of women’s representation in pandemic planning and response.

Globally, women are more likely than men to work in precarious, informal jobs while shouldering a greater burden of unpaid care, and can face interruptions to their work, loss of livelihoods, and increased care responsibilities as a result of COVID-19. Social protection systems that do not address gender inequalities during an outbreak can exacerbate the multiple and intersecting forms of discrimination women and girls face.
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Women also represent approximately 70 per cent of the global health-care and social services workforce, which puts them on the front lines of the response and at increased risk of infection.

As health systems undergo strain due to the virus, efforts must be made to account for the unique challenges faced by female health workers.

For example, gender inequalities may leave women health workers less able to advocate for protective equipment.

They may be less able to attend to their own sexual and reproductive health needs, such as hygiene supplies for menstruating staff or breaks for pregnant staff.

What happens to pregnant women who contract COVID-19?

UNFPA is working to ensure that pregnant women with suspected, probable or confirmed COVID-19 infections, including those who may need to spend time in isolation, have access to woman-centred, respectful, skilled care, including obstetric screening tests, foetal medicine, safe delivery and neonatal care, as well as mental health and psychosocial support.

Health systems must also be ready to address maternal and neonatal complications in these cases. UNFPA is also working to ensure all post-partum women who have COVID-19, or who have recovered, are provided with information and counselling on safe infant feeding and appropriate measures to prevent COVID-19 virus transmission.

Pregnant and recently pregnant women who have recovered from COVID-19 should be enabled and encouraged to access routine antenatal, delivery, and, safe abortion where legal and to the full extent of the law, and postpartum or post abortion care.

Nurses and midwives are at increased risk of exposure. Do they have the necessary safety equipment?

Around the world, women make up about 70 per cent of health and social service workers.

Midwives, nurses and community health workers are on the front lines of efforts to combat and contain outbreaks of disease.

They require personal protective equipment (PPE), but this equipment is currently extremely challenging to source due to massive demand and export restrictions imposed by manufacturing countries.

The protection of health workers, in particular midwives, nurses, obstetricians and anaesthesiologists, must be prioritized. They must be provided with PPE if they are treating patients with suspected or confirmed COVID-19.

Have nurses and midwives on the front lines of humanitarian crises been trained on how to protect themselves from infection?

UNFPA is working to ensure that health care personnel in infection prevention and control are trained or re-trained to reduce the risk of human to human transmission.

Training will be based on World Health Organization guidance. Health workers, particularly midwives, should also be trained in mitigating stigma and discrimination, watching for signs of gender-based violence, and educating people about COVID-19 infection symptoms and related hygiene messages.