The battle to contain the COVID-19 pandemic is far from over. With many countries yet to peak out with the disease, and the rising cases of resurgence, it is essential not to let down our guard. The Australian state of Victoria and South Korea were recently in the news because of a new wave of the disease. Similar stories have been reported elsewhere with Spain being the latest of them. It is in times like this that it becomes important to protect groups which are really vulnerable. Among these are children and infants, the elderly, and not the least pregnant women.
Available data about COVID-19 and pregnancy is incomplete for now. However, there are a few things which are known. The first is that pregnant women are not likely to get more unwell than other individuals if they contact the corona virus. As a precaution, pregnant women have been put on the list of people with moderate risk. The Royal College of Obstetricians and Gynaecologists advised that women who are in their third trimester should make sure to observe the social distancing guidelines to avoid contact with individuals who may have caught the virus.
There are no predictive data as of now regarding the risk of losing pregnancy due to the coronavirus neither can it be concluded yet that there is the probability of mother to child transmission during pregnancy. The few cases of COVID-19 on newborns and maternal-child mortalities are still within the limits of chance events, since they cannot be completely distinguished from events under normal conditions.
Regardless of what is, or is not known, pregnant women are a group of people whose health must in no way be compromised. They face myriads of issues and have certain requirements which should not be undermined. Global public health statistics, for example, have shown an alarming number of women who have lost their lives due to pregnancies. Maternal mortality, which is the loss of lives of women due to pregnancy related complications, has been classified among preventable deaths. Though the United Nations International Children’s Fund (UNICEF) reported that there was an overall 44 percent global decline of maternal mortality (from 385 to 216 deaths per 100,000 live births), from 1990 to 2015, the reduction is still but of a moderate effect in some countries. It translates to an annual reduction rate of 2.3 percent, and this is less than the 5.5 percent set target.
In spite of this impressive global reduction in pregnancy and birth-related deaths, data from bodies like the World Bank Group has it that Nigeria still ranks second, just after India, on the list of countries which account for the most maternal deaths. The World Health Organisation reported that nearly 20 percent of maternal deaths happen in Nigeria. It is estimated that about 600,000 maternal deaths and no less than 900,000 maternal near-miss cases occurred in Nigeria between 2005 and 2015. In 2015 alone, the total number of maternal deaths in Nigeria was about 58, 000 (maternal death ratio of 800 in 100,000 live births) while that in the 46 most developed countries was 1700 in all (maternal death ratio of 12 per 100,000 live births).
While all eyes are on the government and all key stakeholders to double up efforts, and weigh in on these issues, just as it was done successfully with the eradication of the polio virus in the country, what should individuals do in the time being? In the light of these staggering statistics, and with healthcare facilities being stretch to their limits, what can and should be done by and for expecting mothers?
There can be no overstating the roles that good nutrition plays during pregnancy. Some of the maternal deaths accounted for in Nigeria have been said to be due to poor economic status, which had a direct impact on the quality of the food consumed by such persons. As is expected, a pregnant woman’s nutritional requirements are more than that of a woman without pregnancy. The common saying of eating for two is the ordinary person’s way of explaining this. Besides body weight and size being factors, all food classes should be taken in balanced proportions. Emphasis are however placed on plant-based proteins and some animal proteins. These are well spelled out in the nutrition hand book given at the antenatal centres. These guidelines should be followed as advised.
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Medications and supplements should only be used as prescribed by an expert. Regardless of what a pregnant person is feeling, they should not in any case resort to self-medication.
Personal and communal hygiene at this point cannot be compromised. WASH professionals (Water, Sanitation and Hygiene) usually come up with guidelines for keeping personal and collective hygiene during outbreaks. Hence the advisory on hand washing, surface sanitizing, proper waste disposal and others. This is to ensure that harmful microorganisms do not find easy access to the human system and thereby attacking it. Pregnant women will do well to abide by these advisory. In addition, keeping the social distancing rule and avoiding overcrowded spaces is key.
As a way of avoiding crowded spaces, visit your healthcare facilities only when necessary. And when you do, take appropriate measures to keep safe. If possible, get the contact of your healthcare providers and the government’s emergency lines. Doing this, you can quickly reach out in case of an emergency or you observe symptoms that seem to be COVID-19 related. Seek help early when something seems wrong.
On the community level, there is the need to begin to collectively assess the state of our maternity and Primary Healthcare Centres (PHCs) with a view to holding the government responsible to keeping them running properly. Many Primary Health Centres are in total shambles. Some local governments can hardly boast of having a government medical presence in any shade. Sadly, even in urban centres, a number of general hospitals are highly undermanned, to say the least. These, and many more, are issues that should be brought to the fore when the time comes to analyse all that transpired during the coronavirus pandemic.
Adebowale Bello