All4Women coverage: How Covid-19 will affect the future of maternity care in SA

Antenatal care, skilled delivery and postnatal care have a significant impact on the health of the mother, but health systems are struggling as midwives and nurses are being pulled into frontline work to combat the spread of the virus, limiting the support available for expectant mothers at the time of delivery. Additionally many women are reconsidering whether to give birth at a hospital, a hotspot for potential infections amongst both patients and healthcare workers. Dr Howard Manyonga, an obstetrician and Head of The Birthing Team, an affordable maternity programme, weighs in on the conversation.

While our nurses and doctors are working on the frontlines to curb the spread of Covid-19 across the country, other health professionals continue to care for patients who are not infected with the virus. In the field of obstetrics and maternal care, we carry the weight of caring for two patients, mom and baby, at a time where the healthcare system is experiencing severe constraints.

Midwives have had to change how they work to further care for expectant mothers during the pandemic

Although the World Health Organisation (WHO) states that there is no evidence to suggest an increased risk of Covid-19 to pregnant women or mother-to-child transmissions, many women are reconsidering whether to give birth at a hospital, a hotspot for potential infections among both patients and healthcare workers.

Some hospital groups have come up with strict measures that are meant to limit the transmission of the virus

These include cutting down the length and frequency of in-person antenatal visits, restricting birth partners in the labour ward, adhering to a no-visitors policy and isolating the baby from the mother at birth.

Elective caesars unnecessarily consume significant Personal Protective Equipment

Another pitfall of local obstetrics is that the number of women giving birth by means of caesarean section is incredibly high, even before the pandemic, with South Africa having one of the highest rates globally. The procedure, if not medically indicated, unnecessarily consumes significant Personal Protective Equipment per procedure, which could be directed towards more frontline workers, and thus puts more healthcare workers at risk of transmission.

Covid-19 has added further pressure on an already weakened maternal care system, as we face a global shortage of midwives and nurses to provide quality care during pregnancy, delivery and after birth. 

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