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By Irene de Vries, KIT SRHR Advisor

Mothers. Those who love and are loved. Those who inspire. Those who educate, nurture, create, comfort, challenge, and protect. Those who face risks to their health to bring life. And those who risk further marginalisation in a world under the spell of a new virus.

Even though the novel coronavirus does not appear to have severe clinical manifestations in pregnant women or their newborns, a flood of stories is reaching us about the pandemic’s indirect impact on the physical and mental health of mothers and mothers-to-be.

Maternal & newborn health is being threatened

Mothers and babies dying as a result of compromised access to health services – stories that remind us of the 2014 Ebola outbreak in West-Africa – have become a reality. From Uganda, we see narratives of women in labour becoming casualties of the coronavirus lockdown.

Such stories show the larger impact of a reduction of health services. Even a modest ten percent decline in coverage of maternal and newborn care could result in an additional 28.000 maternal deaths and a six-fold increase in neonatal deaths in low- and middle-income countries.

But maternal health is not only defined by mortality or death. Morbidity or being unwell, including physical, mental and longer-term social impacts, are rising. Women deliver their babies alone and partners are denied the wonderful experience of being a supportive companion and seeing their babies take their first breath.

COVID-19 also reveals and further increases gender inequality in families. For example, women’s care roles – for children and sick family members – are increasing, which compromises their economic livelihoods.

The right to choose

Safe and joyful motherhood also includes the right and ability to choose when and how to become a mother. But the pandemic has slowed down the production of contraceptives and access to family planning services globally, resulting in an expected 15 million unintended pregnancies.

Many places are using the pandemic as an excuse to deny women the right to access safe abortion services. This will inevitably lead to an increase in unsafe abortions, which remains one of the leading factors in maternal mortality. At the same time, couples who have been longing to become parents have seen their fertility treatments put on hold, leaving them anxiously wondering if they will ever conceive.

We need to invest in a holistic concept of maternal health

Of course, during this pandemic, it is of utmost importance that we flatten the curve and safeguard public health. But a more holistic concept of health – one where we view health as a state of complete physical, mental and social well-being – is now often forgotten. And this, perhaps, might be the greatest threat of all to mothers and mothers-to-be.

In times of crisis, leaders and health systems tend to divert attention away from sexual and reproductive health and rights. They focus on fighting the virus and increasing resilience to an outbreak in order to avoid future pandemics. All of this is incredibly important. We need strong and inclusive health systems for all. Not merely to protect the globe from this virus; they were always needed, not least because of their role in protecting women’s health and rights.

Let’s continue to invest in them as holistic institutions, combining medical and social approaches to fight the virus and its consequences.

Advocates need to step up, more than ever

As the COVID-19 pandemic continues to unfold, it is crucial that advocates for women’s health and rights redouble their efforts. Women and their partners need to have continued access to quality and respectful services around pregnancy and childbirth, family planning and safe abortion. A virus must not change that.   

About the author: Irene de Vries is an Advisor at KIT Royal Tropical Institute. Her work focuses on sexual and reproductive health and rights, particularly maternal and newborn health. A medical doctor and social scientist, she works to improve health for all.