Pregnant mothers and babies born during COVID-19 pandemic threatened by strained health systems and disruptions in services

NEW YORK, 7 May 2020 – An estimated 116 million babies will be born under the shadow of the COVID-19 pandemic, UNICEF said today ahead of Mother’s Day. These babies are projected to be born up to 40 weeks after COVID-19 – currently straining health systems and medical supply chains all over the world – was recognized as a pandemic on March 11.

New mothers and newborns will be greeted by harsh realities, UNICEF said, including global containment measures such as lockdowns and curfews; health centres overwhelmed with response efforts; supply and equipment shortages; and a lack of sufficient skilled birth attendants as health workers, including midwives, are redeployed to treat COVID-19 patients.

“Millions of mothers all over the world embarked on a journey of parenthood in the world as it was. They now must prepare to bring a life into the world as it has become – a world where expecting mothers are afraid to go to health centres for fear of getting infected, or missing out on emergency care due to strained health services and lockdowns,” said Henrietta Fore, UNICEF Executive Director. “It is hard to imagine how much the coronavirus pandemic has recast motherhood.”

Ahead of Mother’s Day, recognized in May in over 128 countries, UNICEF is warning that COVID-19 containment measures can disrupt life-saving health services such as childbirth care, putting millions of pregnant mothers and their babies at great risk.

Countries with the expected highest numbers of births in the 9 months since the pandemic declaration are: India (20.1 million), China (13.5 million), Nigeria (6.4 million), Pakistan (5 million) and Indonesia (4 million). Most of these countries had high neonatal mortality rates even before the pandemic and may see these levels increase with COVID-19 conditions.

Even wealthier countries are affected by this crisis. In the US, the sixth highest country in terms of expected number of births, over 3.3 million babies are projected to be born between March 11 and December 16. In New York, authorities are looking into alternative birthing centers as many pregnant women are worried about giving birth in hospitals.  

UNICEF warns that although evidence suggests that pregnant mothers are not more affected by COVID-19 than others, countries need to ensure they still have access to antenatal, delivery and postnatal services. Likewise, sick newborns need emergency services as they are at high risk of death. New families require support to start breastfeeding, and to get medicines, vaccines and nutrition to keep their babies healthy.

On behalf of mothers worldwide, UNICEF is issuing an urgent appeal to governments and health care providers to save lives in the coming months by:

• Helping pregnant women to receive antenatal checkups, skilled delivery care, postnatal care services, and care related to COVID-19 as needed;
• Ensuring health workers are provided with the necessary personal protective equipment and get priority testing and vaccination once a COVID-19 vaccine becomes available so that they can deliver high quality care to all pregnant women and newborn babies during the pandemic;
• Guaranteeing that all infection prevention and control measures are in place in health facilities during childbirth and immediately after;
• Allowing health care workers to reach pregnant women and new mothers through home visits, encouraging women living in remote areas to use maternal waiting homes, and by using mobile health strategies for teleconsultations;
• Training, protecting and equipping health workers with clean birth kits to attend home births where health facilities are closed;
• Allocating resources to lifesaving services and supplies for maternal and child health.

While it is not yet known whether the virus is transmitted from a mother to her baby during pregnancy and delivery, UNICEF recommends that all pregnant women:

• Follow precautions to protect themselves from exposure to the virus, closely monitor themselves for symptoms of COVID-19 and seek advice from the nearest designated facility if they have concerns or experience symptoms;
• Take the same precautions to avoid COVID -19 infection as other people: practice physical distancing, avoid physical gatherings and use online health services;  
• Seek medical care early in if they live in affected or at-risk areas and have fever, cough or difficulty breathing;
• Continue breastfeeding their baby even if they are infected or suspect being infected as the virus has not been found in samples of breastmilk. Mothers with COVID-19 should wear a mask when feeding their baby; wash hands before and after touching the baby; and routinely clean and disinfect surfaces;
• Continue to hold the newborn and perform skin-to-skin care;
• Ask their midwife or doctor where they feel is the safest place to give birth and have a birth plan in place to reduce anxiety and to ensure they get to the place on time;
• Continue medical support, including routine immunizations, after the baby is born.

Even before the COVID-19 pandemic, an estimated 2.8 million pregnant women and newborns died every year, or 1 every 11 seconds, mostly of preventable causes. UNICEF calls for immediate investment in health workers with the right training, who are equipped with the right medicines to ensure every mother and newborn is cared for by a safe pair of hands to prevent and treat complications during pregnancy, delivery and birth.

“This is a particularly poignant Mother’s Day, as many families have been forced apart during the coronavirus pandemic,” Fore said. “But it is also a time for unity, a time to bring everyone together in solidarity. We can help save lives by making sure that every pregnant mother receives the support she needs to give birth safely in the months to come.”

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Notes to editor

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The analysis was based on data from World Population Prospects 2019 of the UN Population Division. An average full-term pregnancy typically lasts a complete 9 months, or 39 to 40 weeks. For the purposes of this estimate, the number of births for a 40-week period in 2020 was calculated. The 40-week period of March 11 to December 16 is used in this estimate based upon the WHO’s March 11 assessment that COVID-19 can be characterized as a pandemic.

For new guidance on treating pregnant women and newborns, visit: https://www.unicef.org/coronavirus/covid-19-resources-practitioners