Safe motherhood day: New mothers skip check-ups for fear of Covid

Thirty-one-year-old Mushfika Akter, a teacher at a renowned school in the capital, is currently in her eighth month of unplanned pregnancy.

However, due to the ongoing pandemic, like many pregnant mothers, Mushfika could barely visit a gynaecologist for antenatal appointments, even though she faced several health complications.

The mother of two said she used to visit the doctor every month for routine check-ups during her last pregnancy.

"But this time, from fear of the second Covid-19 wave, I couldn't make any appointments even though I am facing severe health issues like low haemoglobin levels and urinary tract infection. I find it even more risky as I haven't been vaccinated yet."

With her due date approaching, Mushfika is now considering giving birth at a local hospital in her village home as the risk of contracting Covid, according to her, is low there.

The situation is similar for 28-year-old Radifah Chowdhury, who is currently in the 14th week of her pregnancy, with no antenatal check-ups. According to her, she has been going through the most uncertain period of her life.

After getting pregnant without planning to within the first few months of her marriage, Radifah was panicking about her pregnancy. She decided to keep the baby after extensive talks with her husband and after consulting a doctor who strongly discouraged her to discontinue the pregnancy.

However, with so many uncertainties that came along with her pregnancy, she was recently diagnosed with depression and anxiety. And while maternal mental health is of high importance, she does not know where to go for help.

"That I am not happy with the miracle of life also makes people judge me."

In terms of consultation, Radifah said, "I'm just heavily relying on the internet for every symptom but this is not how I had envisioned my pregnancy."

The fear that new mothers have during the pandemic had become even more real after Rifat Sultana, associate news producer of Ekattor, died of Covid-19 after giving birth at the capital's Impulse Hospital on April 16, even before she could hold the baby in her arms.

According to experts, in order to ensure safe a safe pregnancy, it is essential that all pregnant women, including those with confirmed or suspected Covid-19 infections, receive high-quality care, before, during and after childbirth. This includes antenatal, new-born, postnatal, intrapartum and mental health care.

However, the pandemic has created a real challenge for the government to ensure the major pillars of safe motherhood -- family planning, antenatal and postnatal care, safe delivery and essential obstetric care -- for a large number of women, even though, Unicef last year predicted that some 2.4 million babies will be born during Covid-19 pandemic in Bangladesh.

Data from the Directorate General of Health Services showed that only 33 out of 63 district hospitals are performing all key functions of emergency obstetric care.

"Trends in maternal health services in Bangladesh before, during and after Covid-19 lockdowns: Evidence from national routine service data", a study by The Bangladesh Population Council, also indicated that antenatal and postnatal visits were 50 percent lower in April 2020 compared to April 2019.

Even after signs of improvement in June and July 2020, the figures remained 20 to 25 percent lower than those in July 2019, the study said.

At the same time, both normal delivery (42 percent) and C-sections (41 percent) in health care facilities saw a considerable decline during the 2020 lockdown, the study found. 

Experts also believe that since the number of child marriage increased drastically during the pandemic, it could lead to a real health consequence, because when a girl is married during childhood, pregnancy occurs quicker than women who marry at older ages.

A recent study by Manusher Jonno Foundation found that at least 13,886 children from 84 upazilas in 21 districts were forced into marriages from April to October, last year, 48 percent of whom were between 13-15 years old.

Dr Mohammad Sharif, director of maternal and child health services of Directorate General of Family Planning, also admitted that there was a service disruption during last year's lockdown as health facilities were closed at that time.

"According to our MIS data, normal deliveries at Union Health and Family Welfare Centres decreased by only nine percent, and antenatal visits were at 11 percent in 2020. However, the situation has improved this year, as all the centres were opened, and all health workers received protection kits.

"What is more important is during the last year's lockdown, the number of patients were higher in all our maternity hospitals in the capital, due to the closure of all private clinics. This time, we have also been trying to ensure quality services [in all hospitals and clinics]," he added.

According to Pulak Raha, team leader at Advance Family Planning, on this year's Safe Motherhood Day, special attention needs to be paid through massive campaigns to prevent and minimise negative consequences of Covid-19 for pregnant women and new-borns.

Monjun Nahar, head of advocacy and communication at Marie Stopes Bangladesh, said antenatal and postnatal care must be given at least over phone or through mobile apps so that pregnant mothers can avoid the risk of Covid-19 infection through face-to-face visits at health facilities.

She also stressed that in rural and hard-to-reach areas, government hospitals must have a budget for vehicles to transport pregnant mothers from their homes to health facilities.

On the other hand, Pulak said that to ensure antenatal and postnatal visits, and safe delivery in rural areas, the government needs to initiate alternative door-to-door services.