Pregnancy and COVID19: A sensitive condition in a sensitive moment 

Pregnancy is usually an exciting event in every woman’s life, but it can also be quite challenging and the uncertainties of what to expect might be very unsettling.
In the COVID-19 pandemic and given the lockdown and sketchy service schedules of healthcare facilities, we intend that this piece of information can help pregnant women nationwide with everything they need to know to get quality professional assistance to ensure a healthy start for your baby or just to help a neighbour in need.
The Maternal mortality rate in Nigeria is under reported and even the reported cases are already alarming. These cases were reported in Nigeria ’ s seemingly ‘ Normal ’ periods, how about now when the world as we know it is on near stand still.
In fact since #Covid19 began 4 months ago, about 19,000 women have died in pregnancy, during birth or within 42 days after birth. We as a country can’t afford to add to that no.
Poor pregnancy outcomes tell a whole lot on the physical and mental health of women, from death, to infections, to depression, there’s just a whole lot to risk when the necessary support and services are not in place. Also, pregnant women are immunosuppressed during pregnancy, making them easily susceptible to diseases or infections, of which the Novel Corona virus is no different. There’s no telling how this will ravage a pregnant woman’s system if she’s unfortunate to get it.
There are several reasons why a woman would want to visit a healthcare facility, from Antenatal clinics, Doctors appointments, Emergency appointments and delivery appointments.
How will healthcare services be readily accessible to our women when they need it, given the sketchy services of hospitals with special focus on suspected COVID19 cases.
Someone needs to look out for these vulnerable set of humans, whose primary need within this pregnancy period is a safe place to birth life.
This is why we are adopting a tripod approach to proffer solution for the women, which involves themselves, the healthcare facilities and the government.
Women: Our women have a role to play themselves.
Firstly with Immunity building. Pregnancy leaves women in a state of immunosuppression and this makes them open to easily falling into disease states.
I would advice our preggies to seek way to optimize their body immune system this period as much as they can; from healthy nutrition (Eating a balanced diet with plenty Fruits, vegetables, and lots of water), being compliant with their nutrient supplementation via their routine medication, hygiene and social distancing.
 Also self isolation and immediate contacting of Nigeria Centre for Disease Control(NCDC) if they have been exposed or have symptoms in tune with COVID19.
It is also important for every pregnant woman to be Registered in an accredited and efficient delivery Centre, if they are not. For antenatal and also delivery needs.
A good centre should have a qualified midwife, obstetrician, a theatre and anesthesiologist, and a good connection with a referral Centre if they are a primary or secondary health centre. Also, ask about the emergency no of your doctor or hospital labour ward for emergency or delivery appointments.
The hospital
Hospitals and healthcare centres all have a role to play this period, not just towards the pregnant women but regarding all aspects of their healthcare coverage. This is where digital health technology comes in, for remote consultations, management of appointment bookings, patient medical records and other logistics It’s no more news that digital health tools have shown great potential to enhance health services ’ capacity to achieve the goals of the triple aim (enhance patient experience, improve health outcomes, and control or reduce costs).
 It is important for hospitals to adopt these tools to stay connected to pregnant women in this period and attending to their non emergency needs and in emergency cases, giving them working phone nos to the Labour emergency wards to preinform them before their arrival to the hospital or even provide them ambulance services when required.
The Government
There is only much the women and the healthcare facilities can do without the support of the government. Especially in providing basic amenities which can enable technology and lockdown situations to thrive.
 Social determinants like food, light, water, good roads, security, telecommunications network, shelter are very basic requirements without which business including those in the healthcare sector won’t thrive effectively.
Our women will suffer and continue to die, if all these are not in place, especially in a time like this when we are encouraged to stay at home and maintain social distancing. How will they eat, make calls, Access the internet, how secure will they be leaving their houses at night in emergency situations?
timely remuneration for workforce: If there was ever a time not to owe your workers especially in healthcare, it is now. Compensations do the heart good. Also, providing the necessary equipment your workers need to work is very basic and encouraging. We have a low medical work force, it is foolery to risk their lives further.
 Health education, public sensitization is key,  and healthcare insurance.The government shouldn’t only expand the scope of her National health insurance scheme, but should also, fund it to make it effective and accessible to Nigerians. Out of pocket payments are not a way to go, especially this period.
strengthening healthcare systems and funding healthcare), everyone has a role to play to reduce Maternal mortality rates in Nigeria and to prevent a rise in death rates amongst our women especially this period of the COVID19 pandemic.
Also, noteworthy is the fact that, If there was ever a time not to joke about unplanned and unwanted pregnancies it is now. Women and men as well are encouraged to embrace safe sexual practices and reach out to healthcare providers for safe and effective means of contraception.
Onyedikachi Chioma Nwakanma
Public health professional and founder SMILE WITH ME foundation


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