By Okonkwo Chinenye Maryrose
First Published by Midwifery Today, Issue 134, Summer 2020.
The novel coronavirus, which causes Covid-19, is a new life-threatening disease. Covid-19 is a worldwide health hazard that is now spreading throughout the world.
My country, Nigeria, is not exempted. The pandemic has affected us, but the impact is more from the government measures taken to limit the spread of the disease. These include:
- Closure of schools
- Closure of workplaces
- Closure of markets
- General Lockdown
- Stay-at-home principles
As a result of the above changes, there are now a number of adverse effects. These include:
- Increased unemployment
- Food shortages, which were the major complaint after only two weeks’ shutdown. The government’s attempt at food distribution is ineffective and affected by corruption.
- Shortage of money for the population
- Inability to access medical and maternity services
- Inability to access public utilities, e.g, the power supply, and water—a mainstay for hygiene and hand washing
- Lack of available hand sanitizers.
- Unavailability of personal protective equipment (PPE) for health care workers or Covid-19 testing facilities within the communities and states in Nigeria
- Delay in obtaining test results
- Increased pressure on people’s way of life. For example, social distancing is technically difficult in overcrowded homes.
In Nigeria, as of the time of writing this, there had been 493 confirmed cases with 17 deaths and 159 people recovering from the virus. This number was distributed throughout different states in Nigeria. The confirmed cases were from 20 states; 16 states had no confirmed cases. Sex distribution of confirmed cases included 348 males (71%) and 145 females (29%).
In order to combat/prevent this undesirable Covid-19, we have had to re-emphasize our known basic protocols. This includes all former knowledge of health care techniques for prevention of disease spread, including sanitation, hygiene, and disinfection.
During this time, pregnant, birthing women and their carers are compelled to observe the following practices:
- Frequent/regular hand washing with soap, running water, and alcohol sanitizer
- Wearing of face masks
- Socially distancing from people
- Minimizing public exposures
- Lessening travels
- Cleaning and disinfecting surfaces
- Removing outerwear, including shoes, before entering homes
- Avoiding touching eyes, nose, and mouth
- Respiratory hygiene, i.e., covering mouth and nose with bent elbow or tissue while coughing or sneezing, and proper disposal of tissues
- Proper nutrition and water intake in order to boost body immunity.
It is therefore important that pregnant and birthing women and birthworkers/health care providers protect themselves against Covid-19. They must report possible symptoms (fever, cough, difficulty in breathing) for necessary investigations and proper report to the Nigeria Center for Disease Control (NCDC). Testing protocols and eligibility vary from place to place in Nigeria. However, World Health Organization (WHO) recommendations are that pregnant women with symptoms of Covid-19 should be prioritized for testing. If they have Covid-19, they may need specialized care in an isolation unit.
Pregnancy and childbirth are daily occurrences. This physiological fact does not change because of the Covid-19 pandemic. Women’s demands should not take many by surprise, therefore midwives, obstetricians and other health workers work nights and days to save mamababy from preventable and treatable complications in pregnancy and childbirth during this pandemic.
All pregnant women, including those with suspected or confirmed Covid-19 infections, have the right to quality care (including mental health care) before, during and after childbirth, i.e., antenatal, intrapartum, postnatal, and newborn.
All safe and positive childbirth experiences ensure that the woman:
- Is treated with respect and dignity
- Has a companion of choice present during labor and birth
- Receives clear communication from maternity staff
- Is offered appropriate pain relief strategies
- Has mobility in labor, where possible, and the birth position of choice
All health workers must take appropriate precautions to reduce the risk of infection to themselves and others, including hand hygiene and protective clothing, i.e. gloves, gowns, and medical masks.
WHO advises that the mode of birth be individualized and based on women’s preferences, alongside obstetric indications as usual, even when there has not been Covid-19—hence, no specific mode of birth.
Women with Covid-19 may breastfeed their newborns. Close contact and early exclusive breastfeeding helps babies to thrive. If a mother wishes to breastfeed, she should:
- Practice respiratory hygiene during feeding, wearing a mask when available
- Wash hands before and after touching the baby
- Routinely clean and disinfect surfaces she has touched
- Breastfeed safely
- Hold newborn skin-to-skin
- Share room with baby
If a mother is too unwell to breastfeed the baby due to Covid-19 or other complications, that mother shall be supported to safely provide breast milk to baby by expressing milk, re-lactation, or donor human milk.
Together, we must win or at least reduce this novel Covid-19 and help pregnant and birthing women in Nigeria recover, while we address maternal mortality especially during this pandemic. What is new is the clear action by the combined efforts of health professionals (sanitation and hygiene; medicines and supplies; functional, accessible, and affordable health facilities; services and supply; competent and supported midwives, nurses, doctors, health information professionals), academics, community activists, politicians, dedicated women, men, and religious leaders.
No pandemic is good or friendly to any country of the continents in the world. Any pandemic will affect each country’s health care delivery, economy, socialization/social culture, and every other aspect of life.
The disease is novel, has no respect for anyone, impacts our technology, and assaults humanity.
- Nigeria Centre for Disease Control (NCDC) updates (April 2020)
- WHO situation reports, advice, update information as more evidence becomes available about Covid-19 (April 2020)
- Personal experience with daily outcomes in Nigeria concerning Covid-19 menace 2020.
Okonkwo Chinenye Maryrose RN,RM,RNAS,PDE,TRCN
Nigeria Country Contact for Midwifery Today
Directress/ Proprietress, Nneoma Maternity inc. and Member, National Association of Nigerian Nurses and Midwives and Association of General Private Nursing Practitioners.