Covid: Gynaecologists call for ensuring vaccine, antenatal care for pregnant women

The government should ensure vaccine and antenatal care for pregnant women, who have been at higher risk of death from Covid-19, on a priority basis to prevent any massive casualties further, gynaecologists and public health experts have said. 

The maternal deaths jumped in the last one and a half years due to increased home births, coronavirus infection, and lack of antenatal care due to the pandemic realities, they added, noting that the situation was improving amid the ease of the epidemic.

"Currently, pregnant women are receiving healthcare services like normal time after a Covid-induced disaster in maternal care. However, the situation can be worsened again as the new variant Omicron enters the country,"  said Dr Rashida Begum, vice-president of the Obstetrical and Gynaecological Society of Bangladesh.

"We have to be more conscious to prevent any possible massive maternal casualties like the previous time," she told The Business Standard. 

Mentioning that vaccines could reduce the risk of death even after getting infected by coronavirus disease, she urged the government to ensure jabs for pregnant women as early as possible.

"Home births are a major reason for maternal mortality in Bangladesh," said Abu Jamil Faisal, a public health expert and member of the Public Health Advisory Committee of Covid-19.

Before the novel coronavirus outbreak in the country, 50% of deliveries were performed at home but the rate rose to as high as 73% during the pandemic, which contributed to a surge in maternal deaths, he told The Business Standard.

Movement and lockdown restrictions, high pressure of Covid-19 patients in hospital, and the tendency of avoiding public places were the reasons, among others, behind the home birth increase. 

Although the situation started to improve, it might take more time to return to the previous level, the public health expert said.

According to the Directorate General of Health Service (DGHS), 967 women died in childbirth in hospital in 2019, which jumped to 1,133 in 2020. 

The directorate, however, did not release this year's statistics as yet. 

Insiders and experts believe the mortality rates were much higher early this year, particularly in April (estimated 228 in number) as the Delta variant took a toll.

The overall maternal mortality ratio in Bangladesh was 196 per 100,000 births, said a 2016 study titled the Bangladesh Maternal Mortality and Health Care Survey conducted by the National Institute of Population Research and Training (NIPORT) and icddr,b. 

Haemorrhages and eclampsia account for 54% of all maternal deaths in Bangladesh, the survey reveals. 

However, there is no further study or statistics of the overall maternal deaths – in hospitals and homes.

Noted gynaecologist and member of the National Technical advisory committee on covid-19 Professor Rowshan Ara said, "We have now a new fear – Omicron. So, the pregnant woman should be more careful, and maintain all the safety measures including wearing masks and avoiding crowds." 

She recommended taking the vaccine before planning for a baby and also at pregnancy time. 

They said casualties of Omicron were not identified yet, though it was spreading fast. 

However, all the variants and viruses are threats to childbearing women as immunity falls during the pregnancy. 

Meanwhile, 60 counties have so far detected the highly muted Omicron variant and Bangladesh reported the first Omicron cases on Saturday. The country posted six Covid-19 related deaths and 329 new cases in the past 24 hours till 8 am Sunday. With the latest additions, the death toll reached 28,028 and the case tally increased to 15,79,325 in the country.

Dr Mohammed Sharif, director at the Directorate General of Family Planning, told TBS that though there were some challenges in maternal care early pandemic, they were overcoming these over time. 

He is hopeful that maternal care and hospital birth would be at a normal level in the future.