Some pregnant women allege that they no longer get proper care during antenatal visits.
They say that health workers are afraid of touching or coming close to them for fear of contracting COVID-19.
This is a cause for concern, maternal and child health experts say, as the situation may increase Nigeria’s already high maternal and infant mortality rates.
PUNCH HealthWise spoke with a handful of pregnant women who claim that health workers ask them to do the health checks themselves.
A 39-year-old mother of two who is pregnant with her third baby, Mrs. Chinyere Onwuka, told our Correspondent that she cannot compare the current antenatal care with her two previous pregnancies.
She lamented that becoming pregnant during the COVID-19 global pandemic is a risk, owing to the attitude of health workers and the skeletal services being offered to patients.
“Health workers no longer do the normal physical check for us, such as measurement of the tummy, checking baby’s heartbeat and position.
“I am now in the ninth month, but since I started attending antenatal, I have not been examined for one once.
“Each time I visit the clinic, after checking my blood pressure and weight, the nurse will ask me, ‘Hope you are monitoring the heartbeat of your baby? You know you have to do the check yourself? Hope the baby is kicking?’”
She will then ask if I had any complaint? If there is none, we will be advised to go and continue to monitor the heartbeats of our baby and also take our drugs.
Another expectant mother, Mrs. Philomena Audu, from Plateau State, also told similar story.
The mother of three, who is pregnant with her fourth baby, narrates, “We are no longer properly checked because of COVID-19.
“Before now, whenever we attended antenatal clinics, health workers will take time to attend to us and do thorough check. Not anymore.”
Audu added, “But now, everything has changed. We are now asked to do the check by ourselves.
“Sometimes, they ask us to do a scan to know the position of the baby.”
Mrs. Alice Friday, a 38-year-old fashion designer from Cross River State who is eight-month pregnant, said, “During my first pregnancy, whenever I attended antenatal care, the midwife will wear hand gloves and check me very well and she will discuss her findings with me. She will also counsel me as necessary.
“But now, since I registered, they have not checked me. They are not doing that physical examination again because of fear of COVID-19.”
Globally, antenatal care is advocated as the cornerstone for reducing children’s deaths and improving maternal health.
According to experts, antenatal care benefits both the mother and the baby; it assists in screening, diagnosing and managing or controlling the risk factors that might adversely affect pregnant women or pregnancy outcome.
Maternal and perinatal death rate remains a major challenge in Nigeria, with the country’s maternal mortality rate at 512 per 100,000 live births, according to the 2018 Nigeria Demographic and Health Survey.
“A Nigerian woman has a one in 22 lifetime risk of dying during pregnancy, childbirth or postpartum/post-abortion; whereas in the most developed countries, the lifetime risk is one in 4,900,” the World Health Organisation says.
Speaking with our correspondent, Professor of Paediatrics at the College of Health Sciences, University of Ilorin, Aisha Gobir, who is also a Consultant Paediatrician specialising in pulmonology, infectious diseases and adolescent health, said that the experiences of the women can increase deaths and complications in pregnancy.
Gobir notes that pregnant women have to be seen by trained healthcare workers for proper monitoring.
The paediatrician urged all hospitals and clinics offering antenatal care to provide personal protective equipment for health workers to work appropriately.
“The health workers need to be protected to do their work well. Failure to provide PPE can lead to infection of healthcare workers. That will create a disaster of shortage of staff in hospitals,” Gobir warned.
Last January, the Nigeria Medical Association ordered its members to “approach their duties with utmost caution.”
In a joint statement by Adetunji Adenekan and Ime Okon, the chairman and secretary of the Lagos chapter of NMA, hinged their directive on the deaths of its members who contracted COVID-19 in the course of duty, with some eventually dying of the disease.
medical personnel to the raging disease while commiserating with bereaved families.
“There has been an increased rate of infections (morbidity) and deaths (mortality) of our most cherished members of the NMA, Lagos chapter,” they said, stressing the need for all healthcare workers to be more safety-conscious and to adhere strictly to the COVID-19 guidelines, one of which is maintenance of social distancing.
“We also emphasise the need for a very high index of suspicion among healthcare practitioners and providers, particularly during this unpredictable second wave in the state.
“Consider everyone as a suspected COVID-19 case, and ensure universal precautions always,” they counselled members.
Also, Consultant Obstetrician and Gynaecologist, Dr. Bright Airhumwunde, says health workers should consider the health of the baby and not take things too far.
Airhumwunde, who is a Minimal Access Surgeon and Fertility Specialist at Reddington Multi-Specialist Hospital, Lagos, said that poor supervised care during pregnancy can lead to death of the baby.
“Efforts should be made to check these women. It is very risky for health workers not to listen to the foetal movement.
“This is because if the woman does not know what foetal movement is all about and we are not listening to the foetal heartbeats, the baby can die in the womb without even the woman knowing,” the gynaecologist warned.
“We can have an increase in stillbirth and emergency cesarean sections if supervised care is compromised. Not checking the foetal heart and knowing the position of the baby can lead to unwanted death,” he added.
Another Consultant Obstetrician and Gynaecologist, Family Health Department, Federal Ministry of Health, Abuja, Dr. Kamil Shoretire, notes “The implication of a pandemic like this on maternity care is that it is likely to affect attending to women that have early signs of danger.”
“In preparation for future pandemic, public enlightenment is needed along such interventions to ensure that people don’t unnecessarily stigmatise others; to ensure that health facilities are equipped and ready to attend to patients as we have now.
“We strongly feel that COVID-19 has worsened maternal and infant mortality rate in the country,” Shoretire added.
Also, antenatal care coordinator, The Eko Hospital, Lagos, Chinwe Mbaneme, warned that pregnant women who are not properly checked during antenatal care could be exposed to risk of complications during delivery.
“It is dangerous to overlook the examination of the woman and her baby during antenatal care.
“This can lead to maternal mortality, especially in a case where the baby has a bad presentation,” she said.
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