Health

Like most vulnerable groups, soon-to-be and new mothers face an uncertain near future

With hospitals and public transportation shut, expecting and new mothers can’t go for regular check-ups for themselves and their children. Like most vulnerable groups, soon-to-be and new mothers face an uncertain near future

Safe motherhood, which already is a challenge in backward areas, has become a far cry now. Post File Photo

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Elisha Shrestha & Thomas Heaton

Published at : April 22, 2020

Updated at : April 22, 2020 08:05

Kathmandu

When Ashmita discovered she was pregnant with her first child seven months ago, a midwife told her to regularly visit the hospital for check-ups throughout her pregnancy. Ashmita abided.

So every two weeks, she visited the Paropakar Maternity and Women’s Hospital to receive antenatal care. However, her hospital visits came to an abrupt halt when the government declared a lockdown to control the spread of Covid-19 on March 23.

“The last time I visited the hospital, I had my blood and urine tested because I was suffering from extreme fatigue and back pains,” said Ashmita, who did not want her last name disclosed. “The doctor asked me to collect the report a few days later. However, the lockdown was announced, and I have yet to collect the report. I still have health complications, but I’m unable to visit the doctor.”

The 18-year-old is one of many expecting and new mothers dealing with anxiety and uncertainty because of the nationwide lockdown as they are unable to hold regular face-to-face consultations with midwives or hospital staff. Few hospitals have outpatient services currently open, but making it to the hospitals is next to impossible with public transport prohibited.

The Paropakar Maternity Hospital is still open, but Ashmita is unable to get there because she doesn’t have transport of her own.

“I’m stressed and worried thinking that if the lockdown continues, I won’t have anyone to help me except for my husband,” said Ashmita. “My main concern is how will I go to the hospital for my delivery.”

To assist women like Ashmita, the Midwives’ Society of Nepal has been running a phone-in counselling service to provide both clinical and psychological advice to worried mothers-to-be and new mothers. The free service has already dealt with over 100 mothers since the lockdown started, said midwife Rukumani Tripathi.

“Most women are calling us in a panicked state. Some of them burst into tears because they can’t go for regular check-ups,” Tripathi said.

The helpline provides women with relevant information, especially on things like the provision for airlifts in extreme circumstances, and helps connect women to organisations providing food, finances or transportation. Tripathi and her colleagues have mostly dealt with women in Kathmandu, but they’ve also received calls from as far as Pokhara, Jhapa, Nepalgunj and Butwal.

Unable to visit their doctors for check-ups, expecting and new mothers are likely to undergo even more stress, compounded by fears over the coronavirus itself, said Prasansa Budha Lama, project leader at the Young Midwives Committee. Some are uncertain whether they should continue taking calcium, iron or iodine supplements, or whether they can get more while others are worried about transmitting the virus to their child, said Lama.

While the virus is highly unlikely to get to the fetus, the pandemic and the subsequent lockdown have created uncertainty in everyone’s life, but especially for pregnant women, according to Jamuna Maharjan, a clinical psychologist at Transcultural and Psychosocial Organization.

“We have been getting around four to five calls daily from pregnant women who are seeking help for their anxiety. Many are worried about not being able to get antenatal support,” said Maharjan, who also operates a helpline for psychological counselling.

The Paropakar Maternity and Women’s Hospital is also offering telephone counselling and is one of the few hospitals that is still offering outpatient and emergency care for women who are pregnant and those who have given birth, according to Jageshwor Gautam, the hospital’s director.

“For those who want counselling, they can call us at 01-4260405 instead. We have operated a helpline from 10 am to 1 pm every day, where anyone can get counselling from our doctors,” said Gautam.

Although pregnant women are not at high risk of contracting Covid-19, compared to other groups, if they are infected and precautions are not taken during the time of delivery, they may transfer the virus to the baby.

“If the mother is symptomatic, everyone attending to her will be in respirators, while the mother will wear a mask and be kept in isolation. We will also separate the baby from her at birth to prevent the baby from getting the virus,” said Gautam.

Paropakar is located in the Capital, where women have access to relatively more resources, in comparison to women in rural areas. Most health posts, which women rely on, are not up to standard, said Dr Laxmi Tamang, president of the Midwifery Society of Nepal.

“Even in normal times they are not equipped for births,” said Tamang. “In some places, people have to walk hours to get to the nearest health facility.”

This could result in women opting for home births without medical assistance—something the government has long-been pushing against.

“This increases the likelihood of death in mothers and babies,” she said.

Back in Kathmandu, Sagar Shrestha and his wife, who just had a son three months ago, are afraid to take their newborn to the hospital for vaccination.

“My son needs his vaccination, but we have been postponing our visit to the doctor hoping that the Covid-19 pandemic will be over soon,” said Shrestha. “We are worried about catching Covid-19, but we also feel guilty for overlooking the needs of our baby.”

Helplines for Clinical and Psychological Counselling:

Midwives’ Society of Nepal: 9849263350; 9843266115; 9823098038

Transcultural and Psychosocial Organization: 16600102005

Paropakar Maternity and Women’s Hospital: 01-4260405

Ambulance service: 102

Frequently asked questions about the coronavirus outbreak

UPDATED as of September 22, 2020

What is Covid-19?
Covid-19, short for coronavirus disease, is an illness caused by the coronavirus SARS-CoV-2, short for severe acute respiratory syndrome coronavirus 2. Common symptoms of the disease include fever, dry cough, fatigue, shortness of breath and breathing difficulties. In severe cases, the infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.

How contagious is Covid-19?
Covid-19 can spread easily from person to person, especially in enclosed spaces. The virus can travel through the air in respiratory droplets produced when a sick person breathes, talks, coughs or sneezes. As the virus can also survive on plastic and steel surfaces for up to 72 hours and on cardboard for up to 24 hours, any contact with such surfaces can also spread the virus. Symptoms take between two to 14 days to appear, during which time the carrier is believed to be contagious.

Where did the virus come from?
The virus was first identified in Wuhan, China in late December. The coronavirus is a large family of viruses that is responsible for everything from the common cold to Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). After an initial outbreak in Wuhan that spread across Hubei province, eventually infecting over 80,000 and killing more than 3,000, new infection rates in mainland China have dropped. However, the disease has since spread across the world at an alarming rate.

What is the current status of Covid-19?

The World Health Organisation has called the ongoing outbreak a “pandemic” and urged countries across the world to take precautionary measures. Covid-19 has spread to 213 countries and territories around the world and infected more than 31,405,983 people with 967,505 deaths and 22,990,260 recoveries. In South Asia, India has reported the highest number of infections at 5,557,573 with 88,943 deaths. While Pakistan has reported 306,304 confirmed cases with 6,420 deaths. Nepal has so far reported 65,276 cases with 427 deaths.

How dangerous is the disease?

The mortality rate for Covid-19 is estimated to be 3.6 percent, but new studies have put the rate slightly higher at 5.7 percent. Although Covid-19 is not too dangerous to young healthy people, older individuals and those with immune-compromised systems are at greater risk of death. People with chronic medical conditions like heart disease, diabetes and lung disease, or those who’ve recently undergone serious medical procedures, are also at risk.

How do I keep myself safe?
The WHO advises that the most important thing you can do is wash your hands frequently with soap and water for at least 20 seconds or use hand sanitizers with at least 60 percent alcohol content. Avoid touching your eyes, nose and mouth with unclean hands. Clean and disinfect frequently used surfaces like your computers and phones. Avoid large crowds of people. Seek medical attention if symptoms persist for longer than a few days.

Is it time to panic?

No. The government has imposed a lockdown to limit the spread of the virus. There is no need to begin stockpiling food, cooking gas or hand sanitizers. However, it is always prudent to take sensible precautions like the ones identified above.

Elisha Shrestha
Elisha Shrestha was a reporter covering social justice issues for The Kathmandu Post.

Thomas Heaton
Thomas Heaton was a food and travel reporter for The Kathmandu Post. Before working in Nepal, he spent five years in New Zealand, most recently as a food writer for Cuisine magazine.