ABSTRACT
Objective: India reported its first case of coronavirus in Kerala on 30th January, 2020. On March 24, 2020, the Government of India announced the first complete lockdown of the entire nation for 21 days for the containment of the virus. The immediate effect of the lockdown was that the cases and COVID-19-related deaths were significantly controlled. Besides the direct effects, the indirect impact of the pandemic and pandemic-control policies on healthcare services, communities, and the global economy may also affect vulnerable groups like pregnant women. The objective is to explore trends in maternal or neonatal outcomes during this pandemic by comparing the same in pre-pandemic, pandemic, and post-pandemic phases. Materials and Methods: This was a retrospective analysis of maternal and neonatal outcomes over the period from January 2020 to August 2021. The monthly statistics from the pre-pandemic period (2018 and 2019) were combined and then analyzed against the statistics from 2020 and 2021 using the Fisher’s exact test or Chi-squared analysis as appropriate. Results: There was positive correlation between the monthly number of COVID-19-related deaths with the monthly number of stillbirths (p = 0.153). The diagnosis of antenatal complications such as hypertension in pregnancy occurred at the same rate pre-pandemic as in the months during the pandemic. There was a strong positive correlation between maternal mortality and the number of COVID-19-related deaths (p = 0.016). Conclusion: Women’s healthcare is often adversely affected in humanitarian disasters, and our study highlights the importance of planning for powerfully built maternal services in any emergency services.
ABSTRACT
Introduction: Assuring pregnant women have access to safe birth and continuum of antenatal and postnatal care during COVID assuming great importance, though it indeed is challenging. With the numerous existing challenges in implementation of birth companion policies, COVID has made it more difficult to implement birth companion policy which has drastically reduced to a zero. The Health Ministry of India has advised “birth companion” during childbirth in all the public health facilities. This step is one of the parts of low-cost intervention initiated by the government of India to meet the sustainable development goals. Methodology: The adapted birth companion policy was introduced to all pregnant women through antenatal classes. After admission to labour room, birth companion accompanied parturient throughout labour and provided supportive care. To implement birth companion policy and to test benefits of intervention, a quality improvement team was convened. A special care and extra efforts were taken to implement this policy even in COVID-19 pandemic. Results: first PDSA cycle of 8weeks, birth companion support use remained low, with usage in only 20% of deliveries. From weeks 9 to 16 Improvements in adaptation of birth companion policy adherence was observed, with an average of 82% of parturient delivered received support of the birth companion of their choice. At the end of week 32, caesarean section rate decreased from 29.16 % to 26.09 %. With the birth companion of their choice and favourable birthing positions, there was decreased need of operative vaginal deliveries from 2.24% on week one to 1.8 % on week thirty-two. Conclusion: Providing birth companion of choice is the right of every pregnant woman. The current COVID-19 Pandemic is no exception. The Pandemic must not disrupt every woman’s right to high quality, respectful maternity care. In ‘New Normal’ of COVID-19, everyone should strongly adhere to birth companion policy which will result in emotional, practical and health benefits of having birth companion of choice.