Throughout much of the developing world, many expecting mothers die of completely preventable causes because they either give birth in their own homes, without access to skilled birth attendants, or in facilities with limited basic emergency care or poor hygiene. AFP
The late detection of Covid-19 is responsible for one-fifth of the deaths of pregnant women in Indonesia this year, the country’s obstetricians’ association has found.
Additionally, the recent surge in cases driven by the more infectious Delta variant may put expecting mothers at greater risk even as the government scrambles to prioritise their treatment, it said.
The Indonesian Society of Obstetrics and Gynaecology (Pogi) revealed that based on health ministry data, nearly 20 per cent of the 2,179 maternal deaths recorded this year were Covid-19-related, and a majority of these women could have been saved by early detection.
“As many as 72 per cent of pregnant mothers who tested positive for Covid-19 were diagnosed in their late trimester or 37 weeks into their pregnancy, [and only] because they had to get treated before giving birth,” said Pogi head Ari Kusuma in a phone interview with the Jakarta Post on August 18. “It’s much too late for them to get tested at this point.”
This sentiment is shared by many obstetricians and gynaecologists (OB-GYN), as pregnant women fall into a population group that is more susceptible to severe cases of Covid-19.
“Pregnant women need to get immediately tested for Covid-19 if they show any symptoms or have had close contact with someone who was Covid-19-positive,” M Ilham Aldika, an OB-GYN based out of Surabaya, East Java, said at a webinar hosted by Kawal Covid-19 earlier this month.
Pogi carried out a self-reporting survey among its members between April 2020 and April this year and found that among 536 pregnant women who were infected by the coronavirus, some three per cent died while another four per cent required intensive care.
However, the study does not take into account the Delta-driven second wave of Covid-19 cases, which Ari said had tripled maternal deaths in the month of July alone.
More than 56,000 new daily Covid-19 cases were recorded nationwide last month, pushing the healthcare system to the brink of collapse as hospitals in Java experienced a shortage of beds and oxygen while trying to accommodate an overflow of patients.
Even before the pandemic, Indonesia had a spotty maternal mortality record. According to the 2015 Intercensal Survey (Supas), there are 305 maternal deaths out of every 100,000 live births in the country.
The number goes way beyond parameters set under the gold standard of fewer than 70 deaths per 100,000 live births set by the UN Sustainable Development Goals (SDG).
According to the health ministry’s Sample Registration System (SRS) survey in 2016, most maternal deaths can be attributed to hypertension and obstetric bleeding.
A 2020 report by the ministry’s family health directorate said much better care could prevent such deaths, but experts fear its implementation has ceased as more health workers are diverted for Covid-19 care.
Additionally, basic data on pregnant women suffering from Covid-19 remains incomplete.
Coordinating Minister for Maritime Affairs and Investment Luhut Binsar Pandjaitan has called on regional administrations to set up isolation centres for pregnant women suffering from Covid-19 and expand the number of referral hospitals that can treat them.
The health ministry itself only started recommending Covid-19 vaccinations for pregnant women on August 2, with inoculation programmes rolling out in earnest last week.
The South Sumatra branch of Pogi started a programme on August 19 to inoculate 20,000 pregnant women in the province, which kicked off at the Dr Mohammad Hoesin Regional Hospital (RSMH) in Palembang. It was rolled out to every healthcare facility in the province afterward, using the Sinovac vaccine based on the inactivated virus.
“The mortality rate of Covid-19-stricken pregnant women can be between two and four times higher than non-pregnant women. At RSMH alone, 16 pregnant women have died of Covid-19,” South Sumatra Pogi head Yusuf Effendi told the Jakarta Post on August 19.
To get inoculated, pregnant women must undergo health screening, including a sonography check, before getting their shot. They get two doses just like everyone.
The ministry has flagged just three Covid-19 vaccines for use among pregnant women – those by Pfizer-BioNTech, Moderna and Sinovac.
THE JAKARTA POST/ASIA NEWS NETWORK
