Evidence suggests that there has been an increase in maternal and perinatal mortality rates due to the COVID-19 pandemic and the nationwide lockdown. During this time, healthcare services in metropolitan areas have been inundated by the number of COVID-19 infections taking away the emergency care for mothers in labour. The loss of jobs, and people returning home (to rural areas) has resulted in hospitals being overrun and reaching capacity at an accelerated rate.

The pandemic has hindered access to sexual and reproductive healthcare services, and the use of contraception and termination of pregnancy (TOP) has seen a steady decline. Births at healthcare facilities may have increased, but the antenatal care remains variable and area dependant.

In light of these findings, the South African Medical Research Council (SAMRC) and the University of Pretoria (UP) at Kalafong Provincial Tertiary Hospital and the South African Breastmilk Reserve (SABR) are amplifying awareness regarding the importance of prenatal care.

Seven out of ten preterm deaths are stillbirths in South Africa. This figure can be reduced in this care through the use of the Umbiflow device that detects abnormal placental blood flow, thereby detecting foetal growth restriction. The use of this device has resulted in a 47% reduction in stillbirths in nine sites in our country.

In normal times, eight out of 100 infants are born prematurely and on average 11 000 premature babies die each year as a result of preventable infections and complications. The neonatal outcome can be improved significantly for growth-restricted and premature infants by providing them with breastmilk. The SABR supplies donated breastmilk to premature babies in neonatal intensive care units (NICUs) nationwide.

Breastfeeding and donated breastmilk play a life-saving role in supporting growth-restricted babies in the NICU, says Professor Bob Pattinson, Director of the SAMRC Maternal and Infant Health Care Strategies Research Unit. The demand for breastmilk has increased due to more babies being born prematurely, and in some instances, is needed  for those who have been orphaned by COVID-19 or separated from their mothers who are ill from COVID-19.

“The increased demand has resulted in a worrying shortage of breastmilk and we are calling on all potential donors to support babies during this time by donating breastmilk,” says Staša Jordan, Executive Director at the SABR.

South Africa is currently preparing for the phased roll-out of the COVID-19 vaccine. Although it has not been tested in human pregnancy, to date no negative results that affect foetal development have been recorded in animal testing.

The South African Society of Obstetricians and Gynaecologists recommends that vaccines should be offered to women at risk of severe illness following COVID-19 infection. Vaccination is also strongly encouraged for non-pregnant women who are contemplating pregnancy. If a woman becomes pregnant after the first dose of the vaccine, the second dose should be administered as indicated.

Pregnant women should discuss the risks and benefits of COVID-19 vaccination with their healthcare practitioners. Certain groups of pregnant and breastfeeding women may also be at a higher risk of contracting COVID-19 or suffering serious complications, and should consult their obstetrician or gynaecologist with regard to the vaccine. This includes women in, but not limited to, the following categories:

•  Healthcare workers
•  Essential/frontline workers (e.g. teachers or police)
•  Organ transplant recipients
•  People with weakened immune systems due to another condition (e.g. cancer, diabetes or HIV)
•  People with respiratory illnesses (e.g. severe asthma, TB or cystic fibrosis)
•  People with known kidney or heart disease
•  People with obesity

The SAMRC, UP and the SABR aim to strengthen pregnancy education and promote healthy pregnancies. As a general guideline, expecting mothers can increase their chances of a healthy pregnancy by eating nutritious foods, getting regular exercise and drinking enough water. They should avoid drinking alcohol and smoking at all costs while pregnant and breastfeeding. Additionally, they should consult their doctor when they find out that they are pregnant, so that they can be advised on the safety protocols to follow, as well as the appropriate prenatal vitamins and supplements to take, and discuss any health concerns.

For more information on SABR and breastmilk donation, please visit www.sabr.org.za or contact 011 482 1920 | [email protected].

Pregnancy Awareness Week is commemorated annually from 10 to 16 February.