Rise in pregnant women’s deaths from Covid-19 unsettles Brazil

By Nayara Batschke

Sao Paulo, Brazil, Apr 28 (EFE).- The significant rise in Covid-19 deaths of pregnant women is worrying Brazilian authorities, which amid a worsening of the pandemic have called on the public to postpone plans to have children and for the government to accelerate the vaccination of future mothers.

The average number of pregnant and post-delivery women dying from Covid-19 has doubled this year, compared to 2020, an increase that experts attribute to the spread of new variants of the virus and the fragile health policies in certain parts of Brazil.

Between January and April 2021, at least 433 pregnant women or women who recently gave birth lost their lives to the virus, compared with 546 such deaths during all of 2020, according to figures released by the Health Ministry.

In addition, a report by the Brazilian Covid-19 Obstetric Observatory, prepared by researchers from three Brazilian universities, showed that the average weekly number of Covid deaths rose 62 percent this year in the general population while among pregnant women and those who recently gave birth the increase was 186 percent.

“Pregnant women who become infected with Covid have a greater risk of progressing badly and needing intensive care, intubation, which also becomes a risk to the pregnancy,” professor and doctor Rossana Pulcineli Vieira Francisco, one of the creators of the Observatory, told EFE.

She said that, because of physiological changes in the body during pregnancy, pregnant women are more exposed to the risk of infection and developing complications, but she added that the danger is “aggravated” by a “health care system that already shows many weaknesses in attending to pregnant women and those who have recently given birth.”

Brazil, with almost 400,000 Covid-19 deaths and 14.4 million confirmed cases, has seen its health care system slide to the verge of collapse with a large number of its intensive care units overflowing and lacking the medications to keep seriously ill patients intubated.

The situation got even worse with the spread of the new Covid variants, which have already proven to be more contagious than the original strain and resulted in a rapid rise in the number of cases, above all among the young adult population, which is the group in which most of the pregnant women are found.

In the face of this catastrophic scenario in Brazilian hospitals, Pulcineli emphasized that one in every five pregnant women who develop serious cases of Covid do not have access to intensive care while one in every three who do enter an ICU are never intubated.

“The high mortality in that population is a consequence of a restructuring and the fragility of the health care system for providing medical attention to pregnant women, (a situation) that was aggravated and worsened by the increase in demand from Covid-19,” she said.

With more than 210 million citizens, Brazil has a maternal death rate of 55 per 100,000 live births, a much higher figure than the ideal level stipulated by the World Health Organization of 20 deaths per 100,000 live births.

The president of the Brazilian Federation of Gynecological and Obstetrics Associations (Febrasgo), Agnaldo Lopez, said that pregnant women and those who have recently given birth constitute a “very special population that demands special care,” above all in more serious cases.

“Besides those risks, the figures of pregnant women who died without access to ICU reflects the entire health care system and the complete collapse in it that we’re experiencing,” she said.

Amid the unchecked spread of the pandemic and the appearance of new strains of the virus in Brazil, the Health Ministry recently recommended that Brazilian women, if possible, postpone their plans for becoming pregnant.

In addition, the ministry this week included pregnant women and those who have recently given birth in the priority group for vaccination, determining that they “have an elevated obstetric risk independent of age.”

Both Pulceneli and Lopes said they favored the immunization of these women, if and when the decision has been previously discussed with their doctors, and the backed dialogue with specialists regarding whether or not to postpone pregnancy since this is a “personal decision” that involves “multiple factors.”

“Our role is to report that pregnant women and those who have recently given birth have great risk of progressing badly if they contract Covid and that in Brazil we’ve got a rather elevated mortality rate due to Covid in that group,” Pulcineli said.

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