On the Maternity Ward: Protecting Mothers and Babies amid COVID-19

Continuing to work as usual has been quite a challenging endeavour during this period of the corona virus pandemic.  As frontline health workers, midwives are more vulnerable to getting infected with the deadly virus due to the nature of our work; in assisting during labour and childbirth. When this pandemic was declared in Uganda, the government instituted a country-wide lockdown as one of the measures to curb the spread of the disease. Little did I know that this would greatly impact my work as a midwife.

After the ban on public transport across the entire country, I Initially thought that the turn-over of mothers seeking obstetric and gynaecologic care on the maternity unit would reduce. To my surprise, the numbers have remained the same as before. This means that I had to continue executing my roles and responsibilities on the ward amidst the challenges that could come my way. Mothers come to the hospital expecting the best care from me as a midwife. However, there is an uncertain risk involved of contracting the virus from them given that their status is unknown.

In the Ugandan setting, it is cultural that mothers come into labour with many caretakers which makes it a challenge for them to practice social distancing as a preventive measure. We (midwives) have to keep sending the many caretakers away to reduce the number of people that are in contact with the mother and newborn.  We continue to remind them to maintain the social distancing measures. We have ensured that all mothers and caretakers are washing their hands before entering the wards. However, it is not easy in our setting where the wards are crowded.

As a midwife, practicing social distancing is equal to impossible because I have to keep interacting with mothers on the labour ward. Scenarios where we have to monitor a mother using a fetoscope and conduct a normal delivery make it very difficult to avoid getting close to the mother. All of this puts us at a higher risk and increases our uncertainty because we don’t know the status of the women. The best that I can do as a midwife is to wear a face mask, endeavour to wash my hands and also avoid skin to skin contact with my clients.

Transport has been the biggest challenge during this lockdown period.  As midwives, we found it hard to get to our workplaces when the ban on public transport was announced. Luckily, our hospital administration worked tirelessly to provide a hospital van which transports staff from their homes to the hospital and back. Even with this intervention, we face a challenge of arriving at work on time as the vans have to pick staff from their various homes which can be time consuming. Some midwives have had to stay at the hospital until they complete their working days before going back home.

Transport has not only been a challenge to us as midwives but also for the patients themselves as initially, they have to first seek permission from the relevant authorities before finding a means of transport to the hospital. This raised many questions and the Government together with the Ministry of Health decided to remove the condition of getting travel permits for pregnant women going to hospital.  We have had mothers in labour reaching our facility in very critical conditions after staying at lower level private clinics for longer. This increases our work load as we care for mothers with severe complications.

We have had midwives working for longer hours than usual; we currently work 12 hours per day as compared to the usual 8 hours. This change in working patterns means that midwives go back home very late and tired yet have to wake up very early the following day. We are still adjusting to this change.

My appeal to fellow midwives is this: let us to do our best to save the lives of women even amidst the COVID-19 pandemic. We must ensure that we implement all of the preventive measures for our own safety and that of our mothers and newborns.

To love and to serve.

– Catherine Namutosi, Senior Nursing Officer (Midwifery), China-Uganda Friendship Hospital, Naguru.