ICM | Joint Calls to Action: Protecting Midwives to Sustain Care for Women, Newborns + their Families in the COVID-19 Pandemic
The International Confederation of Midwives (ICM) has listened to its Member Associations in all regions, and accounts from the midwives working on the frontlines during this pandemic are harrowing, unveiling an increase in gender discrimination, domestic violence, human rights abuses, the over-medicalisation of birth and fear and misinformation, all culminating in growing distress among women and midwives.
ICM, in partnership with UNFPA, is uniting in solidarity with our global midwifery workforce to launch a series of calls to action for governments, decision makers, donors and health institutions to ensure the protection of midwives, women and newborns during the COVID-19 pandemic.
Click here to access the full statement, and please circulate widely within your networks.
Click here to read our full statement calling for governments to provide personal protective equipment to midwives.
We at the International Confederation of Midwives (ICM), in solidarity with the 143 Midwives’ Associations we represent, stand in support of our long-time partner, the World Health Organization (WHO) as this vital, global institution experiences drastic and unprecedented funding suspension. Click here to read and share our full English statement.
Resources for midwives and other maternity care providers
This web page highlights basic principles of contact tracing to stop COVID-19 transmission; detailed guidance for health departments and potential contact tracers is forthcoming. Click here to read this document from The Centers for Disease Control and Prevention.
At this time, we do not know if someone can be re-infected with COVID-19. Data to date show that a person who has had and recovered from COVID-19 may have low levels of virus in their bodies for up to 3 months after diagnosis. This means that if the person who has recovered from COVID-19 is retested within 3 months of initial infection, they may continue to have a positive test result, even though they are not spreading COVID-19. Click here to access this resource.
Global Financing Facility | GFF Leaders Warn of Emerging Secondary Global Health Crisis from Disruptions in Primary Health Care due to COVID-19
The warning comes from top representatives of the GFF Investors Group in response to emerging findings that the COVID-19 pandemic is halting delivery in GFF-supported countries of essential services such as ante-natal care visits, attended births, delivery of child vaccinations and access to family planning, which have been key drivers in recent global reductions in maternal and child mortality. Click here to access the press release.
Click here to access this resource from the International Centre for Migration, Health and Development
The Safe Delivery App from Maternity Foundation, University of Copenhagen and University of Southern Denmark aims to improve the quality of emergency obstetric and neonatal care and hereby strengthen health care workers skills and quality of care primarily in developing countries. The app will soon feature resources specific to maternal care during the Coronavirus pandemic.
Click here to download the app on the Apple Store.
PMNCH | Compendium of COVID-19 Related Partner Resources on Women's, Children's and Adolescents' Health
PMNCH has developed this compendium of resources that brings together the latest evidence-based information on women, children and adolescent health in the context of COVID-19.
In the context of the COVID-19 pandemic and the need to prevent or reduce infection, this rapid analytic review considers: What is the evidence base and best practice on optimising mother-baby contact? What is the evidence base and best practice on optimising infant feeding? What are the implications of this knowledge for guidance for health professionals, the care of women and babies, and information for women and families?
Click here to access this resource.
This document aims to summarise: 1. Midwives’ views, experiences and feelings during the Covid-19 pandemic. 2. Immediate strategies to optimise wellbeing 3. How to ensure sustained wellbeing for midwives following a pandemic.
Click here to access the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists' comprehensive resource for healthcare professionals on Coronavirus infection in pregnancy.
This paper reflects on the immediate response of the maternity services in the UK to the coronavirus pandemic, and the evidence-informed developments that are now emerging.
As this Technical Brief notes, studies to date do not show an increased risk of severe disease in late pregnancy or substantial risk to the newborn from COVID-19. But its impact on acute care services in settings with under-resourced health systems is likely to be substantial. The brief provides guidance on continuing to deliver a high level of antenatal care. Click here to access this resource.
A key fact about COVID-19 is that the vast majority of infections will result in very mild or no symptoms. Not everybody is at risk of severe disease. Persons of advancing age and those with existing respiratory, cardiac and/or metabolic disorders and immunodeficiencies are at higher risk of moderate to severe disease.
Limited data are available on COVID-19 in pregnancy, but the studies published to date do not show an increased risk of severe disease in late pregnancy or substantial risk to the newborn. Congenital infection has not been found, and the virus has not been detected in expelled products of conception. These findings are reassuring, and are quite different from other recent pandemics, like the 2009 H1N1 influenza A pandemic which resulted in more severe disease in pregnant women, or Zika virus which is teratogenic. Information on the impact of COVID-19 on early pregnancy outcomes remains unavailable at the time of writing. Non-pregnant women of childbearing age are also at low risk of severe disease
Click here to access this resource.
The overarching aim of this guidance is to ensure maternity care providers can deliver respectful and individualised care services that promote the safety of women, babies, families and health professionals during the COVID-19 pandemic. Click here to access this resource.
Women and newborns need quality maternity care services and healthworkers must be supported to provide that care. There are no exceptions in times of crisis, even the current COVID-19 pandemic, which is putting more pressure on already overstrained health systems. Click here to access a variety of resources from White Ribbon Alliance.
This FAQ complements the WHO interim guidance: Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. Click here to learn more.
This form created by the WHO is to be completed for all health workers who have been exposed to a confirmed COVID-19 patient in a health care facility.
To support countries’ preparedness effort on the COVID-19 outbreak, WHO`s Department of Health Security and Preparedness has developed various COVID-19 tabletop exercise (SimEx) packages. Click here to download the exercises.
Click here to access technical advice from the WHO for health workers, humanitarian operations, clinical care, etc.
WHO + IFRC + IOM + UNHCR | Coronavirus disease (COVID-19) Technical Guidance: Humanitarian Operations, Camps and Other Fragile Settings
Click here to access interim guidance on scaling-up COVID-19 outbreak in readiness and response operations in camps and camp-like settings (jointly developed by IFRC, IOM, UNHCR and WHO).
This scientific brief examines the evidence to date on the risks of transmission of COVID-19 from an infected mother to her baby through breastfeeding as well as evidence on the risks to child health from not breastfeeding.
Women and Birth | Caring for the Carers: Ensuring the Provision of Quality Maternity Care During a Global Pandemic
This article provides an overview of important considerations for supporting the emotional, mental and physical health needs of maternity care providers in the context of the unprecedented crisis that COVID-19 presents. Click here to read more.
In light of the increase in cases and deaths of COVID-19 among healthcare workers in the countries and territories in the Region of the Americas, the Pan American Health Organization/World Health Organization (PAHO/WHO) urges Member States to strengthen the capacity of healthcare services across all levels and to equip healthcare workers with the appropriate resources and training in order to ensure an adequate and timely response to the pandemic within the healthcare system. Click here to access this resource.
The global COVID-19 pandemic has put enormous stress on healthcare systems and hospital staffing. However, through all this, families will continue to become pregnant, give birth, and breastfeed. Unfortunately, care of the childbearing family has been de-prioritized during the pandemic. Additionally, many healthcare practices during the pandemic have not been positive for the childbearing family or breastfeeding. Despite recommendations from the World Health Organization to promote early, direct breastfeeding and skin to skin contact, these and other recommendations are not being followed in the clinical setting. For example, some mothers have been forced to go through labor and birth alone in some institutions whilst some hospitals have limited or no parental visitation to infants in the NICU. Furthermore, hospitals are discharging mothers and their newborns early, limiting the amount of time that families receive expert lactation care, education, and technical assistance. In addition, some hospitals have furloughed staff or transferred them to COVID-19 wards, further negatively impacting direct care for families and their newborns. We are concerned that these massive changes in the care of childbearing families will be permanently adopted. Instead, we must use the pandemic to underscore the importance of human milk and breastfeeding as lifesaving medical interventions. We challenge healthcare professionals to change the current prenatal and post-birth practice paradigms to protect lactation physiology and to ensure that all families in need receive equal access to evidence-based lactation education, care and technical assistance.
CDC - Receipt of COVID-19 Vaccine During Pregnancy and Preterm or Small-for- Gestational-Age at Birth
In this large, multisite, retrospective cohort study, receipt of COVID-19 vaccine during pregnancy was not associated with increased risk for preterm birth or SGA at birth. The absolute risk for severe morbidity associated with COVID-19 in pregnancy is low; however, women with symptomatic COVID-19 during pregnancy have a more than twofold increased risk for intensive care unit admission, invasive ventilation, and extracorporeal membrane oxygenation, and a 70% increased risk for death, compared with nonpregnant women with symptomatic infections (8). Evidence of the bene!ts of COVID-19 vaccination during pregnancy continues to accrue, including the detection of antibodies in cord blood (9). Together, these !ndings reinforce the importance of communicating the risks for COVID-19 during pregnancy, the bene!ts of vaccination, and information on the safety and e"ectiveness of COVID-19 vaccination during pregnancy.
Click here to access the report.
Information for pregnant women
Click here to access the Public Health Department of England's social distancing guidelines, including guidance for those who are at increased risk of severe illness from coronavirus, such as pregnant women.
JGHS | Where do Women Birth During a Pandemic? Changing Perspectives on Safe Motherhood During the COVID-19 Pandemic
During the coronavirus disease 2019 (COVID-19) pandemic, health systems all over the world are either stressed to their maximum capacity or anticipating becoming overwhelmed. The population is advised not to attend hospital unless strictly necessary, yet this advice seems to apply to all but healthy women during childbirth. Click here to read more.
This video demonstrates how mothers with Covid can safely breastfeed, providing their newborn with the best source of nutrition and protection to survive and thrive. Produced by PMNCH with technical guidance from WHO and in collaboration with Medical Aid Films and Studio Eeksuarus.
Click here to access the Royal College of Obstetricians and Gynecologists and the Royal College of Midwives’ Q&A on general information and advice for all pregnant women during the coronavirus pandemic.
Clcik here to find updated advice from the Royal College of Obstetricians and Gynaecologists for pregnant women who are working in the NHS and other work settings during the coronavirus outbreak
Click here for guidance on whether it should be recommended that women wear face-coverings or facemasks during labour and birth.
As a new UK study revealed that 55% of women admitted to hospital with coronavirus were from black, Asian and minority ethnic (BAME) backgrounds, the Royal College of Midwives (RCM) has launched a campaign to offer greater support and advice. Click here for more information.
UNFPA (Spanish) | En la Medida en que Sigue Propagándose el COVID-19, se Aconseja a las Mujeres Embarazadas y Lactantes que Tomen Precauciones
Pregnancy is a special time full of excitement and anticipation. But for expectant mothers facing the outbreak of the coronavirus disease (COVID-19), fear, anxiety and uncertainty are clouding this otherwise happy time. To learn more about how women can protect themselves and their little one, UNICEF spoke with ICM President, Franka Cadée. Click here to read the full article.
WHO (French) | Alors que le Covid-19 se Propage, les Femmes Enceintes et Allaitantes Doivent Prendre leurs Précautions
In this resource, the WHO provides the most up-to-date information on commonly asked questions surrounding COVID-19, pregnancy, childbirth and breastfeeding.
WHO (Spanish) | Preguntas Frecuentes Sobre la COVID-19, el Embarazo, el Parto y la Lactancia Materna
These questions and answers (Q&As) are based on the most recent interim recommendations from the WHO Strategic Advisory Group of Experts on Immunization (SAGE) for COVID-19 vaccines that have been approved by WHO under Emergency Use Listing (EUL)a as of 15 February 2022:
• Pfizer–BioNTech BNT162b2
• Moderna mRNA-1273
• AstraZeneca AZD1222 Vaxzevria™, SII COVISHIELD™ ChAdOx1-S [recombinant]
• Janssen Ad26.COV2.S
• Sinopharm BIBP
• Bharat Biotech BBV152 COVAXIN
• Novavax NVX-Co2373
COVID-19 Vaccine Information
As the COVID-19 pandemic continues to evolve globally, more evidence is emerging that suggests strong benefits of maternal immunization against COVID-19. Country experiences with COVID-19 and pregnancy vary significantly, but some are beginning to recommend COVID-19 vaccination for pregnant and lactating women.
Click here to access the July newsletter from the COVAX Maternal Immunization Working Group
The New England Journal of Medicine | Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons
Resources on Covid-19, gender and SRHR
The COVID-19 crisis has created unprecedented strains on health care systems, including inpatient and outpatient, emergency care and surgical services. Regardless of these constraints, women will always need sexual and reproductive healthcare, including access to safe abortions.
Read FIGO's full statement calling for abortion access and safety during COVID-19 here.
Refugee settlements are usually densely populated, the people live in crowded tents/communities, with unresponsive public health infrastructure, as well as daily and frequent mobility between settlements and urban zones for work. It is also unlikely that they will have decent washing facilities. As a result, COVID-19 outbreak can spread quickly; affecting mainly women and girls' sexual and reproductive health.
Click here to read FIGO's full statement and call for interventions.
Guttmacher Institute | Crisis on the Horizon: Devastating Losses for Global Reproductive Health Are Possible Due to COVID-19
Every year, nearly 700 million women access modern contraceptive methods, over 90 million give birth in a health facility, and tens of millions access safe abortion services in low- and middle-income countries (LMICs) all around the world. However, in the midst of this pandemic, bad policies and structural barriers may contribute to many people losing access to these essential services. Click here to learn more.
IAWG | Progmatic Guidance for Sexual and Reproductive Health In Humanitarian and Fragile Setting During COVID-19 Pandemic
The Inter-Agency Working Group on Reproductive Health in Crises created this resource to provide programmatic guidance for decision making on sexual and reproductive health, including maternal and newborn health services, in fragile and humanitarian settings in face of threat or reality of COVID-19.
Global responses to the coronavirus disease 2019 (COVID-19) pandemic are converging with pervasive, existing sexual and reproductive health and justice inequities to disproportionately impact the health, wellbeing, and economic stability of women, girls, and vulnerable populations. Learn more about this issue here.
This article from the Lancet outlines the importance of incorporating a gender analysis into preparedness and response efforts during a health outbreak to improve the effectiveness of health interventions and promote gender and health equity goals.
UNFPA, the UN sexual and reproductive health agency, is working to ensure that accurate information is provided to women of reproductive age and pregnant women on infection precautions, potential risks and how to seek timely medical care. The organization has prepared this statement on the topic.
RCCE + UN Women | How to Include Marginalized and Vulnerable People in Risk Communication and Community Engagement
This guide, led by UN Women and The Regional Risk Communication and Community Engagement, outlines populations at disproportionate risk in public health emergencies, and key implications for risk communication and community engagement.
This resource from WHO and Human Reproduction Programme outlines what the health sector/systems can do to address violence against women during the COVID-19 response.
Click here to access this resource on protecting sexual and reproductive health and rights, and promoting gender equality during COVID-19.
Across every sphere, from health to the economy, security to social protection, the impacts of COVID-19 are exacerbated for women and girls simply by virtue of their sex. This resource from the United Nations outlines the impact of COVID-19 on women.
Pregnant women with COVID-19 have a higher risk of certain complications compared to non-pregnant women with COVID-19 of the same age. Read more about COVID-19 vaccination in pregnancy and breastfeeding here in this report from Burnet Institute.
MIDWIVES SPEAKING OUT ON COVID-19: THE INTERNATIONAL CONFEDERATION OF MIDWIVES (ICM) GLOBAL SURVEY (3-PAGE SUMMARY)
In early 2020 as the COVID-19 pandemic grew, ICM coordinated a global research study—funded by the United Nations Population Fund (UNFPA) and Johnson & Johnson—to better understand the challenges and concerns of professional associations of midwives during the COVID-19 pandemic. The aim of the study was to gather information from midwives’ associations across the world to determine the impact of the global pandemic. A descriptive cross-sectional survey using an on-line questionnaire was sent via email to every midwives’ association member of ICM.
A total of 101 responses were received from across the globe between July 2020 and April 2021. All the regions and sub-regions where ICM has member organisations responded: Francophone and Anglophone Africa; North America and the Caribbean; Latin America; Western Pacific; Eastern Mediterranean; South East Asia as well as Northern, Central and Southern Europe. The study identified the sheer scale of many of the global issues facing midwives and women from the start of the pandemic until midway through 2021. The common themes included a lack of supply of PPE, the move to online and telephone consultations in addition to the uncertainty of where to give birth in the context of fear of infection and the changing status of maternity facilities becoming COVID-19 facilities.