India leads with most expected births amid virus lockdown

China, Pakistan, Nigeria, Indonesia are also expecting high numbers of births

NEW DELHI: As the world prepares to celebrate the Mother's Day on Sunday, India is expected to see 20.1 million pregnancies and births after the eruption of the novel coronavirus outbreak in the country, according to estimates by UNICEF.

Warning that pregnant mothers and babies born during the Covid-19 outbreak were threatened by "strained health systems and disruptions in services" across the world, the UN agency said this could put the lives of mothers and their newborns at risk.

Representing the Coalition for Reproductive Health and Safe Abortion, obstetrician Subhasri Balakrishnan pointed out the danger that this situation posed for mothers and babies in India.

"A Chennai-based diabetic pregnant lady was rushed to the hospital for complications. We later learned that under the lockdown, she was trying to ration her insulin dosage," she recounted.

Balakrishnan told Anadolu Agency that the pandemic affected "surveillance of maternal issues in rural areas," with the report and review of all pre and post-natal issues and deaths -- a routine practice under normal circumstances -- has come to a standstill.

"Most community health workers have been diverted and thus we're not even sure what issues these women will be facing," she said

She also added that the pandemic was leading to a parallel epidemic that would not only have short-term repercussions but would also affect long-term mortalities.

Following India, four other countries that are expecting high numbers of births since Covid-19 was declared a pandemic on March 11. These include China at 13.5 million, Nigeria at 6.4 million, Pakistan at 5 million, and Indonesia at 4 million.

Newborn health in India

India suffered an infant mortality rate (IMR) of 32 per 1,000 live births in the year 2018, though this improved to nearly 30 per 1,000 live births by 2019, according to most recent data released on the country's National Sample Registration System.

These figures are among the highest in the world. Despite the decline in IMR over the past decades, one in every 31 infants dies within the first year of their life nationwide.

"During the national lockdown period, community-based vaccination services have been interrupted. However, facility-based immunisation services continued," said UNICEF India health chief Luigi D'Aquino.

"As of this week, India has adopted a strategy of cluster containment, whereby in Covid-19 'hotspots' the access to immunisation and other maternal and child health services is restricted, whereas, in other clusters in the country, services including outreach immunization have been progressively resumed," D'Aquino told Anadolu Agency.

UNICEF estimates have indicated that globally up to 116 million children may miss immunization services due to Covid-19. The full impact of the interruption of immunization services is yet to be documented.

Global births amid virus

An estimated 116 million babies will be born around the world under the shadow of the pandemic.

UNICEF said its analysis was based on data from the World Population Prospects 2019 report by the UN Population Division.

Mothers and newborns will be greeted by the harsh realities of the virus, UNICEF said, amid global containment measures such as lockdowns and curfews, as well as overwhelmed medical facilities, shortages in supplies and equipment and the redeployment of birth attendants like midwives to treat Covid-19 patients.

The agency also signaled that most countries with high births already had high neonatal mortality rates even before the pandemic and could see these levels increase with the outbreak.

"Expecting mothers are afraid to go to health centers for fear of getting infected or missing out on emergency care due to strained health services and lockdowns," said Henrietta Fore, the Executive Director of UNICEF.

"It's hard to imagine how much the coronavirus pandemic has recast motherhood," she said.