What Happened to Obstetric Care During the COVID-19 Pandemic?

An interesting correspondence in The Lancet Infectious Diseases Journal, published 5 October 2020 by Khalil and others reported an increase in stillbirths during the COVID-19 pandemic which was unlikely to be directly caused by viral infections since none of the women had COVID-19.

They compared the number of women booking for prenatal care, attendances at obstetric triage services for unscheduled care and number of births at St George’s University Hospital London in two epochs 1 February to 15 June 2020 and 1 February to 15 June 2019. They found significantly fewer obstetric triage visits in the 2020 epoch than in the 2019 epoch.

This difference was significant for both pre lockdown and lockdown periods. There were also fewer births during the 2020 epoch than during the 2019 epoch. However, this difference was significantly only for the lockdown period. Their findings suggested that the observed rise in stillbirths was possibly due to reduced care seeking.

A possible explanation for the greater fall in triage attendance, 19% when in birth 6% was that women might have perceived triage attendances as avoidable, whereas obviously labour and birth are not.

They concluded that their findings were consistent with the increase in deaths and reduction in care seeking observed in the general UK population during the COVID-19 pandemic.

They went on to encourage an urgent need to evaluate maternity service delivery, care seeking and pregnancy outcomes nationally so that plans could be drawn up for immediate post pandemic care and during any further future health system shocks.

This highlights another aspect of the social factors involved with lockdown and healthcare.

As with the worrying statistics over cancer screening and cancer treatments, this shows that no aspect of healthcare was immune to the shutting down of healthcare facilities both National Health and private during this COVID crisis.

It also highlights the fear which the population has suffered.

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