The Democratic Republic of Congo’s deadliest Ebola epidemic is having a devastating impact on pregnant women, with maternal deaths in Ituri province surging as the outbreak outpaces the health response. According to the United Nations reproductive health agency, deaths among pregnant women have roughly doubled in just over three months, with 63,700 pregnant women still at risk in affected areas. Ebola restrictions placed on frontline health facilities are preventing some blood transfusions from being administered, potentially contributing to the increasing maternal mortality.
In one instance, a woman with severe anaemia died after being refused a blood transfusion, leading to an angry mob storming the hospital and several Ebola patients escaping. The DRC already had one of the highest rates of maternal mortality globally before the outbreak, due to ongoing conflict, mass displacement, weak health infrastructure, and financial barriers. The health system in Ituri province, the epicentre of the outbreak, was already severely strained.
Maternal haemorrhage, including severe bleeding after childbirth, is the leading cause of maternal death worldwide, and anaemia increases the risk of severe complications and death. Women are disproportionately affected by the outbreak, accounting for more than half of confirmed Ebola cases. They are also at high risk of infection due to their roles as primary caregivers for the sick and as health workers.
At least 160 frontline health workers have been infected, and 43 have died, with midwives facing a very high risk of infection due to exposure to bodily fluids during childbirth. The outbreak has also led to a decline in antenatal care visits, obstetric complications being managed by health facilities, and contraceptive uptake. Fear of infection has kept women from attending health centres, and misinformation about the source and spread of the virus has disrupted the response.
The UN has warned that the response is now running out of funding, with only enough to cover “the next weeks” as promised allocations are yet to be distributed. The outbreak is also having a devastating impact on children, with almost two children a day being orphaned since the start of the outbreak. At least 180 children have lost both parents or primary caregivers.
The UN has said that the DRC outbreak is on course to be the largest ever, potentially surpassing the 2014-2016 West Africa crisis. The international humanitarian organisation has warned that the response efforts have been severely hampered by unprecedented international humanitarian aid cuts, reducing the capacity of humanitarian organisations by more than 30 per cent and leaving local health networks unprepared. The agency has called for increased funding to support the response and prevent further maternal and neonatal morbidity and mortality.
