In Liberia, Guinea and Sierra Leone, the Ebola outbreak is having a horrifying impact on pregnant women, regardless of whether they have Ebola.
Above: The Médecins Sans Frontières Ebola treatment centre in Freetown, Sierra Leon, where, in January, medical aid workers opened a clinic specializing in care for pregnant women with Ebola | Photo Credit: Pablo Krause/MSF via MSF
The woman was lying still on the floor of the ambulance when Emma Åkerlund opened the doors. Between her legs was a tangle of fabric with something inside — the body of a newborn boy with the placenta and umbilical cord twisted up in his mother's skirt. If he survived the delivery, he did not last long after.
The woman had gone into labour earlier that day in November last year. But health workers feared that she had Ebola, and refused to treat her. She had spent hours alone in the back of the ambulance as it made its way to ELWA3, an Ebola management centre in Monrovia, Liberia, run by the medical aid group Médecins Sans Frontières (MSF).
Åkerlund, a gynaecologist and obstetrician, was able to examine the woman while wearing full protective gear: a waterproof body suit, gloves, boots and goggles. She asked the woman if she wanted to see her son; the mother declined. So Åkerlund zipped the baby into a body bag and sterilized it with bleach, just in case the mother and child were infected.
Tests performed later that day proved that they were not. There had been no medical reason for doctors and nurses to turn the woman away. And although there is no guarantee that the child would have survived with proper medical care, there was no reason for him to come into the world — and then exit it — on the floor of an ambulance.
"I'm not blaming anyone for not taking them in," Åkerlund says. "It's a huge problem to try to take care of pregnant women in an Ebola epidemic."
...The epidemic has so far infected more than 23,900 people, killing 9,700 of those, and although it is on the wane it is unclear when it will end. For maternal health, the effects are devastating. The United Nations Population Fund (UNFPA) estimates that, either directly or indirectly, the epidemic will result in as many 120,000 maternal deaths by the end of October.