"I never thought I would go through my pregnancy like this," laments Irene Silva, a Uruguayan woman who has confined herself inside her home in Montevideo out of fear of catching Covid-19.
In recent months, the pandemic has hit many pregnant women in Uruguay hard. Alarm bells rang in the country of 3.5 million when eight pregnant women died from the coronavirus between April 29 and June 8. Before the pandemic, the same amount would die in an entire year.
Although she has maintained strict precautions since the start of the pandemic, these recent maternal deaths prompted Irene to reinforce her rules even more. "I still try to compartmentalise a bit, if it is not very distressing," adds the 36-year-old teacher, currently in her sixth month of pregnancy.
Uruguay, which in recent weeks was among the countries with the highest number of deaths from Covid-19 worldwide proportional to its population, is not in a unique position within the Latin American region.
The Pan American Health Organisation (PAHO) said that more than 231,500 pregnant women were infected with Covid-19 in the Americas in 2020. In 2021 to date, 1,453 died of complications from the virus.
The figures, showing a fatality rate of 0.63 percent, derive from data from 29 countries and territories in the Americas, said the regional office of the World Health Organisation (WHO) in its latest epidemiological bulletin.
Compared to a previous report from May, Suriname registered the highest relative increase in total Covid infections. Uruguay took first place in terms of deaths.
In June, Brazil was still the country where pregnant women were most likely to die from Covid-19 (fatality rate of 7.22 percent). While the South American giant registered an average of 10 maternal deaths per week in 2020, the figure climbed to 41 in June according to official figures.
In Mexico, the coronavirus became the main cause of death in pregnant women, rising from 20 percent last year to 36 percent in 2021 so far, authorities reported.
PAHO said that birth rates were up in June in both Haiti (5.06 percent) and the Dominican Republic (4.20 percent).
A study by the Centres for Disease Control and Prevention in the United States showed that pregnancy increases the risk of suffering a severe form of Covid-19, which comes with risk of premature birth.
The danger of serious illness “doubles" when pregnant women are obese, or have hypertension or diabetes, said Chilean Undersecretary for Health Paula Daza.
In Chile, where of some 15,200 pregnant women with Covid-19 more than 3,700 were hospitalised, 70 percent of those infected had some comorbidity, the most frequent being diabetes.
Daza highlighted the increase in serious cases among pregnant women in 2021, a year after the start of the pandemic.
The same phenomenon was detected in Argentina.
"In the first wave … we did not have pregnant women [in the intensive care unit]. But in this second wave, we are noticing many of the intensive therapies are for pregnant women," said Carina Balasini, from the Argentine Society of Intensive Care (SATI).
Almost 50 percent of pregnant women in intensive care in Argentina are obese or overweight.
The increase in Covid-19 cases in the general population, attributed in part to new variants of the virus, may explain the increase in deaths and hospitalisations among pregnant women. However, experts also point to overwhelmed healthcare systems as a key factor.
"The care of pregnant women and newborns has been disrupted in almost half of American countries," said PAHO Director Carissa Etienne during the International Day of Action for Women's Health on May 28.
"If the situation continues like this, the pandemic is expected to erase more than 20 years of progress in women's access to family planning and the fight against maternal deaths in the region," she warned.
In Brazil, since the beginning of the pandemic, of the 14,000 pregnant or postpartum women hospitalised with Covid-19, more than 1,400 (10 percent) have died, according to the Brazilian Obstetric Observatory Covid-19 (OOBr).
"The system, which was already fragile, was overloaded and began to respond poorly to the situation," Rossana Francisco, professor at the University of São Paulo, told AFP.
Other countries showed an abrupt jump in the deaths of pregnant women even in 2020. In Colombia, maternal mortality increased 38.4 percent last year as compared to 2019, according to the National Institute of Health.
Several Latin American countries – including Argentina, Chile, Mexico and Uruguay – recently integrated pregnant women into priority groups for coronavirus vaccination.
"When there is high transmission of Covid in a country and women are exposed … the benefits of getting the vaccine definitely outweigh the risks,”said Soumya Swaminathan, WHO Chief Scientist.
The expert strongly encouraged vaccination in women who are breastfeeding. "There is no risk," she said.In Uruguay, Irene Silva is calmer now that she has received her Covid vaccine.
"You have to take care of yourself," she said. “What is happening is very ugly, but I prefer to focus on the good to come.”
by Gabriela Vaz & Alina Dieste, AFP