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Childbirth During COVID-19 Lockdown
These are extraordinary times. The COVID-19 global health crisis that is affecting so many high-income countries is now threatening much of the developing world. Although Africa's case rate so far is much lower than in Europe and the United States, the continent is especially vulnerable.
South Africa confirmed its first novel coronavirus case in early March. In the weeks that followed, infections were mostly in suburban areas and largely involved travelers returning from outside the country. But the situation changed fast. At the end of March, the first case was confirmed in Cape Town's largest township, Khaylelitsha, where thousands of families live in close proximity to one another, making physical distancing difficult.
Chloe, her husband Patrick and their 4-year-old daughter, Ava, are just one family in a nation of more than 50 million people who are restricted to their homes during the lockdown. During this period of confinement, Chloe and Patrick collaborated on a photo diary chronicling the days surrounding the birth of their second child.
"Isolation girls. She did my makeup and then I did hers after watching a little makeup tutorial," writes Chloe of this photograph with her daughter, Ava, at home in Johannesburg, South Africa. Chloe has been in self-isolation since before the country's nationwide, military-patrolled lockdown officially began at the end of March, joining other African countries that have imposed strict curfews and shutdowns to prevent the spread of the novel coronavirus.
"Swollen feet. A universal pregnant reality. Possibly made worse by lack of proper exercise due to the COVID-19 lockdown. I can stretch and walk in my house and garden, which I'm grateful for, but I'm craving a long walk in a park," Chloe reflects. South Africa is a mixed-income country, and Chloe's family's suburban experience differs from those in lower-income areas.
"Lockdown babies are self-isolating in their mamas. Waiting in a suspended bubble that is the uncertain lockdown, and also waiting with my body for the uncertainty that is birth. It's uncertainty within uncertainty, and some days it is a lot. But there is literally nothing I can do. So, I wait, play, cook, eat, talk, create and think. What else can one do?"
"Day 2 of official lockdown. Trying not to lose too many marbles," Chloe comments, echoing the challenges of many parents around the world in lockdown. As health systems buckle, borders close and families struggle to stay afloat, COVID-19 is claiming lives and livelihoods. And the crisis is battering essential services that secure the education and protection of children, often with deadly costs.
"My daughter's face in the morning when we told her I was in labor and she was going to meet her baby brother soon. She ran excitedly to me and gave my tummy a kiss before we left. She stayed with her grandparents for the duration of our hospital stay."
"The deserted streets of Johannesburg on a Wednesday morning during rush hour. Traffic absent due to the lockdown, en route to the hospital. Eerie and surreal."
"Getting my temperature checked and hands sanitized by Olga, who wakes up at 4:30 AM to be at the hospital on time. Eager to make a living, many drivers of public taxi transports overload their vehicles above the government guildance, making social distancing an impossibility for many."
"A labor of love. Riding out the waves of contractions that get stronger and stronger, using my breath. The warm water is helping, somewhat." For health professionals working in government hospitals, it's a concern how medical care will be split between COVID-10 cases and other emergencies, since even on a virus-free day, hospitals are already stretched beyond their capacities. Overburdened health systems threaten more than those who fall ill. In the poorest parts of the world, children in need of basic yet essential services are at risk of not receiving them.
"It's all over. We did it. Brought life into the world at a time when everything is so uncertain. The relief and love are palpable. Nothing else matters." Chloe and her husband, Patrick, hold thier newborn son, Fionn, photographed by their attending physician, Dr. Bopape. © UNICEF/UNI321984/Bopape
"Elation. Fionn is born! The room is full of love and jubilation. Nurse Connie [pictured above], the midwife and pediatrician are guessing our baby's weight before he is put onto the scale. The highest guess was 4 kilograms; he ended up being 4.25 kilograms [9.36 pounds] and 57 centimeters [22.4 inches] long, a little giant born in the time of coronavirus."
The day after his birth, Fionn receives a vaccination from a nursing sister at the hospital. "A sister administers live polio vaccine drops. Seems important in a time when we so desperately need a vaccine for COVID-19," writes Chloe. The world must take the opportunity to rebuild better and greener; investments in education, child protection, health, nutrition and water and sanitation will reduce the damage caused by COVID-19 and future crises.
"Sally, a health care worker, feeding Fionn 25 milliliters of colostrum hand-expressed onto a teaspoon and then sucked into a syringe in order to get his blood sugar up. She called our boy Oros, which is the equivalent of the Michelin Man."
"Dr. Bopape, the hospital's pediatrician, examining our baby the day after his birth and showing us some burping techniques. His face is still very swollen from a natural birth."
"Easter Sunday 2020. The grandparents meet their first-born grandson through a windowpane. As they are at high risk for COVID-19, we are protecting them from us as much as we are protecting ourselves from them. A bit sad, but still joyful. Hard to be apart at a time when we long to be together."
"The moment Ava's been longing for, holding her baby brother for the first time. She sang him a song. The chorus went: 'You are so cute, you are so cute.' "
The pandemic and its aftershocks pose an enormous but not insurmountable challenge. By working together, we can ensure that COVID-19 does not threaten social and economic development for a long time to come and help make families and communities more resilient.
UNICEF remains steadfast in its mission to provide essential support, protection and information as well as hope of a brighter day for every child. UNICEF stands united with one clear promise to the world: We will get through this together, for every child.
Top photo: "Being outside always makes us feel better," Chloe O'Doherty writes in the photo diary she and her husband, Patrick O'Doherty, made at the end of her pregnancy, as the first cases of COVID-19 were confirmed in Cape Town, South Africa. "Hard to think of most of South Africa doing lockdown in tiny overcrowded homes, unable to effectively social distance with no access to trees, grass and greenery. And many more without access to running water. Protecting ourselves and others through proper handwashing and hygiene practices has never been more important. But for many children, basic water and hygiene facilities remain out of reach." © Photos by Chloe O'Doherty and Patrick O'Doherty for UNICEF