LEYTE/ EASTERN VISAYAS, The Philippines -- Faithjoy “Joy” Abuyabor, is a 41-year-old registered midwife. While helping pregnant women is her vocation, Joy herself too is five (5) months pregnant now. “I need to get a 4D ultrasound test for my ante-natal care. But, with this COVID-19 on the horizon, I don’t know when I can get one,” She lamented.  

Celebrating the International Day of the Midwife (5 May) in her house in Leyte, Joy is contemplating, as a midwife and as a pregnant mother, she probably is in the best position to understand what many Filipino pregnant mothers are going through, especially amid the COVID-19 outbreak. 

Common fears of pregnant mothers

After the first COVID-19 case was detected in the country in late January 2020, the Philippine Department of Health (DOH) has so far confirmed 9,485 positive cases. 14 cases are from Eastern Visayas, one of whom has passed away, with three others recovered. Because of the surge in the suspected coronavirus cases in the country and associated quarantine measures put in place by the government, pregnant women feel it more and more difficult to access maternity services at the hospitals. The reasons can vary - some hospitals seem so overwhelmed with the care of the COVID-19 patients that their maternal healthcare capacity is overstretched.  Some pregnant women now feel reluctant to go to hospitals because of the fear of getting infected.  Others find it simply too difficult to find transport to the hospitals due to quarantine.

The country was shocked on 26 April when a pregnant mother in Metro Manila died from complications after she gave birth at home, after being rejected by six hospitals.

“The number of patients, in general, seems to have increased in the Philippines, beyond the capacities of the hospitals to accept to attend to all of them,” Joy stated.

“A few weeks ago, I received an emergency call at 2:00 AM in the morning from a pregnant woman who suffered from abdominal pains, saying, “I think I am about to give birth.” She did have a ‘quarantine pass’ and transportation, but she and her husband thought that they could be sent to jail if they left their house and broke the curfew.  They did not want to bother the local officials, either, and instead called us for help. 30 minutes after the call, she delivered her baby at home. Though her place was a bit far, we managed to arrive just a few minutes after her delivery, in time to administer an injection to control her bleeding and secure the safety of both the mother and her baby.  It was a close call,” Joy recalled her relief.

Role of a midwife

Midwives are trained health professionals. The main duties of a midwife involve looking after pregnant mothers, providing prenatal care, performing safe birth, and offering postnatal care, including family planning. They may deliver babies at homes, birthing centers, or hospitals.

“The midwives perform normal deliveries. Once we learn that a patient has a complication that poses bigger risks, we refer her to a higher-level hospital and an obstetrician. We work closely together with them,” Joy adds.  

According to the National Database of Selected Human Resources for Health, as of 31 December 2019, there are more than 20,000 midwives in the country.  99 percent are women.

“When women feel anxious about their pregnancy or childbirth, some seem to feel more comfortable opening up themselves to share their feelings and conditions to fellow women.  And the midwives are the professional experts on safe pregnancy and childbirth.  I know how they feel.  Look at me - I am an experienced one myself, ” she jokes.   

UN Under-Secretary-General and United Nations Population Fund (UNFPA) Executive Director Dr. Natalia Kanem underscores the role of midwives in an earlier statement, “Midwives’ life-saving skills go far beyond delivering babies; midwives educate, empower, and enable women to lead healthy lives and to exercise their right to sexual and reproductive health. Amid the current COVID-19 pandemic… midwives risk their own lives to save those of pregnant women and newborns.”

Hope she learned from UNFPA support after Haiyan

Joy confidently says, “I know many mothers are afraid these days. It would be a lie if I said I were not concerned myself. But, I know what to do.”

In 2013, the Eastern Visayas was devastated by the Super Typhoon Haiyan that claimed the lives of more than 6,000 Filipinos. “The typhoon was so strong that it rampaged all of what our province used to have. Everyone was in distress.  So many perished everywhere.

Since I was also trained for first aid, I helped treat the survivors. Some of them were pregnant women, and we wanted to assist them. We had a makeshift clinic made out of tarpaulins. We improvised sterile bandages out of boiled clothing. We cleaned the beds that we had found on the streets and used them just to get a semblance of a hospital.”

After a week or two, aid agencies and relief items started to arrive in Leyte. “UNFPA provided safe delivery kits, supplies, and even emergency training.

From that training, I learned the value of having the right skills, while staying resilient and innovative. I learned that regardless of your profession, it is important that you have the skills to manage emergencies while adapting to the new normal.  As a midwife, for as long as I know how to manage a patient and control infection, I can deliver babies safely -- I can provide services to my fellow women, to my community. I learned from UNFPA that even if I am one of the affected by a disaster, I can still be a responder. I was inspired by that experience.”

Joy’s fighting spirit

“And that experience is paying off today, in responding to the COVID-19. For instance, it is true that the arrival of personal protective equipment is delayed because of logistical challenges due to the lockdown, but I am not worried. If we need to sew our masks ourselves to protect our staff and patients, we will just do it.

She continues, “I have come face-to-face with the two biggest disasters in the recent history of the Philippines – Typhoon Haiyan, and COVID-19. They are different, yet how we should approach coping with the challenges may be the same.

We saw Haiyan enter and leave our country. COVID-19, in contrast, is an invisible adversary.

Both have shaken our health systems.  But I am hopeful from my experience and training as a midwife, and what I learned from the previous disaster, that we can overcome COVID-19 just like we did over Haiyan. It hinges on people’s will and financial resources - for the latter, I also would like to count on global solidarity and empathy.” Joy never loses her unwavering enthusiasm for her work in the community, similar to the other tens of thousands of her fellow Filipino midwives, and midwives across the world, risking their own precious lives to save the others’ lives, as front liners fighting this unprecedented COVID-19 pandemic. 

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