Pregnant Deaths from COVID-19 in Sub-Saharan Africa: Causes, Risks, and Lessons
The COVID‑19 pandemic reshaped global healthcare, but its impact on pregnant women in Sub‑Saharan Africa was especially devastating. As the virus spread, maternal mortality in this region spiked—making it the worst-hit in the world for pregnant COVID‑19 deaths.
Why did this happen? What factors made pregnancy so risky during the pandemic in these nations? This article explores the data, systemic challenges, and potential solutions for safeguarding maternal health in future crises.
Understanding the Regional Impact
According to multiple global studies, Sub-Saharan Africa reported the highest mortality rate among pregnant and recently pregnant women with COVID‑19. Infections in this group often resulted in complications such as respiratory failure, emergency caesarean sections, and even death.
Approximately 9 in every 1,000 pregnant women infected with COVID‑19 died from the disease or related complications in this region—nearly 1%. This far surpasses figures from high-income countries, where the risk is substantially lower due to stronger healthcare systems.
Case Studies from Six Countries
Research conducted in six countries—Democratic Republic of Congo, Ghana, Kenya, Nigeria, South Africa, and Uganda—showed that pregnant women with COVID‑19 had a significantly higher risk of severe illness, ICU admission, and death compared to non-pregnant women with COVID‑19.
- Pregnant patients had a 2 to 5 times greater chance of needing intensive care.
- Over 98% of the deaths were directly related to COVID‑19 and not pre-existing conditions.
- Comorbidities like HIV and tuberculosis further raised risk of ICU admission.
Why Were Pregnant Women So Vulnerable?
1. Fragile Health Systems
Many regions in Sub‑Saharan Africa lack adequate access to oxygen, ICU beds, and trained medical staff. Pregnant women with COVID-19 who developed complications such as pneumonia often could not access life-saving interventions.
2. Disruptions to Maternal Health Services
The pandemic led to nationwide lockdowns, health worker shortages, and supply chain issues. Antenatal visits, institutional deliveries, and postnatal care were severely disrupted for months. In some areas, services were unavailable for up to 6 months.
3. Delay in Seeking Care
Many women delayed or avoided care due to fear of infection, misinformation, or travel restrictions. This delay often meant that complications progressed too far before they could reach help.
4. Prevalence of Coexisting Conditions
HIV, TB, anaemia, and malnutrition are common in the region, and all increase vulnerability to respiratory infections like COVID‑19. These health burdens made COVID‑19 deadlier for expectant mothers.
Comparative Global Data
Globally, maternal deaths rose by over 40,000 in 2021 due to COVID‑19. Stillbirths, premature deliveries, and emergency surgeries also increased, especially in low-income nations. Sub-Saharan Africa alone accounted for 70% of these losses.
By 2023, the region recorded nearly 182,000 maternal deaths annually—a number feared to grow if systemic challenges aren't addressed post-pandemic.
Real-Life Consequences
Many women in rural Africa were forced to give birth at home without skilled assistance. Midwives reported lacking gloves, PPE, or access to ambulances. Several hospitals had to turn pregnant women away due to staff being redeployed to COVID wards.
Sadly, the stories are all too common—mothers unable to breathe, unable to reach hospitals, or giving birth on roadsides because transport was not available. These tragedies weren’t just due to the virus—but to system collapse.
What Needs to Change?
1. Strengthen Maternal Health Infrastructure
Investing in clinics, staff training, and essential equipment is key. Oxygen supplies, rapid response ambulances, and ICU availability must become basic standards.
2. Prioritise Pregnant Women in Health Crises
Pregnant individuals must be included in pandemic preparedness plans. Vaccine access, early testing, and treatment protocols tailored for pregnancy should be developed and promoted.
3. Continue Safe Maternity Services During Emergencies
Governments must classify maternity care as “essential,” ensuring it is maintained even during lockdowns or health worker shortages. Telemedicine and community health models can bridge gaps in care.
4. Address Social Determinants
Health is deeply linked to poverty, education, and access to transportation. Improving these will reduce overall maternal vulnerability, not just during pandemics.
International Response and Funding Gaps
Unfortunately, many international aid programmes supporting maternal health were cut or reallocated during the pandemic. WHO has warned that without renewed commitment, global progress in maternal health may reverse by a decade.
Grassroots NGOs and community groups have stepped up, but systemic investment is still lacking.
FAQs on COVID-19 and Pregnancy in Sub-Saharan Africa
Q1. Why were pregnant women at higher risk of death from COVID‑19?
Pregnancy suppresses the immune system, making women more vulnerable to respiratory complications. In Sub‑Saharan Africa, this risk was magnified by poor healthcare access and underlying conditions.
Q2. Was vaccination available for pregnant women?
Vaccines were initially unavailable or underutilised for pregnant women. Even when available, misinformation and supply issues led to low uptake in many African nations.
Q3. What are some lessons learned?
Pregnant women must be treated as a high-priority group in public health crises. Health services must stay operational during pandemics, and investments in maternal health should never pause.
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Conclusion
The pandemic exposed severe cracks in maternal health systems—especially in Sub‑Saharan Africa. Pregnant women paid a devastating price for global unpreparedness and local underfunding.
However, these losses should not be in vain. With proper attention, funding, and policy reform, we can prevent future maternal deaths—even in times of crisis.
Maternal health is not optional—it’s a human right.