A Young Mom’s Journey to Deliver Safely in a Pandemic
From the community to the hospital, health care champions in Ghana help ensure safe, respectful, and quality care for pregnant women
Mary Atta-Boisson found out she was pregnant and a stark new reality eclipsed her plans to finish high school and pursue a career.
Young and alone, without a partner’s support, the 18-year-old feared disgrace and homelessness. She also faced the real prospect of giving birth during a global pandemic, as COVID-19 rapidly spread around the globe.
“I was very sad and scared,” recalled Mary, who cried herself to sleep at night and, for as long as possible, tried to keep the pregnancy a secret.
For months she stayed hunkered down at home, with only her parents aware of her pregnancy. As a result, she missed several critical prenatal care visits.
Even though she knew she should see a doctor or midwife as her pregnancy progressed, Mary was afraid of going to a health facility during the pandemic. Many people from her community in the Central Region of Ghana had shared that nearby health centers and hospitals were overcrowded and overwhelmed; social distancing and good hand hygiene measures were impossible to enforce; and many nurses and patients sick with COVID-19 were quarantined onsite.
Regular prenatal care throughout a pregnancy helps identify potential concerns early and reduces the risk of pregnancy and birth complications. Compared to babies of mothers who receive prenatal care, babies born to mothers who don’t receive it are three times more likely to be born underweight and are five times more likely to die in infancy.
Thankfully, a community health worker stopped by Mary’s home for a routine visit when she was only halfway through her pregnancy.
Learning that Mary was approximately 19 weeks pregnant, the health worker supportively explained that the risks of missing prenatal care outweighed the risks associated with COVID-19. She also reassured Mary that health centers and hospitals were instituting proper COVID-19 safety protocols to protect those seeking essential care, especially women and children.
Through the MOMENTUM Country and Global Leadership project, USAID has supported training for health workers in more than 25 facilities across Ghana since the start of the pandemic. Training sessions have focused on COVID-19 infection and prevention control standards, emphasized the importance of providing respectful and nurturing care for mothers and babies, and helped participants understand when to refer pregnant women for more specialized care.
Because some rural communities might not have access to the complex or emergency health services they need, USAID has also supported networks of care that connect rural primary health facilities with district hospitals, improving communication between more experienced providers at hospitals and community health workers like the one who visited Mary.
Convinced that visiting a health facility was the right choice for herself and her pregnancy, Mary donned a facemask and set out for St. Luke Catholic Hospital the next morning.
She was immediately impressed by the hospital safety protocols. Before entering she was required to wash her hands with soap under running water at a bucket stand by the entrance. A masked nurse also checked her temperature, offered her hand sanitizer, and asked if she had any symptoms consistent with COVID-19. Seeing other hospital visitors wearing masks and practicing social distancing provided her with a huge sense of relief.
In the prenatal care unit, Ruth Boham, the midwife-in-charge, gave Mary a warm welcome and provided her with detailed, accurate information about her pregnancy and a thorough physical exam. Before the end of the appointment, Ruth scheduled Mary for regular visits for the remainder of her pregnancy and shared her personal contact information in case Mary had any concerns or complications between appointments.
Ruth recognized that the pandemic is taking a huge toll on clients, especially those like Mary who are pregnant for the first time.
“We were receiving about 30 or 35 pregnant mothers every day before the pandemic but [since] COVID-19, the number has reduced to five or sometimes three,” Ruth shared, citing fear of infection as the main reason that women are avoiding facility-based care.
But community outreach efforts, such as public service announcements on the radio and home visits, have emphasized the infection prevention measures in place. All employees at the St. Luke Catholic Hospital in Apam, Ghana have now received USAID-funded training in good hand hygiene, proper use of masks, and disinfection techniques to keep surfaces clean. USAID also donated gloves, masks, and thermometers as well as mops, buckets, and pedal-operated waste bins.
Women’s health providers, like Ruth, are also highlighting the compassionate, respectful care side of their work, in addition to safety and quality, so that pregnant women can feel confident when visiting the health facilities.
After diligently attending her prenatal care visits for the remainder of her pregnancy, Mary has since safely delivered a healthy baby girl, whom she named Alfredia Boisson after her father.
“I was worried about becoming a mother, but I am so glad I have her in my life,” says Mary, who hopes to return to school and finish her education. “When Alfredia smiles at me, it is so beautiful.”
Since the beginning of the COVID-19 pandemic, USAID has worked alongside our partners to rapidly deploy support and assistance to countries in need — both to fight COVID-19 and to protect the continuity of care for mothers, newborns, and children around the world.
About the Authors
MOMENTUM Country and Global Leadership, led by Jhpiego and 12 partners, is a USAID-funded project that works alongside country governments and local institutions to improve measurable outcomes for maternal, newborn, and child health, family planning, and reproductive health care. Emmanuel Attramah, a Knowledge and Communications Officer for Jhpiego in Ghana, developed this story.
