Fearing COVID, struggling Malawian women forgo prenatal care

BLANTYRE, Malawi (AP) — Prenatal services at the health clinic were free, but the motorcycle taxi fare cost more than Monica Maxwell could afford. Just four weeks before delivering her baby, she cobbled together 1,400 kwacha ($1.75) for the 50-kilometer (31-mile) round trip. It was only her third visit -- fewer than her first two pregnancies. The money she made selling tomatoes at the local market dried up due to the pandemic. Her husband’s income selling goat meat also dwindled.

“It was the most difficult period of our lives. We had no money for our daily survival,” Maxwell, 31, said as she waited outside with other women to be seen by a medical midwife. “Mostly we stayed home.”

In a country where hospitals are so bare that women are expected to bring their own razor blades for cutting their babies' umbilical cords, the deepening poverty brought on by the pandemic is further imperiling women's lives.

Officials say far fewer pregnant women in Malawi are getting the health care they need amid the pandemic, with many forgoing medical visits and relying solely on traditional birth attendants, who provide emotional support and administer traditional herbal treatments but are technically banned by the government from delivering babies because of their lack of formal training. Many families can’t afford clinic visits, or, like Maxwell, the transportation to get there; they also fear they’ll catch coronavirus in a medical facility.

At risk are the gains that Malawi — a largely rural sliver of a country, with 18 million people — has made over the past decade to combat its poor record of maternal deaths. Malawian women face a 1-in-29 lifetime risk of death related to a pregnancy or birth, according to the United Nations Population Fund. The country has 439 such deaths per...