A new mother of twins is attended by maternal health nurse Ana Paula Francisco Adrade. Nurse Adrade says it has been challenging to get enough gloves and face masks to safely care for pregnant women. © UNFPA Mozambique

UNITED NATIONS, New York ‒ “We were all alone, all the time,” Tatuli Paghava, 31, told UNFPA in Georgia. She was explaining how the COVID-19 pandemic has made it nearly impossible to survive being a mother.

“Everything got harder… especially for the mothers who are doing everything alone,” added Ani Mardaleishvili, 32, also in Georgia. She works in finance and also manages her 4-year-old daughter’s remote learning. “And I’m expecting a second child soon,” she said. 

Mothers already shouldered tremendous financial, physical, emotional, and intellectual burdens before the onset of the pandemic. But now ‒ under increasing economic pressures, attenuated access to health care, diminishing social support and growing unpaid care responsibilities ‒ many of these burdens have become crushing. 

All of this is taking a toll on the long-term health and welfare of mothers. Women have been disproportionately affected by pandemic-related job losses, and researchers are starting to see signs of rising stillbirths, maternal mortality and poor maternal health outcomes around the world. 

Asking Mothers to do the Impossible

Even under normal conditions, mothers face extraordinary expectations that often defy science and reality. It begins during pregnancy, women around the world told UNFPA.

Suhail Imad Kazem, a nurse in Iraq, was given this advice: “‘Don’t eat lemon when pregnant because the baby will be bold,’” she recalled, laughing. 

“‘Eat nuts for an intelligent child,’” Najla Hamid, a medical doctor in Iraq, said she was told. 

A newborn baby is placed alongside its mother, who is wearing a facemask.
For Marina Ridjic, in Sarajevo, one unexpected challenge was giving birth while wearing a facemask. “The moment when you first smell your child, it is through a mask,” she said. Image courtesy of Marina Ridjic

“Someone advised me not to watch horror movies,” Ms. Mardaleishvili said. “Why should watching a horror movie be a problem? I don’t know.” 

“The funniest thing I have been asked during my pregnancy is that I should not scratch my belly because my son will be born hairless,” said Rafca, in Lebanon.

The unrealistic expectations only continue into motherhood. “I was told that, should I drink too much water, the child will urinate a lot. That was the strangest advice I received during my postpartum period,” Sangrila, 31, in Nepal, said. 

Not All Advice is Harmless

Some women face intense pressure to have sons rather than daughters, reinforcing gender inequalities and discrimination. It is impossible for a mother to choose the sex of her child, and yet some women are asked to. “People were insisting that I have a male child,” said one Syrian mother in frustration.  

In many places, women must perform hard labor during pregnancy. “During the time of my pregnancy, I was told to work on the farm,” recalled Naikya Devi Maharjan, 42, a mother of four from Nepal. “We would get no time to rest. We had to work on the farm and also at home.”

And many women get no reprieve even while they recover from childbirth and learn to care for their newborns. “As a young mother, I had no experience with taking care of a baby,” explained Vivian Omondi, an 18-year-old with a 3-month-old baby in Kenya. “It’s also been hard balancing schoolwork and being a mother.”

COVID-19: A crisis for mothers

Now, under the pandemic, many mothers have lost support and stability. 

A woman wearing a black headscarf rocks a baby in a basket.
Motherhood is even more challenging in humanitarian emergencies. Nur Bibi rocks her fourth baby in a hanging crib in her shelter in Cox’s Bazar, Bangladesh. © UNFPA Bangladesh

“There is no business, no money. People are not working… it brings stress, so it is a bad year,” said Babirye Aisha, a Ugandan woman living in South Sudan. 

“Explaining all this to children in the right way can be hard,” Ms. Mardaleishvili said.

Pregnant women are also seeing barriers to health-care access, as well as rampant misinformation about the pandemic. “Someone told me that drinking chamomile tea was useful for me and my child and prevented us from being infected with the COVID-19 virus,” said one pregnant woman in Aleppo, Syria.

Many are uncertain whether and how often to seek maternal health services. “I felt the need to avoid health institutions for my prenatal checkups,” Amira Cerimagic told UNFPA in Sarajevo, Bosnia and Herzegovina. “I didn’t feel it was that safe to give birth in a hospital.”

Ms. Cerimagic was, fortunately, able to safely deliver at home with a midwife. But similar fears are widespread around the world, raising concerns that women may resort to delivering without skilled care. This can be dangerous and even deadly if complications arise.

“Patients fear that they will contract COVID-19 if they go to the facility,” Noreen, a nurse in the Philippines, explained. “There were a lot of attempted home deliveries.” 

These anxieties, and challenges like transport limitations and food insecurity, have “had a negative impact on their reproductive health,” said Dr. Laeila, in Syria. “This has increased the number of miscarriages” as well as anemia and other problems, she said. 

Midwives Keep Moms -and Themselves- Safe

Nurse Kazem, in Iraq, said she and other health workers try make pregnant women and new mothers feel safe. She said, “It is crucial to ensure the provision of services and give them the feeling of safety they lack.”

A midwife in a face mask and hair cover helps a new mother learn to breastfeed. The new mother is also wearing a facemask.
Lydie Mawelo, a midwife, helps a new mother breastfeed at a hospital in Kinshasa. © UNFPA DRC

The role of safeguarding new and expectant mothers often falls to midwives. But, they themselves have faced sharply increased workplace and caretaking burdens.

“Our responsibility increased. We had to take care of ourselves, spread awareness, protect the pregnant women we visited, and protect our families,” said Roua. She is a midwife and mother of two in Lebanon.

UNFPA is working to increase support for midwives, including through infection control training and the provision of personal protective equipment. UNFPA is also supporting telemedicine and mobile clinics. This will improve women’s access to life-saving antenatal care and sexual and reproductive health services. 

But the longer-lasting solution to these greatly unequal burdens on mothers – gender equality, social norms that value and support mothers, and programs to ensure their health and well-being – remain distant goals.

Society must stop asking, and expecting, mothers to do the impossible. It may be hard to imagine, but a better world for mothers is possible. 

UNFPA.org originally posted a version of this article.