CHALLENGES OF THE COVID-19 EPIDEMIC TO THE PAKISTANI OBSTETRIC SYSTEM: PROBLEMS, SOLUTIONS, PROSPECTS

© 2020 Marina BAKANOVA

2020 – № 2 (20)

Keywords: medical anthropology, COVID-19, public health, the concept of obstetrics

Abstract: Undoubtedly, the COVID-19 epidemic that broke out this year has had a significant impact on all aspects of human life, including medicine. In Pakistan, as a country with a weak state provision of medicine, there have been dramatic shifts. During the epidemic, multidisciplinary public hospitals were redesigned to increase the admission of COVID-19 patients, which reduced the number of beds for patients with other diseases, including for women in labor. On the other hand, private hospitals are mostly small, unable to ensure the safety of medical personnel and doctors, and often simply closed. Large and expensive private hospitals that have retained the practice have significantly increased prices and the number of maternity tests on admission. The sharp decline in classical medical care for women in labor has led to a reciprocal growth in alternative methods of obstetrics, including home birth attendance by midwives. In the event that childbirth proceeded without complications, such alternative assistance was quite effective. In cases of obstructed childbirth (by the mother or child), mortality, morbidity and disability increased sharply. However, special problems were caused by planned and emergency caesarean sections (currently the gold standard of childbirth for wealthy Pakistanis), which either became very expensive or were carried out illegally in clandestine conditions with extremely early discharge of patients. The COVID-19 epidemic had an extremely negative impact on the health of women in labor and children of this period, which demonstrates not so much the danger of it itself, but the unpreparedness of the medical systems of developing countries (including Pakistan) for new health challenges and the need to reform them under the supervision of WHO.