Áurea Monteiro, 28, passed away at 3:45 p.m. on March 31, 2021 in the ICU of Santa Casa de Belém, in Pará. Five hours later, Dienne Santos, 38, died in an ECU (Emergency Care Unit) seven kilometers away.
Both suffered complications from Covid after childbirth, leaving their babies orphaned and a trail of mourning that persists in families.
In the capital of the neighboring state, in Boa Vista, Roraima, the indigenous health nurse Gracione da Silva Santos, 44, still mourns the death of his wife Almiza Prado, 37, in June 2020, in the first year of the pandemic. Today he takes care of the youngest, Valentina, born with her mother intubated from her in the ICU, and four other children.
The stories expose failures in public and private health services at the height of the health crisis, help explain why Brazil doubled the maternal mortality rate in 2021, with the North region leading the way, and point out the priority areas that require improvements to reduce preventable deaths in 90% of situations.
Data from the Federal Government’s Previne Brasil program, extracted by Impulso Gov, a non-profit organization, show that, on average, 34% of Brazilian municipalities were unable to provide six prenatal visits to 45% of their pregnant women (target of the program) in 2022. In the North, this rate was almost double.
Housewife Dienne Santos was one of the pregnant women who did not undergo prenatal control during the pandemic for fear of Covid, according to her mother-in-law Antonia Eremita Santos, from Belém. She began experiencing symptoms of the infection seven days after giving birth to Giovanni on March 14, 2021.
With a lot of cough, she sought a UPA, was medicated and discharged. That same night, with a fever and shortness of breath, she returned to the health center. Without a place in the ICU, she was admitted and then intubated. She died in the UPA, after ten days, leaving her husband, baby and 6 and 9 year old daughters.
According to the OOBr (Brazilian Obstetric Observatory), puerperal women hospitalized for Covid were 2.5% more likely to die from complications of the infection compared to pregnant women.
“In the puerperium [período hasta 42 días después del parto], women are at greater risk of thrombosis, and Covid also predisposes to thrombosis. A cesarean section already leads to an inflammatory response and can be enhanced by Covid”, explains obstetrician Rossana Pulcineli Francisco, USP professor and OOBr coordinator.
According to Milena Ferreira Porfírio, coordinator of the Belém Health Department, the increase in maternal mortality was related to the fact that maternal and child actions were paralyzed, with efforts aimed at confronting Covid.
At the state level, the Department of Health of Pará attributes the increase in maternal deaths in the pandemic to the lack of structure in primary care. He says that the State has reorganized and strengthened the work process at the levels of maternal and child care, from the prenatal program to highly complex hospitals.
Roraima, where Almiza died, led the ranking of maternal mortality in 2021, with 281.7 deaths per 100,000 live births, a level similar to that of African countries.
The State Department of Health affirms that it has been registering a substantial increase in the demands for care in all available units.
According to the portfolio, a series of measures have been adopted to improve the service, such as the training of professionals, the hiring of public servants and the evaluation of indicators.
Translated by AZAHARA MARTIN ORTEGA
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