Maternal deaths have doubled in the epicenter of Congo’s Ebola outbreak in Bunia, Ituri province, as pregnant women avoid hospitals out of fear of infection, quarantine, and violence. According to United Nations Population Fund data, weekly maternal fatalities rose from 3.1 to 5.8 between May 25 and July 19.
As Congo faces the fastest-growing Ebola outbreak on record with more than 1,600 confirmed deaths, a severe shadow crisis is unfolding across the health system. Pregnant women are avoiding healthcare facilities. Public health officials emphasize that fear of being isolated upon presenting with a fever has driven down prenatal visits. This avoidance has triggered a rise in fatalities during childbirth across the eastern region.
Esther Lutula, a 26-year-old resident of Bunia, delayed her prenatal checkups after the outbreak was declared on May 15. Speaking from her home, she expressed a common dread shared by many in the region: the fear of entering isolation solely for presenting with a fever. That delay represents a hazardous gamble against severe obstetric complications.
Data compiled by Noemi Dalmonte, deputy country representative of the United Nations Population Fund (UNFPA) in Congo, reveals that maternal mortality across Ituri doubled following the spread of outbreak reports. Before the outbreak, the region averaged about 3.1 maternal deaths weekly. That figure climbed to 5.8 deaths per week between late May and mid-July. Furthermore, deaths occurring outside health centers jumped from 9.1% to 17.4% over the same timeframe.
At the Bénédicte Clinic in Bunia, Dr. Sonny Mwembo, the medical director, reports a drop in institutional engagement. Monthly prenatal care registrations dropped from 60 women to around 10. Yabiri noted that community members fear immediate quarantine upon showing any sign of illness. As a result, many pregnant individuals choose to stay home, monitoring fetal movement as their primary indicator of health.
In Plain English: The Clinical Takeaway
- Misconception vs. Protocol: Fear of quarantine deters life-saving visits.
- Obstetric Risk: Avoiding clinical supervision during pregnancy prevents early detection of complications.
- Systemic Strain: The diversion of clinical staff and medical supplies toward the outbreak response reduces access to essential maternal care services.
Epidemiological Strain and Healthcare Infrastructure Breakdown
Congo has among the world’s highest rates of both childbirths per woman and deaths around childbirth. Women in the country average almost six children, and at least 19,000 women died from pregnancy complications in Congo in 2023, tying with India and second only to Nigeria globally, according to U.N. data. Sub-Saharan Africa accounts for 70% of global maternal deaths, recording around 180,000 pregnancy deaths every year.
The current outbreak has strained the healthcare system. Health facilities across the five affected provinces are redirecting staff and supplies to the response. This reallocation reduces access to essential maternal care services. Compounding the operational crisis, at least 44 health workers have died from infections, while others have walked off the job protesting the lack of payment. Additionally, at least 12 attacks have been recorded against health facilities and teams since the outbreak was declared in mid-May, fueled by community anger and misinformation.
| Metric Indicator | Pre-Outbreak Baseline | Outbreak Period (May 25 – July 19) |
|---|---|---|
| Average Weekly Maternal Deaths | 3.1 deaths | 5.8 deaths |
| Proportion of Deaths Outside Health Centers | 9.1% | 17.4% |
| Bénédicte Clinic Monthly Prenatal Registrations | ~60 women | ~10 women |
Contraindications & When to Consult a Doctor
Anyone experiencing acute obstetric complications must seek professional evaluation.
- Absolute Red Flags: Immediate emergency care is required for acute obstetric complications.
Path Forward for Regional Public Health
Public health agencies face a challenge: controlling viral transmission while rebuilding community trust in institutional healthcare. Aid organizations continue deploying outreach teams to educate residents on how dangerous the disease is and the necessity of maintaining prenatal care.
References
- United Nations Population Fund (UNFPA).
