By PPH Foundation
As health authorities respond to the latest Ebola outbreaks in Central and East Africa, maternal health experts are warning that pregnant women remain among the most vulnerable populations during public health emergencies. For expectant mothers, Ebola can create a dangerous intersection of infectious disease and obstetric complications, significantly increasing the risk of severe bleeding, maternal death, and adverse pregnancy outcomes.
Although Ebola affects people of all ages, evidence shows that pregnant women infected with the virus face a heightened risk of pregnancy-related haemorrhage, miscarriage, stillbirth, preterm delivery, and maternal complications. The United States Centers for Disease Control and Prevention notes that Ebola infection during pregnancy is associated with pregnancy-related haemorrhage and fetal loss, making maternal care particularly complex during outbreaks.
The challenge becomes even greater when postpartum haemorrhage occurs. PPH remains the leading cause of maternal deaths worldwide, accounting for a significant proportion of maternal mortality. During Ebola outbreaks, healthcare workers must manage severe bleeding while simultaneously protecting themselves and other patients from exposure to infectious blood and body fluids. This creates what experts describe as a "double emergency" for both mothers and health systems.
The World Health Organization has previously developed specific guidance for managing pregnant women during Ebola outbreaks, noting that women infected during pregnancy often experience severe maternal morbidity and extremely poor pregnancy outcomes. WHO further emphasizes that maintaining access to safe maternity services during outbreaks is essential for preventing additional maternal deaths.
Lessons from previous outbreaks continue to demonstrate the risks. During the recent Ebola outbreak in the Democratic Republic of Congo, the first identified case was a pregnant woman who presented with fever, haemorrhage, and severe illness before later dying from complications of Ebola virus disease. Similar experiences have been documented in Uganda and previous outbreaks across West and Central Africa, where maternal and newborn outcomes deteriorated significantly when routine maternal health services were disrupted.
Prof Moses Obimbo, Project Lead of the End Postpartum Haemorrhage Initiative, says Ebola outbreaks remind the global health community that maternal health services must remain operational even during public health emergencies.
“Pregnancy does not stop because an outbreak has occurred. Women will continue to become pregnant, go into labour, and experience complications such as postpartum haemorrhage. Health systems must be prepared to manage both infectious disease outbreaks and obstetric emergencies simultaneously. Every pregnant woman deserves safe, timely, and quality care regardless of the circumstances,” says Prof Obimbo.
Prof Obimbo further notes that preparedness should include functional referral systems, adequate protective equipment, emergency obstetric care capacity, blood availability, infection prevention measures, and continuous training of healthcare workers. These investments not only strengthen outbreak response but also improve routine maternal healthcare and reduce preventable deaths from postpartum haemorrhage.
The current Ebola outbreaks serve as an important reminder that maternal health cannot be separated from emergency preparedness. When health systems are disrupted, pregnant women often face the greatest risks. Protecting mothers requires resilient healthcare systems capable of responding to infectious disease threats while continuing to provide lifesaving maternity care.
Sources
- Centers for Disease Control and Prevention. Clinical Guidance for Ebola in Pregnant Women. CDC; Updated May 3, 2024. Available at: https://www.cdc.gov/ebola/hcp/clinical-guidance/clinical-guidance-for-ebola-in-pregnant-women.html
- World Health Organization. Ebola Disease Fact Sheet. Geneva: WHO; 24 April 2025.
- World Health Organization. Guidelines for the Management of Pregnant and Breastfeeding Women in the Context of Ebola Virus Disease. Geneva: WHO; 2020.
- World Health Organization. WHO Guide: Management of Pregnant Women in Ebola. Geneva: WHO; 2020.
- World Health Organization, UNICEF, Save the Children. A Guide to the Provision of Safe Delivery and Immediate Newborn Care in the Context of an Ebola Outbreak. Geneva: WHO; 2015.
- World Health Organization. Consolidated Guidelines for the Prevention, Diagnosis and Treatment of Postpartum Haemorrhage. Geneva: WHO; 2025.
- World Health Organization. Ebola Virus Disease – Democratic Republic of the Congo, Disease Outbreak News. September 2025.
- Obimbo M. Quoted in: Postpartum Haemorrhage: Key Facts, Risks and Lifesaving Measures. Willow Health Media. October 2024.
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