For many Sierra Leoneans, the COVID -19 outbreak has brought back memories of Ebola, especially among pregnant women, about visiting the hospital. The race is on to protect these women and as well prevent maternal deaths from increasing like how it happened during the Ebola crisis.

Pregnant women do not appear to become unwell than other healthy adults if they get COVID -19. Currently, there is no evidence that says that pregnant women who are infected with COVID -19 are more at risk than other healthy individuals. COVID -19 is an illness caused by a new virus that is spreading rapidly across the world.

The government of Sierra Leone declared a state of emergency on March 25^th, 2020, seven days before the first index case of COVID -19 was reported. The virus has spread steadily since then with 1,272 cases confirmed and 51 deaths as of June 2020.COVID -19 pandemic could have a huge knock-on effect on women’s health, says the united nation.

The COVID -19 pandemic could have serious consequences for women and health according to the United Nations population fund, especially women in underdeveloped countries like Sierra Leone .the pandemic has disrupted access to sexual and reproductive health and gender-based violence services.

Data available on the impact of COVID-19 on pregnant women is currently limited, with suggestions of increased susceptibility to vertical mother-child transmission.

However, there have been a lot of challenges with regards to social distancing, using a face mask, and providing care for patients with suspected signs and symptoms of COVID -19 in our unit. Due to the proactiveness of the hospital administration and the infection prevention and control (I P C)focal person, strict infection prevention and control measures were instituted in order to provide quality care delivery services to our client. Even though the patients flow rate of attending our unit was fluctuating as there was a knowledge gap about the disease, and the majority of the patients were afraid of health facilities, but through our continuous health educations sessions, we were able to persuade our patients to visit the hospital facility for safe delivery.

CASE REPORT FOR NORMAL DELIVERIES AND CESEARIAN SECTIONS FROM JANUARY 2020 TO AUGUST 2020

• Normal deliveries cases from January to august 2020= 308
• Caesarian sections from January 2020 to august 2020 =93

COMPARING THE NUMBER OF CASES BEFORE COVID -19 AND DURING COVID -19

BEFORE COVID -19	DURING COVID -19
A total number of admissions – 563.	Total number of admissions – 306
Number of normal vaginal deliveries – 403	Number of normal vaginal deliveries -308
Caesarian sections -162	Caesarian sections -308

We recorded one death case in the maternity ward during COVID-19, it was on the 25 /7/2020, and the cause of the death was hemorrhage due to a ruptured uterus and attempted home delivery.

The case was brought in the hospital facility on the said date, and she was accompanied to the ward by her relatives with the complaint of been in labor at home for over 12 hours with labor not progressing .on examination she was restless, cold, and clamming skin, pale conjunctiva, sole and palmer pallor  .fundus at 39 weeks, cephalic presentation, fetal heart rate absent and decent at 0-stations, also cervix fully dilated with no membrane felt.

Iv normal saline 500 ml was set up, plus oxygen therapy applied .lab was called for possible transfusion, and all nursing care rendered but unfortunately patient past away, and her death must have been as a result of fear of coming to the hospital because of the COVID -19 pandemic and as a result home delivery was attempted which proved fatal and lead to a loss of life .so these are the negative impact of the COVID -19.

 The way forward in preventing such deaths is to embark on massive sensitization during antenatal visits, health promotion talks about hospital deliveries and discouraging home deliveries as this will help reduce the maternal mortality rate in Sierra Leone.