Protecting hard-won gains for mothers and newborns in low-income and middle-income countries in the face of COVID-19: call for a service safety net

Summary box There are an estimated 5. 4 million largely preventable maternal and perinatal deaths each year.1–3 Improving the survival and well-being of mothers and newborns is indisputably a global priority. This is as true today as ever and as the world grapples with the COVID-19 pandemic. For maternal and newborn health (MNH), a critical question today is not only the extent to which pregnant or postpartum women and newborns are vulnerable to COVID-19-infection4 but also the degree to which the safety of giving birth and accessing treatment for complications in health facilities is being compromised by the direct and indirect effects of the virus, thereby reversing hard progress in MNH over the last 30 years. We know that infectious disease outbreaks can devastate provision of such care, for example, during the Ebola outbreak in West Africa.5 In this commentary, we use insights from those on the ground in low-income and middle-income countries (LMICs) to highlight both the impact of COVID-19 on facility births and the innovative local solutions …