Pregnant in the Time of Ebola

1. Front Matter

   Pages i-xxxiv

   PDF

2. The West African Ebola Epidemic, Women, and Their Children

   1. Front Matter

      Pages 1-1

      PDF

   2. Ebola’s Assault on Women, Children, and Family Reproduction: An Introduction to the Issues

      • Sharon A. Abramowitz

      Pages 3-9

   3. Effects of the West African Ebola Epidemic on Health Care of Pregnant Women: Stigmatization With and Without Infection

      • Adrienne E. Strong, David A. Schwartz

      Pages 11-30

   4. The Challenges of Pregnancy and Childbirth Among Women Who Were Not Infected with Ebola Virus During the 2013–2015 West African Epidemic

      • Regan H. Marsh, Katherine E. Kralievits, Gretchen Williams, Mohamed G. Sheku, Kerry L. Dierberg, Kathryn Barron et al.

      Pages 31-51

   5. Ebola Virus Disease and Pregnancy: Perinatal Transmission and Epidemiology

      • Lisa M. Bebell

      Pages 53-65

   6. Comprehensive Clinical Care for Infants and Children with Ebola Virus Disease

      • Indi Trehan, Peter Matthew George, Charles W. Callahan

      Pages 67-85

   7. Ebola and Pregnant Women: Providing Maternity Care at MSF Treatment Centers

      • Severine Caluwaerts, Patricia Kahn

      Pages 87-101

   8. Understanding the Personal Relationships and Reproductive Health Changes of Female Survivors of Ebola Infection in Liberia

      • Christine L. Godwin, Alexandria Buller, Margaret Bentley, Kavita Singh

      Pages 103-120

   9. Gender-Based Violence Among Adolescent Girls and Young Women: A Neglected Consequence of the West African Ebola Outbreak

      • Monica Adhiambo Onyango, Kirsten Resnick, Alexandra Davis, Rupal Ramesh Shah

      Pages 121-132

   10. Translating Models of Support for Women with Chronic Viral Infection to Address the Reproductive Health Needs of West African Ebola Survivors

       • Caroline Crystal, Laura A. Skrip, Tolbert Nyenswah, Hilary Flumo, Alison P. Galvani, David P. Durham et al.

       Pages 133-146

   11. Maternal and Infant Survival Following Ebola Infection: Their Exclusion from Treatment and Vaccine Trials and “Primum non nocere”

       • David A. Schwartz

       Pages 147-155

3. Liberia

   1. Front Matter

      Pages 157-157

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   2. Caring for Women in Labor at the Height of Liberia’s Ebola Crisis: The ELWA Hospital Experience

      • Rick Sacra, John Fankhauser

      Pages 159-183

   3. Risk and Recognition: The Traditional Midwives Who Filled the Gap in the Time of Ebola

      • Theresa Jones

      Pages 185-196

   4. Having Belly During Ebola

      • Janice L. Cooper, Meekie J. Glayweon

      Pages 197-209

   5. Health Workers, Children, and Families: Child Protection and Communication Challenges in the Context of the Ebola Virus Epidemic in Liberia

      • Dominique de Juriew

      Pages 211-218

   6. Maternal and Reproductive Rights: Ebola and the Law in Liberia

      • Veronica Fynn Bruey

      Pages 219-242

   7. Uncovering More Questions: Salome Karwah and the Lingering Impact of Ebola Virus Disease on the Reproductive Health of Survivors

      • Christine L. Godwin, David A. Schwartz

      Pages 243-250

   8. All the Mothers Are Dead: Ebola’s Chilling Effects on the Young Women of One Liberian Town Named Joe Blow

      • David A. Schwartz

      Pages 251-260

This comprehensive account of the deadliest Ebola outbreak in history examines its devastating effects on West Africa’s most vulnerable populations: pregnant women and children. Noted experts across disciplines assess health care systems’ responses to the epidemic in Liberia, Guinea, and Sierra Leone, emphasizing key areas such as pregnancy, prenatal services, childbirth, neonatal care, and survivor health among pregnant and non-pregnant women. The 30 chapters hone in on gender-based social issues exacerbated during the outbreak, from violence against women and girls to barriers to female education. At the same time, chapters pinpoint numerous areas for service delivery and policy improvements for more coordinated, effective, and humane actions during future pandemics. 

A sampling of the topics: 

• Ebola virus disease: perinatal transmission and epidemiology
  
• Comprehensive clinical care for children with Ebola virus disease
  
• Maternal and reproductive rights: Ebola and the law in Liberia
• Ebola-related complications for maternal, newborn, and child health service delivery and utilization in Guinea
• The Ebola epidemic halted female genital cutting in Sierra Leone—temporarily 
• Maternity care for Ebola at Médecins Sans Frontières centers
• Stigmatization of pregnant women with and without Ebola
• Exclusion of women and infants from Ebola treatment trials
• Role of midwives during the Ebola epidemic

Pregnant in the Time of Ebola is a powerful resource for public health specialists, anthropologists, social scientists, physicians, epidemiologists, nurses, midwives, and governmental and non-governmental agency staff studying the effects of the epidemic on women and children as a result of the most widespread Ebola outbreak to date.

• ebola virus disease (EVD) epidemic
• women's reproductive health
• pregnancy complications and risks
• West African women and children
• emergency response
• maternal morbidity and mortality
• childbirth and delivery
• developing countries
• obstetrics
• maternal health
• ebola treatment center
• emerging infections
• infant health
• infectious disease epidemiology
• gender violence
• global public health
• infant morbidity and mortality
• midwifery
• traditional and skilled birth attendants
• medical anthropology
• maternal and child health

“It is an important, worthy project, and the volume is the most comprehensive work on “lessons learned” from the West Africa epidemic. It will be an invaluable resource for policy makers and practitioners faced with future health emergencies of international concern.” (Catherine Bolten, African Studies Review, Vol. 63 (3), 2020)

“This is a comprehensive and detailed source book for anyone in the medical, public health, anthropology, and political fields who wish to learn about and from the Ebola epidemic of 2013‐15. … It is a rich resource from which to build in order to prevent, provide rapid intervention, and ameliorate the consequences of future Ebola outbreaks.” (Joan Ann MacEachen, Doody's Book Reviews, November 8, 2019)

• Department of Pathology, Medical College of Georgia, Augusta University, Augusta, USA

  David A. Schwartz

• University of Rene Descartes Paris V La Sorbonne, Paris, France

  Julienne Ngoundoung Anoko

• Department of Anthropology, Rutgers University, New Brunswick, USA

  Sharon A. Abramowitz

David A. Schwartz, MD, MS Hyg, FCAP, has an educational background in Anthropology, Medicine, Public Health, Emerging Infections, Women's Health and Epidemiology. He sub-specializes in Obstetrical, Fetal, and Perinatal Pathology as well as Emerging Infections, and has a professional interest in reproductive health, and maternal and infant disease and death in both resource-rich and resource-poor countries. Dr. Schwartz has organized and directed large national and international investigations of health of women and children, obstetrical disease, perinatal pathology, and epidemiology for many government agencies including the CDC, NIH, and USAID, and has consulted and taught in these specialties in resource-poor nations. He has been a recipient of many grants, and was a Pediatric AIDS Foundation Scholar. He edited a newly-published book regarding anthropological and public health aspects of maternal morbidity and mortality in developing nations that was published in October, 2015(Maternal Mortality: Risk Factors, Anthropological Perspectives, Prevalence in Developing Countries and Preventive Strategies for Pregnancy-Related Deaths), and was previously a co-editor of an award-winning 2-volume medical textbook on infectious diseases with Appleton-Lange Publishers (Pathology of Infectious Diseases. Volumes I and II). He is the editor of a 36-chapter text currently in progress for Springer, Maternal Health, Pregnancy-Related Morbidity and Death Among Indigenous Women of Mexico & Central America: An Anthropological, Epidemiological and Biomedical Approach. He has authored more than 120 peer-reviewed articles as well as 47 chapters in his specialty areas in the medical literature. Dr. Schwartz is an experienced editor, currently serving on the Editorial Boards of three major international journals, and is associate editor for one of them. He has previously taught at several universities, and is currently a clinical professor at the Medical College of Georgia. Dr. Schwartz has long experience at understanding and integrating the anthropological, biomedical, epidemiological, and public health aspects of emerging infectious diseases as they affect society, especially women and children. Both Drs. Schwartz and Abramowitz have recently been active in addressing aspects of the current global Zika virus situation.

Julienne N. Anoko, PhD, MS, is a social anthropologist (PhD) from the Sorbonne University in Paris, France. She completed her academic preparation (MS) in the areas of epidemiology and public health, and gender and health. For more than 15 years, she has been supporting several institutions (public administrations, NGOs, international development, and United Nations organizations) in addressing social norms and gender issues both during emergency outbreaks and into development programs for better efficiency and accountability. Between 2005 and 2014, Dr. Anoko supported the World Health Organization and UNICEF during the Ebola and Marburg outbreaks, as well as the H1N1 influenza pandemic in both developed and developing countries in Africa, America, and Europe. In 2015, she joined the United Nations Mission for Ebola Emergency Response (UNMEER) in Guinea to coordinate, support, and leverage the Social Mobilization and Community Engagement pillar in order to implement interventions compatible with local contexts to gain community trust and participation into the overall response. Between 2015 and 2016, she was appointed as in-house social anthropologist of UNICEF in the Guinea-country Office to support the mainstreaming of social norms into both the Ebola emergency response and development programs. Dr. Anoko has published books and papers and contributed in developing several guidelines for United Nations agencies dealing with her areas of expertise. She had been featured in articles from NPR, National Geographic, The Washington Post, WHO, and others. She is recipient of the "Research and Innovation 2015 Award" for her engagement in the field during the West African Ebola epidemic from the French Red Cross Humanitarian Fund.


Sharon Abramowitz, PhD, is an independent consultant and former assistant professor of Anthropology and African Studies at the University of Florida in Gainsville. She is currently pending as a research affiliate with Rutgers, The State University of New Jersey. As a medical anthropologist, Dr. Abramowitz has conducted research on community-based response to epidemics and pandemic events, Ebola, humanitarian intervention, mental health, gender-based violence, health sector transitions, and post-conflict reconstruction in West Africa since 2000. She is the author of Searching for Normal in the Wake of the Liberian War (University of Pennsylvania Press 2014), co-editor of Medical Humanitarianism: Ethnographies of Practice (University of Pennsylvania Press 2015), and has authored many peer-reviewed articles in leading scientific journals. Presently, Dr. Abramowitz plays a leading role in social science's response to the West African Ebola epidemic, and is the principal investigator for the Ebola 100 Project, which is establishing a "history of the present" of humanitarian experiences during the Ebola outbreak. She also is conducting research on community-based responses to epidemic and pandemic events.

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