Dilemmas in Managing Pregnant Women With Ebola: 2 Case Reports.

We report 2 cases of Ebola viral disease (EVD) in pregnant women who survived, initially with intact pregnancies. Respectively 31-32 days after negativation of the maternal blood EVD-polymerase chain reaction (PCR) both patients delivered a stillborn fetus with persistent EVD-PCR amniotic fluid positivity.

Midwives' experiences of caring for pregnant women admitted to Ebola centres in Sierra Leone.

OBJECTIVE: to explore and describe midwives' experiences of caring for pregnant women admitted to Ebola centres in Sierra Leone. DESIGN: a qualitative interview study with an exploratory and descriptive approach. SETTING: individual semi-structured interviews with midwives who provided care for pregnant woman in eight different Ebola centres in Sierra Leone during the Ebola outbreak in 2014-16. PARTICIPANTS: 11 midwives, Sierra Leoneans and expatriates, who worked for three different humanitarian organisations in Sierra Leone during the Ebola outbreak in 2014-2016. FINDINGS: three themes emerged as a result of the analysis. The first theme described how personal and public fears of Ebola infection affected the midwives' professional and personal lives. Secondly, motivation and support influenced the midwives' ability to cope with challenging midwifery care and finally competency, creativity and courage was described as essential for improving clinical guidelines and learn for the future. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: midwives who worked in Ebola centres in Sierra Leone have a wide range of experiences in caring for pregnant women affected by Ebola. Their views should therefore be sought and considered when new guidelines are being developed on how best to provide care for pregnant women during an outbreak of Ebola virus disease, or any comparable infectious disease. Balanced information, sufficient training, adequate equipment and access to support by colleagues and peers would assist the midwives in coping with the challenges they face.