In South Kivu, one of the first provinces to be impacted by the virus, women traveling to give birth in hospitals decreased by an average of 10% between January and June in the two hardest-hit health zones, Ibanda and Kadutu, according to government statistics seen by Devex.

One nurse working in a clinic near Bukavu, who did not want to be named, told Devex she has never seen as many babies die upon delivery as she has in the past four months. In July, one woman did not have enough money to get to the hospital for prenatal consultations, as she had lost her job when the markets closed, the nurse said. The woman started having contractions at home, but by the time she arrived at the clinic, the baby was dead.

“It’s very bad,” the nurse said. “I feel very hurt when I see this. It’s a human life.”

Health care workers have also been affected. In March, doctors went on strike in Bukavu because they were overworked, poorly paid, and did not have enough personal protective equipment, said Dr. Immaculée Mulamba Amisi, an expert in sexual and reproductive health who works with Cordaid in DRC. “Health care workers ended up revolting and went into the streets,” she said, adding that around 45% of infected people at the beginning of the pandemic were health service providers.

Despite the challenges, aid groups warn that sexual and reproductive health services should be not only maintained during crises, but expanded.

“During the West Africa Ebola outbreak, we saw significant impacts on sexual and reproductive health services. There were sharp increases in maternal and neonatal deaths and stillbirths related to the decrease in people using and accessing services,” said Nathaly Spilotros, adolescent sexual and reproductive health adviser for the International Rescue Committee.