Labour during a pandemic
Childbirth is one of the most life changing events a woman can experience. The moment in which a new human life is born is unforgettable. Although the process of labour may differ for each woman, it can be fraught with danger. Labour and childbirth can still result in death even in 2020. As a result, it is a time in a woman’s life that can be surrounded by great fear and anxiety.
Stepping aside from labour, its hard to have any discussion about health these days without addressing the elephant in the room; Covid-19 (Coronavirus). This global pandemic has resulted in the loss of hundreds of thousands of lives to date and is understandably causing global panic and anxiety. Hospitals are now places the public fear due to the risk of contracting the virus.
Now imagine being pregnant in this pandemic, due to give birth to your baby in the midst of a global outbreak of a deadly virus. I would struggle to name a more fear and anxiety provoking combination! As the old wives tale goes ‘Babies are born when they decide to be born’.
Pandemic or not, women are going into labour. Day and night.
Pandemic or not, women are going into labour. Day and Night.
I realise now that I haven’t introduced myself; My name is Rumbi, a new doctor but also a practising midwife. During the last few months I have been working increasingly as a midwife and have seen the Coronavirus develop from minor outbreak in a different continent to global pandemic at our doorstep and how that has impacted the experience of labouring women.
Following lots of discussions with labouring women and midwife colleagues, I have compiled a list of 5 key messages I would like to convey to women labouring during the pandemic.
5 key messages for women labouring during a pandemic
1. The safety of mum and baby is our primary concern
As discussed above labour in itself can be dangerous thus having skilled midwives (and obstetricians were needed) is important in the safe delivery of your baby. Covid-19 adds different complexities to the delivery of this care. Instead of being able to see the face of your midwife you will instead see someone gowned in full PPE; gown, mask, visor. More fitting with a space mission than a labour ward.
This can make hearing the midwife more difficult and can also make understanding the nuances and tone of what is being said trickier too. A lot of the skills needed in a good midwife include body language, being able to reassure women not just with words but also with facial expressions and gestures. A gentle squeeze of the hands. It doesn’t have the same effect with cold blue gloves on but ultimately it’s there to keep both you and your baby safe.
2. It is safer to seek care for the delivery of your baby
During pregnancy, as midwives we discuss with women what their options are for the location of the birth. This could be delivering in the hospital, a birth centre or a planned home birth (with midwives present). As the pandemic has developed, many women are fearing attending the hospital, both for their scheduled antenatal checks but also for labour and deliver. As already mentioned, labour can be extremely dangerous. This means its always safer to attended your planned birth location than to deliver at home unassisted due to anxieties around covid-19.
it's always safer to attended your planned birth location than to deliver at home unassisted due to anxieties around covid-19
3. No visitors allowed
The birth of a baby is a joyous time not just for women and their partners but also for the entire family and many women want to share those moments with relatives. In the current climate, most hospitals have enforced heavy restrictions on visiting, maternity departments are not any different. This has been done to reduce the spread of Covid-19 in keeping with government guidelines. This has led to many unhappy grandparents or upset siblings that they cant come and visit the baby in hospital. I would recommend women take this as time to bond with their baby uninterrupted. As any parent would tell you, children grow up so quickly so these early moments are to be valued and cherished. I would also recommend to utilise all the modern technology at our disposal e.g. video calls.
4. Will I have to go through labour alone?
This is a question I have heard lots from mothers over the last few weeks. Labouring without a birthing partner is not something many women would chose to do, however certain circumstances may mean this is the case.
Most hospitals at present are allowing one birthing partner to be with the mother during labour and delivery. If however the woman is Covid positive, this means anyone in their household must be under quarantine and remain at home, this is a circumstance where a partner might then not be able to attend the labour.
I have also encountered women labouring without their birthing partner not due to being covid positive but due to being unable to arrange childcare for their other children because of the national lockdown thus their partner has to stay at home with the children whilst they go to deliver the baby. I would say all women should keep updated on the local hospital policy around birth partners as local guidelines may differ.
5. The word midwife means ‘with woman’
I would like to end by highlighting that the word midwife literally means with woman, thus their job is to help and support you no matter the circumstances. Even through four layers of PPE.
Thanks for reading!
Dr Rumbi is a qualified doctor and midwife.
Follow her on instagram: @rumbithemedic