Giving birth during a pandemic

This was a piece written in July 2020 for my MA portfolio for the University of Lincoln. It remained unpublished on until January 2021 when it had been marked and graded.

By columnist Ailsa Adams, mother to two boys with a baby girl on the way.

Covid-19 has changed the way we communicate with each other. Weekly quizzes and get togethers with friends and family remotely soon became the best way of keeping in touch. Speaking to women and mothers about their experiences remotely seemed impossible though, especially given the personal details they were revealing to me.

A slightly panicked house scout to find the tidiest spot ensued as lockdown has ravaged through each room in turn, even the mess is messy. How I long for a fancy bookcase to portray an inaccurate image of intelligence and organisation, just like we are used to seeing on the news. I hope my own pregnancy and children might put their minds at rest as we are members of a club with stretch marks and questionable bladder ability worn like a badge of honour.

My first interview is with Emma Epton from Boston. Emma has a little girl called Libby who is five and has been trying to conceive for a long time for her second child. I have known Emma for over ten years so thankfully it was a good starting point to get used to communicating over Zoom. Once the niceties are over, I could see her face drop as we got onto the subject of pregnancy. Emma had an ectopic pregnancy last year and has lost one of her fallopian tubes after surgery.

“Coronavirus has really put us off trying for a second. I would be so nervous pregnant during a pandemic and it has perhaps made us realise how lucky we already are with our daughter,” she says with a smile.

As the conversation develops she admits that reaching the decision had made her want a second child more than ever.

“It is typical really, it would be a terrible time to be pregnant but I would really be delighted if it did happen. Perhaps though it is for the best if the pandemic keeps restrictions in place for years to come. It might ultimately take the decision out of our hands,” she concludes.

Emma isn’t alone in putting off decisions for starting a family. Initially experts were expecting a baby boom, Nadine Dorries, the MP responsible for Maternity Services, even tweeted back in March “I am wondering how busy we are going to be nine months from now.” Quickly it became clear that people were changing plans though, which isn’t surprising given that most people have increased stress levels, not overly conducive to making a baby.

Next, I compare my own pregnancy with Kirsty Lilly, a mother to two girls, Isabella and Florence, with a third baby on the way.

As the camera flicks on I am relieved to see that she too is bookshelf free as she instantly apologises that the children are running slightly wild so may interrupt the Zoom call. I have a little chuckle as scenes of children interrupting broadcasts have become commonplace on the television. In some ways the new way of working has shown us all in a more natural environment. As she focuses on me, I can see in her eyes she is desperate to know what the children are doing right now. I try and reassure her we can be as stop-start as she likes.

“I am finding the juggling a little bit of a struggle I must say. I am a Human Resources manager and work mainly with people without children so their understanding at times is lacking. Added to this is the fact my husband has chromes disease so we have been shielding limited to the house and garden for months,” she explains.

Kirsty readjusts her screen apologising: “Sorry I hate that I can see myself, despite being only 16 weeks pregnant I think I have developed an extra chin for each week.” I instantly love her as I readjust the maternity leggings currently cutting me in two.

As we are at the same hospital for birth, it is interesting to swap stories of our experiences so far, though I am starting to feel like Kirsty is enjoying being at home a little more than I am.

“When I was told to shield, I was a little relieved. I was only a few weeks pregnant and felt so tired and poorly. With it being my third pregnancy, I already looked bloated and feared everyone might guess. For me it took the pressure off and I could work from home juggling my other children and hibernate,” she concludes.

Kirsty reveals her strangest craving third time pregnant is for beer. Obviously drinking pints of larger is a no-go, so Kirsty has been buying non-alcoholic varieties.

“Having a non-alcoholic beer has really helped curb the craving. I will admit I cracked one open last Thursday afternoon after a conference call and my husband looked at me daggers. Turns out a beer during work hours isn’t socially acceptable even without the alcohol,” she chuckles.

As the call ends, I can’t help but smile at her confident, breezy take on being pregnant for the third time. We both agree that wearing masks to appointments and having to go alone to all the scans is tough. So much so that Kirsty has booked a private scan this week to find out the sex of her baby. For that, her husband is allowed to be in the waiting room, so at least he can sort of be there.

My next interview is with a first-time mother called Sarah Moore who had her baby girl, Lily in April. For Sarah it was easier for her to have a quick phone conversation with follow up messages back and forth on Facebook Messenger. Sarah sounds so tired, I can’t help but feel sorry for her and think back to my own first time. Nothing prepares you for how hard night feeds are the first few months and to face it all with just her partner and no family allowed in her home is a terrifying thought. In Sheffield where she lives you are currently only allowed one birthing partner once active labour is established.

“It was very scary to enter the labour ward to be assessed, whilst in the early stages alone. As this was my first baby neither my partner or I were really sure of when to go to hospital, we followed the advice yet went back and forth to the hospital three times before I was actually in active labour,” says Sarah.

Sarah explains that she didn’t have to wear any form of personal protective equipment but that all midwives and medical staff had gloves, gowns and masks. Her own birth plan largely was followed so for her, pandemic or not, it was successful.

“Once I got into the birthing room and my partner was back with me, I didn’t really notice or think about the pandemic. Midwives were all wearing masks and generally being careful but this didn’t bother me, the only thing that bothered me was that I really wanted my partner and my mum there,” she adds with a sad face emoji.

Sarah stayed in hospital for one night while feeding was established but was happy to get home the next day and be reunited as a family. The following weeks did however prove hard for her as she had to drive to hospital for all routine appointments. Normally the visits take place in your own home.

“This really was a struggle as my partner doesn’t drive and I had to attend alone so it was sore to drive and carry the car seat alone,” says Sarah.

I have kept in touch with Sarah over the last few weeks and was delighted to hear that she was able to stay with family under the new guidelines that came in on 4 July. Life as a family of three has been a struggle and she really felt her mental health was suffering not being able to spend time with family and friends.

For Charlotte Goodley, the pandemic had less of an impact on birth as she was booked for an elective cesarean section. Charlotte is a great friend who I met doing pregnancy yoga a few years ago with her first-born Aspen. Charlotte gave birth to Orla in April.

As a midwife herself, I have to ask if she was relieved to have timed her pregnancy seemingly so well to avoid working during the pandemic.

“I really wouldn’t have minded working, I am young, fit and healthy so hopefully it wouldn’t have caused too much of a problem if I had contracted it. I feel a little guilty really that my friends are working and I am not. Especially because I slightly changed my career to sonography in later years and the clinic has had to close due to staffing a lot over the last few weeks,” says Charlotte.

Being a midwife and giving birth in the same environment can have its perks as Charlotte was able to pick the Surgeon and midwife staff. The operating room looked exactly the same as a high level of PPE is normal in the sterile environment.

Visibly upset, Charlotte does admit that while she was fully prepared and knew exactly what was happening at all times, her daughter had to spend time on the neo-natal ward.

“Nothing can prepare you for that, no matter how many times you have been on the other side of it reassuring mums all will be ok. It was completely heart breaking being split from Orla for the first few hours of her life,” Charlotte adds.

Whilst the pandemic has undoubtably had an impact on the mental health of the mother’s I have spoken to for this article, it is really comforting to know that the births for the most part have gone as expected.

I did manage to speak to a midwife to get the medical point of view, though this unfortunately was a quick phone call and then a series of emails due to her work schedule. The majority of emails came through in the middle of the night between shifts.

Amy works for the United Lincolnshire Hospital Trust and her story on her time working during the pandemic is hard to read as I can feel the anger and despair coming through the email.

The PPE shortages were all over the news at the start of the pandemic and though Amy always had enough access to PPE, the lack of testing directly impacted her.

“Back in late March I had a really sore throat and perhaps the worst headache I have ever had. I spoke to the Matron on the ward and begged to be tested as I really thought it was likely I had coronavirus but because I didn’t have a cough or temperature and access to testing was so limited, I was told no and had to continue to work,” says Amy.

The reality of work and a pandemic is shocking as some hospitals do not have access to excess staff so had Amy and others had gone off poorly, it would have potentially resulted in a short term closure for expectant mothers.

“Now testing is more widely available we have more access and an anti-body test has shown I did have coronavirus. I feel awful imagining who I could have infected, but what could I do?” she adds.

The role of the midwife has altered significantly as they are alone with birthing mothers a lot more as fathers wait outside until active labour is established. For Amy this doesn’t pose as much as a problem as the PPE they have to wear.

Amy explains: “I find the PPE really hard because as a midwife you are very close to the women. They hold on to you for support and sometimes want a hug. You rely on expressions from your eyes instead of greeting with a smile. It’s like the PPE acts like a barrier between you and the woman which is awful as a midwife is all about being ‘with women.’”

I am surprised to read that there is no set infrastructure or processes to check on the midwives’ mental health, instead Amy thinks she would approach the Matron if things were getting on top of her. Given shortages and the way she had to work poorly, I am not overly confident she could get access to mental health support if she needed it.

“I really can’t wait for things to go back to normal, the only plus for me is fathers can no longer stay the night. It can really impact breast feeding and establishing that bond between mother and baby. Often parents chat through the night which can keep other mothers awake. We have also found that the mothers all bond between bays which has been lovely to see,” Amy adds.

Writing this article remotely was difficult but in all honesty, it was the nicest few hours I have spent all lockdown, nattering into a computer screen with friends and strangers alike. As I prepare for my own birth in November I hope the world looks a little different, though I am comforted by the women I have spoken to that my own experience should still be the birth I want it to be.

Top tips to help you prepare for your own birth during a pandemic

1)Plan your ideal birth but make sure you have a few back up plans incase things do not go the way you expected.

Annette Ashford, owner of the Village Midwives, a private midwifery service said: “One thing I would say is there are elements you can control and elements you can’t. Try to focus on those you can control, for example, the type of birth you want and how you can try and make that happen or adapt when things change.”

2)Add a daily practice of yoga into your routine. This can be as little as ten minutes but it can help with strength and help focus your mind ready for the birth.

3)Try Hypnobirthing. Celebrities and supposedly even royalty have long backed Hypnobirthing as a fantastic way of giving birth, a coveted endorsement that might suggest it’s worth a try. With the help of MP3 tracks, breathing techniques, familiar scents, vision boards and minimal intervention it can help control the birthing environment.

4)If a homebirth is an option for you, it is worth considering to avoid hospitals. For a homebirth two local midwives come to your house and help you labour wherever you feel comfortable. Often mothers opt for an inflatable birthing pool.

5)Consider a Doula for your birthing experience. A Doula is a birthing partner you pay for who is an expert in advocating your rights and wishes during birth. Though it can be an expensive luxury, with other children potentially at home and less family and friends able to offer childcare support, it is an option to consider.

6)Get used to wearing a mask for periods of time at home so appointments are less daunting with a mask on.

7)Be prepared to throw all your principals out the window and if you need medical intervention or drugs to get you through the birth, accept that it is ok to deviate from your birth plan to do what is right for you and your baby.

8)Make yourself up a little care package with your favourite snacks in, face creams, magazines, drinks, and any other home comforts. You might not use it during the birth but it will come in handy afterwards.

9)If the NHS in your area is no longer offering antenatal classes, book with a private midwife offering home visits or zoom calls.

10)Remember that things might be a little different but it will be a year to remember and it is exciting you will always be a part of it giving birth.

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