For many parents-to-be, preparation feels like a tangible way to stay in control. You might even call it nestling. It’s donning the spare room with a cot, soft toys, and a fresh lick of paint. It’s spending hours browsing strollers online in the hopes of finding “the perfect one”. It’s reading all the books and blogs in the hopes of streamlining our way to parenting success.
But no amount of online shopping or prenatal yoga can prepare us for a global pandemic.
Ahead of one of life’s most pivotal milestones, mothers-to-be are shifting their plans to accommodate tough new social distancing restrictions. In those moments where comfort and support are what we’re craving most, limits to the number of support people in hospital rooms mean fathers, grandparents, doulas, and close family members may miss out. The gravity of this is difficult to grasp until you’re the one on the other side of the door.
But no one understands the impact of giving birth during a global pandemic like the pregnant women navigating the weeks and months ahead, as well as the healthcare professionals by their side throughout it all.
Is it safe to give birth in a hospital during COVID-19?
We’re all becoming familiar with the new restrictions around public gatherings and social distancing measures that have forced the majority of us to stay home. But for pregnant women, preparing for what their birth will look like has become an even more uncertain challenge.
Many pregnant women told Kin most Sydney hospitals are now only allowing one support person to be present during the birth to abide by general infection control measures in hospitals.
Along with this, the government and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) are advising expectant women to seek telehealth options during pregnancy, limiting the time of all antenatal visits to less than 15 minutes, and advising women to consider early discharge from hospital (if it is safe to do so).
Sydney-based obstetrician and expert in high-risk obstetrics, Doctor Colin Walsh, is quick to remind women that the level of care they’ll receive during delivery won’t be impacted despite the outbreak of the pandemic.
“You’ll be looked after by your obstetrician and midwife in exactly the same way as before,” Walsh explains.
"The main differences are related to general infection control in the hospital. So, you and your partner will be asked screening questions and have your temperature checked on arrival. You’ll see staff wearing more protective equipment than usual. Visitors are restricted to one per patient and your partner counts as that one.”
“We understand it will be disappointing for some patients not to have visitors, but it’s one of the most important ways we can protect everyone in the hospital. In the hospitals where I work, we’re not asking mums to leave earlier, but we are finding some mums are choosing that option, and we’re happy to facilitate that as long as they are well and have good support at home.”
Should I give birth at home instead?
Melanie Jackson, a midwife in private practice based in the Blue Mountains, has noted a trend towards more women choosing to switch to home birth options in an effort to avoid the tense hospital environment.
“Birth is an uncertain time and women try to prepare as many things they control as possible,” says Jackson.
But Jackson acknowledges there are a string of challenges associated with giving birth at home, including additional out of pocket costs and issues of accessibility (as many homebirth midwives are booked out month in advance).
“At the moment, we do have Medicare rebates for a portion of antenatal care and postnatal care,” explains Jackson. Unfortunately, the birth portion of homebirth is yet to be covered by Medicare, with the costs quickly mounting into the thousands (making homebirth often an all too expensive option for women). In fact, Jackson notes there are less than 200 private midwives in all of Australia, making it difficult for many women to access these services during times of crisis (like we are currently experiencing).
Aside from issues of accessibility, the preparation needed to successfully facilitate a homebirth means it's not an option women should choose on a whim.
“If women choose free or home birth that’s completely fine, but they need to accept that the responsibility is on them to prepare to acquire the knowledge they need to keep themselves safe,” explains Jackson.
What it’s like to be pregnant during COVID-19
The waiting game that is pregnancy is an inherently emotional time. Coupled with the anxieties of a global pandemic, pregnant women are facing a whole host of additional challenges. In fact, mothers-to-be are bearing a heavy emotional burden with the ABC reporting the national mothers’ support group Perinatal Anxiety and Depression Australia (PANDA) has seen a 30% increase in calls for assistance (with this figure only expected to increase in the weeks ahead).
For Sydney-based mother-to-be Amy, entering her final week of pregnancy has been a turbulent time. With her first child due any day now, Amy and her partner are eagerly anticipating his arrival.
“Our number one priority is the health of our child, so we’ve self-isolated for the past 5 weeks,” Amy tells Kin. “My husband knows that if he contracts the virus he can’t be there for the birth so that has been the number one motivation for us to just stay home and stay safe.”
Although the couple are open to "go with the flow" when the day comes, restrictions around the number of visitors they can have in hospital means their closest family members won’t be there when they need them the most.
“I think the main thing for me is not having the support I was planning and hoping for,” says Amy.
“My mum lives overseas and therefore won’t be able to come over for the birth as intended, and at this stage won’t meet her grandson for a while which is very sad.”
For fellow mother-to-be Kahlie, the outbreak of COVID-19 has thrown her entire world into turmoil in the space of just a few weeks. An international pilot by day, Kahlie tells Kin she was due to stop flying and work in the office last month, just as the pandemic unfolded in Australia.
“I was immediately stood down without pay, with three months to go until I was due to start my maternity leave,” she says.
With less than nine weeks to go until the arrival of her first child, Kahlie has been unable to start antenatal classes (all have been canceled due to the pandemic). But aside from the anxiety of being in the dark about how to care for a newborn, Kahlie (like many pregnant women) is feeling the impacts of social distancing now more than ever.
“It breaks my heart that my partner can’t hold my hand when we see the images on the ultrasound and listen to it’s little heart beat together,” she says.
“My mum was so excited to be included in the birth... Now that we can only include one person in the room (and of course that will be my partner) she broke down in tears saying she’d been waiting for this moment her whole life”.
And for pregnant women who were hoping to have the support of a doula (a trained child birth support companion) by their side during labor, these new restrictions have had a big impact on their birthing plans. Now expecting her second child, mother-to-be Kate won’t be able to have her doula by her side in hospital as planned and is “devastated my daughter won’t be able to visit her new sibling after the birth, too.”
“It’s not an ideal time to be birthing, so it has definitely added some unwanted pressure and anxiety... I’ve just told myself this is the way it is and I will have to adapt,” tells Kate.
What can pregnant women do to prepare for a birth during COVID-19?
Although we might not be able to control outbreak numbers, mothers-to-be can shift their focus onto what parts of their birth plan they can take ownership of during this unprecedented time. For Dr Walsh, he believes pregnant women should steer clear of misleading information online and focus on speaking directly with their own healthcare provider about their unique situation.
“Be reassured that your obstetrician and the midwives and all the hospital staff are there to look after you, just like before the pandemic. It’s natural to be anxious, but if the anxiety is getting on top of you please talk to your doctor,” explains Dr Walsh.
Melanie Jackson echoes these remarks, encouraging women to ditch the frenzy of panicked information online for personalised advice. “I’ve been encouraging women to contact their care provider directly to really understand what the pandemic will mean for their particular birth, and not to pay attention to what other people’s experiences have been,” Jackson explains.
For mothers-to-be looking for additional resources or support, Jackson has created a hub of free tips and practical advocacy strategies designed to help mothers and families navigate the new challenges presented by COVID-19. For further advice about how women can prepare themselves for birth during this time, RANZCOG’s COVID-19 FAQs page provides helpful insights into commonly asked questions related to navigating pregnancy and the pandemic.