Making a birth plan is something we have come to expect. Many women spend hours preparing theirs, researching, visualising, and planning how they would like their labour and birth to be. Most understand that things may not go quite to plan but now we have to consider birth during Covid-19 -a major game changer.
What I write today may well be “out of date” tomorrow, as the world seeks to work out what this virus means for us all. We are all living in a time of immense change and that can be frightening and disorientating. Your hormones in pregnancy work to make you protective of your baby, this is obviously a good things but can make calm and rational review of plans more difficult. As midwives we work to create a calm and safe place for you when we work together, whether before, during or after the birth. In the face of Covid-19, that continues to be our aim. The most recent expert advice is here: RCOG Guidelines.
You may well be familiar with “Maslow’s heirachy of needs” which ranks the things we need to live. The principle is that until one level is satisfied, the next cannot be. In the face of a crisis, in this case considering birth and Covid-19, we need to ensure that we have fully addressed the things which as fundamental to survival before looking at the more optional. enhancing issues. This is why you may find that your choices are restricted.
So what might be different to your expectations?
Most hospitals in the UK are being very strict about visitors. In most cases you will not be allowed to take anyone with you to appointments, including scan and consultant appointments. This is to protect the staff and you, in accordance with the principle of social distancing.
It is obviously disappointing for your partner to miss out on seeing your scan, but preventing the spread of infection is more important. Staying safe is more important that “enjoying” the experience. Sorry- this is tough love.
Hospital birth and Covid-19
In UK hospitals, births rooms are individual and in most cases have en-suite facilities. Hygiene is always important and now are even tighter. Hospitals are working out ways to keep those with possible symptoms of Covid-19 and those without very well separated. This means that once in a birthing room, if you have a midwife who stays with you, the chance of infection is low.
Discussions are underway with the NHS to allow private midwives to care for their clients in hospital. That would mean you could be sure that you would have your own midwife who will stay with you, rather than having to simultaneously care for someone else. Call me if you want to know more about this. Remember that the infection is passed by droplet infection and so (mainly) directly person to person. It is not floating freely in the air as droplets fall to the ground almost immediately. It is meeting people which increases your chance of becoming infected, not being in the hospital building.
My advice, if you and baby are well, would be to plan to go straight home (directly from that room) within a few hours. Your immediate family can then meet your baby. If you are a first time parent you may want to consider making contact with one of the Luna Hive’s great doulas to give you extra support in the early days, whether by visiting you or by the wonders of modern technology!
If you have to stay in hospital, the restriction on visitors is in place to keep you protected. Use technology to let family and friends see your baby.
Home birth and Covid-19
Many women are reconsidering the idea of home birth – both because of the apparent increased risk of infection in hospital but also because of the understanding that hospitals are short staffed. Home birth is a great option for some women. For others, the actual or potential need for medical back up means that hospital is better for them. Whilst hospitals are short of midwives due to many being in self-isolation, many hospitals simply cannot free up midwives to support home birth. As private midwives we are getting a huge number of calls to discuss this. Homebirth is absolutely something to consider (both my daughters were born at home). However, it is important not to ignore or minimise possible problems. If things become difficult, ambulance response times are inevitably much slower than usual right now.
Decision making for birth and Covid-19
In all my work as a midwife I am committed to being honest and open with my clients. Covid-19 raises a lot of issues but there is a great deal of half-truth and misinformation out there. If you want to know the facts, and to explore your choices, please feel that you can contact me. An initial consultation by phone is always free.