The Doula Issue 39 Autumn 2020 - Flipbook - Page 21
Every trust has a different demographic of pregnant
mothers and so at the start of the pandemic in
March every trust was given the freedom to develop
their own guidelines according to the needs of their
service users. This has evolved and been reevaluated
frequently as more information has emerged about
the virus which means that there is no uniformity or
standardization in how each trust has reacted and
implemented guidelines and rules.
Mothers are tested if staying in
on a ward and alongside other
inpatients; Midwives can choose
to have anti body testing.
The infection rate remains
extremely low and so we do not expect
labouring women or their partners to wear a mask in labour,
but we do. The PPE guidance has been stepped down in
As I live in a rural area with low areas of population density
we have been impacted minimally by women testing
positive or having symptoms. We have adhered to the trust
guidelines about PPE, visitors to the hospital and access to
ourselves. Our home birth service wasn’t disrupted and we
continued being available as normal. I have supported some
fantastic waterbirths at home in mask and apron.
We have set visiting times for partners and this continues to
be advantageous for the staff on post natal ward due to the
business and constancy of people moving in and out of the
ward. Access to mothers is more immediate, more intimate
and feels more meaningful. We are given to understand
for now that these restrictions are important measures for
reducing the spread of the virus and will remain. Beds are
configured a safe distance away from each other.
Mothers appear accepting and now familiar with this
arrangement. Some opt to go home quicker from the labour
ward so not to be separated from their partner at all.
Initially mothers were staying at home, and the day
assessment centre was quiet. Fewer people phoned the
triage line or attended for reduced movements and other
concerns. The doctors were not seeing women in antenatal
clinic and many scans were paused, so the wards were not
full of mothers who were referred in by doctors on the basis
of a scan report. Midwives started to feel as if they could be
midwives, not obstetric nurses responding to doctors orders
and expectations. More women came in spontaneous labour
since the scans were not being done, so less inducements.
We noticed on the post natal ward how mothers were
chattier, kept curtains open and wandered around in
underwear. Without the open visiting everyone appeared
more relaxed. This was contra to their own expectations, as
most women described feeling scared to be alone and not
having their partners alongside them. They were pleasantly
surprised to discover they were ok. The night shift midwives
reported that babies cried less, and the ward was quiet at
night. They wondered if this was due to fewer inductions and
interventions meaning babies were calmer and less stressed.
Mothers were also able to respond more instinctively to the
babies and need less help and support from the team of
midwife and care assistant. The community midwives
found that babies were not losing so much weight, in some
cases babies lost no weight and only gained weight.
They attributed this to several things: the parents were
staying home and not disrupting a baby’s responsive feeding
needs, plus the mothers felt more constantly supported as
partners were not returning to work in the usual way.
The assumption is that milk production was greater and
transfer more effective.
The infant feeding team developed new ways of support:
Facetime and added lots of videos and info to their facebook
page as patient-facing contact was not recommended.
As the weeks went by anxiety set in as scans were not
being done (and babies were well) so some scans were
re-introduced, we entered a type of limbo land whereby the
inductions increased in numbers and the terrible situation of
fathers sitting in the car park waiting for hours became the
normality. The ante natal ward became a place of stress with
women coming in alone and spending a lot of time texting
and updating partners outside.
Now five months on most colleagues are back at work,
some continue to work from home.
Parents with a baby or twins on special care were
particularly challenged by one parent visiting at a time:
this posed additional worry and isolation for both parents.
A couple with twins arranged how they could be with a baby
each and see each other that way together.
To sum up: the pandemic has been difficult and yet
rewarding. A mum came in by herself as her partner was in
London feeling unwell. She laboured and birthed beautifully
and very happily with me and a colleague. A work friend
took her and her baby home alone; she exuded capability
with this adapted plan. For other women spending days
on the ante natal ward with few or none of their emotional
props and supports has been difficult. Couples have not had
time together and are missing big chunks of time to update
and be next to each other, but what they feel and notice
about this is hard to gauge because it’s not something
they are able to articulate at the time. Whenever I have met
a mother on the ante natal ward, I recommend she goes
outside to meet her partner and they have a chat, a hug and
a kiss and come in together as a united pair and parents
to be. There have been some unexpected gifts during the
pandemic. Similarly, we have observed and noticed the
impact of society and parents working practices on babies’
wellbeing through feeding, bonding and growth. What the
long term effects are we cannot say yet. I must say that if I
worked in a city which had experienced covid illnesses my
guess is that the level of anxiety would be heightened and
there would be more far-ranging and insidious reactivity than
my work has revealed.
My hope in writing this has been to provide a useful
depiction of the changes in maternity services since march
from a midwives perspective, and will help to show you a
woman’s birth journey from one of our hospitals.
Eleanor qualified as a midwife in 1993 and has
worked in the NHS ever since. Alongside it she has
trained in several mind and body modalities and
works in private practice supporting women and
men with an emphasis on pregnancy birth, impact
of birth and and well-being.
© Doula UK | Autumn 2020 | The Doula 21