There’s little question that lockdown measures have had a huge impact upon us all. From a decline in mental wellbeing to redundancies across the board, few people have been left unscathed by the COVID-19 pandemic. But while many of us are now jumping back into ‘normal life', for those embarking upon parenthood for the first time this year, the challenges are just beginning.
One of a number of groups still facing up to ever-changing restrictions, people who are pregnant continue to face huge hurdles accessing the care they might want or expect. From partners being unable to attend scans to the mass cancellation of antenatal classes, new parents have been having a rough ride since March 2020.
Now, with home births being suspended in a number of health boards across England, including in Essex and Kent, a brand new challenge is being faced.
"Originally, we decided we wanted to give birth in a fully detached, midwife-led birthing centre. These are natural birth centres that champion all the hypnobirthing techniques I planned to use, allow your labour to progress naturally, and will quickly transfer you to the main hospital should you need more medical support," explains expectant mother Amelia Perrin from Essex, who is currently 39 weeks pregnant. "As so few births are actually deemed low risk enough to use these facilities, you can also almost guarantee a birth pool."
However, she adds, at her 37-week appointment she was told that due to understaffing, all the birth centres in my area had been shut down. "This was a huge blow to me, especially as I had consistently been told how lucky I was throughout the pregnancy to be low-risk enough to use a birthing centre and how wonderful they were," Amelia shares. "Seeing that I was disappointed, the midwife then suggested a home birth – which I had never considered before due to the general faff and logistics – but it’s actually statistically the safest place to give birth, as you have two midwives at your side, dedicated to your care."
Amelia immediately set about purchasing a birth pool as well as setting up her lounge with groundsheets. "We even ordered a new L shape sofa so I would have somewhere comfortable to get potentially stitched upon and for resting immediately after birth."
However, just after her 39-week appointment, she started to feel contractions and contacted the labour ward for some advice. "Only then did the person on the phone tell me that home births had been suspended for the last week (again due to understaffing) and that I should’ve been told this.
"I was literally in the lounge on the phone - looking at my blown up pool ready to go - thinking I was going into labour, nearly in tears as she said this. It suddenly felt like I needed to rethink everything, and was being put on the spot. It turns out I wasn’t in labour but had I been, I would’ve had to make a split decision on the phone with no warning at all, with my entire birth plan out the window."
For those who choose a home birth, it’s often about a sense of control, says Helen Robinson, Private Midwife, which works in collaboration with the NHS supporting women during and after pregnancy. "There are fantastic midwives in a hospital, but I can understand pregnant people wanting to be in an environment that they feel comfortable in," she notes. "And, it’s really tough when that choice is taken away, but there a few things that you can do.
"The first is to have a chat with your midwife and explain how you’re feeling. All midwives are trained to try and support, as long as it’s safe to do so, your birth plan, even in a hospital environment. Oxytocin levels (the hormones that stimulate labour) are always going to be increased when you’re calm, so we’ll always want to make you as comfortable as possible. You still have a choice and a right to decide about how you have your baby. You can also ask to escalate this if you feel like you need more support."
In terms of the hospital itself, Helen recommends finding a way to make the environment more positive. "You can also adapt the environment that you’re in. Pack scents, photographs or even a pillow and throw, it will instantly make that environment more homely. It’s also worth remembering that hypnobirthing techniques or other skills that you’ve developed are just as useful in a hospital environment."
For many people, the hospital environment itself is intimidating, whether that’s due to a previous traumatic birth, family experience or, for Amelia, potential exposure to COVID-19.
"Because the only hospital available to me has a COVID ward and is a testing site, it makes me very nervous to be admitted. I chose to wait until after my pregnancy to get my jabs, so I’ll essentially be admitting myself to a high-risk area, unvaccinated," she says. "The knowledge that I could have a home birth, or at a birthing centre birth (where there are only one or two other people birthing at a time, and it’s completely detached from a traditional hospital), was actually a factor that made me feel more comfortable going into birth not being vaccinated. If I knew from the start I definitely had to be in a traditional hospital for birth I potentially would’ve made a different decision on this."
Helen explains that this is something that a lot of pregnant people are afraid of. "I completely understand this fear, but, I can tell you from experience that within hospitals, they’ll keep infected areas separate. Maternity staff are really well trained in infection control."
Abbie Aplin, of the Royal College of Midwives, told BBC News that several staffing issues had created a 'perfect storm'. Longer-term shortages had been exacerbated by the pandemic, with some staff away from work due to illness, shielding or isolating, she said.
"We’ve certainly seen a reduction in women that are seeking a hospital-based birth over COVID-19," explains Pat Barlow, Operations Manager at Private Midwives, adding that "while it’s not accessible for everyone, exploring an appointment with a private midwife can ensure that they’ve got the time to run through a birth plan and manage your expectations. With so many appointments, it can be trickier to do this with the NHS, but an appointment early in pregnancy can be the cheapest option."
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