Covid restrictions on women giving birth are causing heartbreak. We need to be more humane
Having a baby is one of the most significant life events in the human spectrum of experiences. While it is a physical experience, it is also a profoundly social, psychological, cultural, and spiritual experience. This is something that is forgotten at times by busy health providers, but never by those giving birth and their partners.
Despite this, women still seek to “find their tribe” and gather around them people who will support them on their journey. This includes partners, extended family, health providers and even doulas and birth photographers.
When the Covid-19 pandemic took the world by storm in 2020 this was all upended.
The “tribe” was disbanded, the support all but ceased and pregnant women and their partners faced restrictions that were devastating and bewildering. Health providers likewise were, and still are, stressed and conflicted.
Our study of Australian women having a baby during the pandemic, called Birth in the time of Covid-19 (Bittoc) is exploring the impact of this right now.
I, along with most people, think lockdowns are needed when case numbers rise. We all need to make sacrifices, but we also need common sense, compassion, and some flexibility.
For those that say, “we can’t provide different rules for different people”, I say “we already do”. There are hospitals mere kilometres apart in Sydney right now making different rules and sometimes these rules change. Women go online and see this, and the distrust rises.
NSW Health may say women can have their partner or support person with them in the birth unit, postnatal and antenatal wards, but this is clearly being interpreted in different ways.
Last week this hit the media with reports that visitors, including fathers, were banned from hospital wards in western and south western Sydney where Covid-19 cases are highest.
While partners could attend the birth in most places, some hospitals were sending them home as early as half an hour after. This part of Sydney has a large multicultural population, and translation of information about the restrictions was slow and created distress and misunderstanding.
In our research midwives have told us of the heartbreak they are experiencing. Some are breaking the rules, sneaking the other parent into neonatal units, and ignoring time limits imposed, but they also run the risk of being disciplined and losing their jobs, so they are caught between a rock and hard place.
So, what can we do differently now? I am not advocating the whole family should come into the birth room or postnatal ward, but have we gone too far, and can we do this more humanely and safely?
We must think about our midwives and doctors in this as well. One Covid exposure could shut down a maternity unit or have hundreds of staff sent into isolation, as we have seen happen recently. This could paralyse the health system and then we really would be in trouble.
What struck me about some of the rules imposed in maternity units in Sydney was sending the partner home half an hour after the birth simply did not make sense. This is a magical time when skin to skin contact, the first breastfeed and weighing and measuring the baby is happening. These first moments matter.
A partner who has been there all through a sweaty intimate labour and birth is not going to add risk by remaining in the birth room until the woman goes to the postnatal ward or home.
Many hospitals now have postnatal units with individual rooms and an ensuite for women. Enabling the partner to stay in this case and not affect other women is much more possible.
Having a negative Covid test could also add reassurance. Some partners have offered to do this daily if it means they could see their partner and baby following the birth. Going home soon after a straightforward birth also needs to be normalised and then well supported with community midwifery visits.
We need to make sure interpreters are used and the required information is available to non-English speaking families. Without their partner, women who don’t speak English may lose their
only advocate.
Telehealth can be used much better than it currently is. For example, our research makes us question why during antenatal visits and ultrasounds FaceTime is not used more to connect the partner if they can’t attend.
Frankly, I don’t understand why, when we shop with others around us when buying milk and bread, we can’t have a partner present during an ultrasound appointment.
But, there are some surprising positives we have found in our research.
Being uninterrupted by unnecessary visitors postnatally, both in hospital and at home, was considered the most surprising positive.
Women commented on the lovely bubble of calm, love and connection that resulted between them and their partner without lots of visitor interruptions. Midwives told us babies were more settled and women breastfed more easily.
To now remove partners from this “postnatal bubble” is really concerning. Already we are not heeding our own lessons learned from the restrictions imposed last year.
What is also critical to consider is any limitation on human rights during this time must be necessary and proportionate to the threat. It should be as minimal and as short as necessary to address the public health response and be regularly assessed and end as soon as the emergency is over.
Women have told us in our Bittoc study of the fury they felt when people went back to playing the pokies and football stadiums were half filled but they still could not have their partner come to the antenatal visits, choose a water birth or have their doula attend the birth.
We published a paper last year illustrating how Covid-19 highlights an ongoing pandemic of neglect and oppression when it comes to women’s reproductive rights. Most importantly special attention must be given to those most likely to be disproportionately impacted by the rights limitations, such as those who do not speak English, come from disadvantaged backgrounds or have past trauma.
Humanity will be forever reshaped by the Covid-19 pandemic. We are already seeing this enacted as we become more comfortable in a world of virtual interaction, working from home, and wearing masks to do our shopping.
Whoever thought a term like “lockdown” would be used in non-wartime? Or “pandemic babies” would almost sound endearing? All through history human beings have found their inner strength and discovered the best and worst about themselves when tested.
We need to be there as health providers and a community for childbearing women and their families, both during and after the pandemic. We need to be able to catch the pieces when mental health falters, and support resilience and growth. Most important of all, we must learn from this experience and remember what worked well and what did not.
It will be unforgivable if we squander this opportunity.
If you care at all about the heartache women and their families are going through right now, or what it must be like to die alone or receive cancer treatment without loved ones to support you, then there is something you can personally do to help – get vaccinated, as soon as possible.
Hannah Dahlen, AM, is a professor of midwifery at the school of nursing and midwifery at Western Sydney University