PREGNANCY AND MATERNITY IN THE PANDEMIC
By Kelly Grehan
While the coronavirus crisis has forced all of us to postpone plans, and in most cases completely rearrange our lives, there is one group who will not be changing their plans; babies. As a result, women are facing pregnancy and new motherhood far removed from what they had planned and hoped for. We need to work to mitigate the impact of the Covid-19 outbreak on new mums – both now and in the long term.
However joyous the arrival of a new baby is, it is always a challenging time for new mums, with so much physical, emotional, and situational change. For those dealing with this during lockdown this is likely to be a particularly confusing and difficult time.
While there is as yet no clear evidence of greater risk from Covid-19 to pregnant women, or adverse affects on their children, pregnant women have been warned to take extra care to avoid infection. As a result, pregnant women have been advised to exercise stringent social distancing, leaving them physically more isolated.
While pregnant women have been advised to work from home where possible, Maternity Action and Pregnant then Screwed have both highlighted the fact that some employers are not enabling this. They also reveal the huge financial uncertainty caused by double whammy of maternity leave and Covid-19 related cutbacks.
Traditionally, pregnancy and birth are times of celebration with family and friends, although they can also be lonely. During the pandemic, some will experience feelings of grief as rituals of celebration such as baby showers, antenatal classes, and even shopping for baby clothes are no longer possible, at least in person.
Often pregnancy is a time for building up post birth networks as antenatal classes allow women and couples to meet other people in the same situation who are able to support each other. Women are often told this can be good protection against postnatal depression. While some sessions are being held online, women will still be missing out on opportunities to build supportive friendships.
Changes to maternity care may lead to feelings of isolation. Midwife and consultant appointments may be held by phone. During face to face appointments, midwives may be wearing PPE. Women may not be permitted anyone with them at scans.
Birth is also changing. Many trusts have understandably suspended home births. Only one birth partner is now permitted, and no visitors are allowed at the hospital. In the best of circumstances looking after a new baby is tiring, especially when you are recovering from a traumatic birth. Breastfeeding, wound care, lochia – all of these things can be difficult. Experiencing this without your usual support system may feel catastrophic.
Most women experience an assortment of feelings in the first few days after they have had a baby. These can range from extreme happiness to mood swings of anxiety, exhaustion and tearfulness. These feelings are often part of the ‘baby blues’ which affect around 50-80% of women. It is often welcome, at this time, to have someone around to tell you this is normal – to make you a cup of tea, run you a bath – take the pressure off.
Postnatal depression is estimated to be experienced by one in ten new mums . Midwives and Health Visitors have been trained to spot the signs as it emerges. Babies’ grandmothers and aunties and even neighbours are (usually) well placed to notice the signs too, and to help with the recovery. That contact is sadly now missing. Given the common symptoms of postnatal depression – feeling low most days, lack of interest or pleasure in normal activities, loss of appetite, difficulty sleeping, tearfulness, irritability and anxiety – women may dismiss their feelings as a result of living during a pandemic and so go untreated.
There is a lot of truth in the old saying ‘it takes a village to raise a child’ – particularly in the early days. But the village can not presently help mums in person, and many women are unable to access their support system just when they need it most. No leaving the baby or other children with friends for a few hours while she gets some sleep; no visits from her own mum to tell her what a good job she is doing; not even the ability to leave older kids in school or nursery for the day – and instead having to home school. For single mums the pressure may feel too much to cope with.
There is also some marvellous pioneering practice going on. The NCT (National Childbirth Trust) and others are offering online group antenatal classes, which will help expectant parents develop a support network from other parents-to-be. Breastfeeding support and some baby groups 7have also moved online. The internet – for so long seen as a spreader of fake news- is now a lifeline for mums to get support along with accurate information from medical professionals.
We need to ensure services directed towards pregnancy and maternity are properly funded and accessible to all mums, and ensure that health visiting programmes are a focus for investment, to ensure no new mum falls through the cracks. We must encourage mums to seek help if they are struggling. When this is over, we must recognise the stress new mums have been placed under and their inevitable grief at what they have missed out on during this period and give them opportunities to commemorate and celebrate.
New mums also want to show their baby off. They want to share them with close family, to regale people with birth stories, be stopped by strangers in the street who tell them how beautiful their baby is. The lockdown denies them that experience.