Having a Positive Birth during the COVID-19 Pandemic
I control what I can and let go of what I can’t.
Write that down and stick it somewhere you’re going to see it! It’s going to be the most important thing you learn this whole pregnancy!
Corona Virus is changing the way maternity services are running.
As the Corona Virus situation develops, things are changing rapidly. We are likely to see if a shift in birth place choices, if we haven’t already. In many areas home births are off the cards, birth centre have become isolation areas, and women are being moved to Labour Wards. Limitations are being put on visitors. Some birth choices may be unavailable. Things are certainly going to look a little different. The situation is unprecedented, the changes are just as hard for the care providers as they are for pregnant women, and quite understandably anxiety levels are rising and everybody is feeling upset, utterly disappointed and downright pissed off!
So have those feelings, feel what you need to feel; rant and rage and cry if you need to (I have). And then allow yourself to settle. Ask yourself, what now?
What do we know about your choices?
The downsides
In some instances, a Labour Ward may be the only available birth place
As home birth services are withdrawn and care is centralised due to staffing numbers. We know that being on a labour ward can increase the chance of intervention in birth- likely due to a combination of the environment, and the ease of accessing intervention.
Water Birth may be unavailable
Due to the possibility of Corona Virus being transferred through water, hospitals are restricting access to water birth for women with confirmed or suspected COVID-19 (As per RCOG guidance correct 27/03/2020). Some Labour wards do still have birth pools available for asymptomatic women, however availability will obviously be less.
Partners may not be allowed in the hospital before established labour & birth.
The ‘early labour’ part is being sited everywhere as a reason for panic. But here’s the thing- in a spontaneous labour (ie not an induction) you would never have even been in hospital for this part of labour anyway! Even without the corona virus issue- hospitals would be encouraging you to stay home for the earlier part of labour and only admitting you once you were in ‘established labour’ anyway. So there shouldn’t be disruption here.
If you are having an induction, there may be a small portion of your early labour- or certainly the induction process (where you may not be having contractions) where you are now alone and previously wouldn’t have been.
Partners may not be allowed to the postnatal ward.
To limit the spread of the virus, many hospitals have now limited visitors to the postnatal ward to just one- or even none.
The upsides
Midwifery led care should still be available
Even on the labour ward; meaning doctors wont routinely look over the notes of women with otherwise uncomplicated pregnancies. We know that midwife led care improves outcomes for women with ‘low risk’ pregnancies.
Water can still be used
For women without symptoms, pools on the labour ward can absolutely still be used. Labour Ward rooms often have an ensuite bathroom with bath or shower that can also be great for comfort during labour. And at home you can use your bath or shower too for comfort in the earlier stages of labour.
Mothers and Babies should not be split
Even if a mother has confirmed COVID-19, except in very rare circumstances where baby needs admission to NICU AND Mum has confirmed/suspected COVID-19, the current guidance is that they should not be routinely separated. The long term benefits of keeping mum and baby close currently outweigh the prevention of spreading COVID-19 in the family unit. (See RCPCH guidelines here)
Breastfeeding is still encouraged
For both women with and without confirmed/suspected Corona Virus, breastfeeding is still encouraged for those who want to breastfeed. (Keeping hands clean and following the recommended guidances from the NHS to reduce the spread of COVID-19 is of course still relevant- more here)
Partners are allowed in labour
Maternity care and end of life care are the 2 areas in hospitals currently accepting visitors of any kind. Having emotional support from someone you know and trust is considered an important part of the process and safety of birth, so hospitals, the RCM and RCOG are trying to maintain this wherever possible. One partner is still welcome in hospitals across the UK- your chosen partner must be well- so it’s worth having a back up just incase. More tips about birth partners and corona virus here.
What can we control?
Even with these changes, there is still so much we can control about our birth experiences!
There has never been a more important to understand what your body and mind need to give birth safely. You need to create a space that makes you feel relaxed and unobserved. You need techniques to help keep your mind calm and your body physically relaxed. You need tools to help you feel comfortable. You need to start to really, really tuning into your instincts, because they are going to tell you exactly what to do! Your body is perfectly designed to give birth to a baby, but the process needs to be supported and encouraged. So how do we do it?
Environment
A Labour Ward room doesn’t have to look like a hospital room, the space is yours and yours only for the duration of your birth- so take steps to transform it- here are some ideas…
Turn off the lights
Play Nice Music
Play Relaxation Scripts
Use essential oils/ nice smells
Bring a cushion and a blanket from home
Put up affirmations
Make a ‘baby shrine’- put baby’s scan photo/ first outfit/ photos of their siblings/ their nursery/ places you can’t wait to take them- somewhere to focus on if you need it.
Limit the number of people coming in and out
Keep conversation to a minimum
Move the bed out of the middle of the room
Ask for a birth ball, stool, mat etc to provide alternatives to ‘laying on a bed’
Ask your midwife to help- you don’t have to walk in all ‘Lawrence Llewellyn Bowen’ and start ‘operation changing rooms’. You can just say to her ‘we wanted to be on the birth centre- please can you help us change the room a bit?’
Consider your home environment too for early labour- how can you move, where can you rest, turn out the lights, watch a funny film, plus all of the above!
Comfort Measures
Gathering as many comfort measures as you possibly can is going to help reduce the chances of intervention and help both at home and in hospital.
Water- this doesn’t just mean ‘birth pool’ and it doesn’t just mean in hospital- bath, shower etc at home or on the labour ward can still be so helpful! You may find there is a pool available on the labour ward too, in which case jump at it!
TENS Machine- Can be used from early labour and is a very effective method of comfort in labour.
Hot water bottles- on your back or between your legs, a totally underestimated method of pain relief!
Eye mask and ear plugs- to block out the rest of the world and stay in you safe zone in your head!
Essential oils- Lavender, Rose, Citrus, Clary Sage, Geranium- all helpful in aiding relaxation and reducing pain and work brilliantly alongside hypnobirthing.
Breathing- an incredibly well researched and effective method of pain relief! We teach 2 breaths for birth in our online course!
Massage- if you’ve got a birth partner there are several massage techniques on our online course- but ultimately any physical contact from someone you know and love is going to help!
Hypnobirthing- A multitude of techniques, in particular the use of guided relaxations can be used to help you maintain a deep state of relaxation, stay comfortable and in control.
Movement- Rocking, Swaying, Dancing, Hip Circles, Stamping, Adopting whatever position instinctively feels right certainly helps you to feel comfortable in labour.
Nipple or Clitoral Stimulation- yep really. Both HUGE producers of oxytocin, the hormone needed to facilitate birth- when it crosses into your brain in literally makes you feel GOOD (Which you probably know, since you did MAKE this baby too).
Decision Making
Whilst it may feel like certain things are out of your control when it comes to Corona Virus- in terms of the actual birth itself, your rights are exactly the same. Whether or not to accept vaginal examinations, whether or not to accept intervention like induction or breaking of the waters in labour, whether or when to consider instrumental birth of caesarean- these things were always your choice beforehand and they still are now.
A useful tool when it comes to decision making is called using your ‘BRAIN’- gather this information and you can be confident your choice is fully informed and right for you and your baby in that moment.
Benefits- what are the benefits of accepting this and what are the benefits of declining?
Risks- what are the risks of accepting this and what are the risks of declining?
Alternatives- What else could we try?
Instinct- What does it feel like we should do?
Nothing- What if we did nothing for 10 minutes? An hour? A day? A week?
Mental State
When you go into labour, most women find that for a time they’re happy to chat between contractions, maybe watch a film, maybe do some cooking- ‘potter’ essentially! Think of this as being ‘upstairs’. Most of us reach a point when we want to go ‘downstairs’, we want to be focused on the fact we are in labour, we probably arent chatting as much and we are starting to tune into those instincts. Eventually you’ll find yourself moving to ‘the basement’, like your whole mind has just gone underground. Your eyes instinctively close and you’re blocking out the rest of the world. You spend most of labour inside your own head! (You will likely reach this place at home, before travelling to hospital!)
Once you move into the deepest part of yourself in labour, the environment that matters most is the one inside your head! You eyes will likely be closed now and you may not even notice what the room looks like (I didn't at all!). So the one thing to start doing now, is finding the mental space you want to be in when you give birth. One where you feel confident and calm. It might be picturing a physical space your mind could travel to (My mind spent most of labour in the woods and in a luxury hotel in Spain we had been to once before!- whilst my body spent labour on an antenatal ward full of people!), or it might be a deeper 'sense' of a place, but this is where to focus your attention right now!
The birth-ed online course is perfect to support you to find all of this- the practical, the physical, the emotional. And it’s just £40! So if you feel like you want to explore all of the in more depth, come join us!
You can do this, you will do it, you ARE doing it.
Information correct as of 27/03/2020