Birth in a time of Covid-19

I think most people are a bit anxious right now. There’s a lot going on and a lot to get your head around. But if you’re pregnant, it must be especially worrying. Particularly if it’s your first and you already don’t know what to expect. Pregnancy and birth keeps you on your toes at the best of times, but birth in a time of Covid-19 comes with further considerations.

You can read the Royal College of Obstetricians & Gynaecologists advice on coronavirus infection and pregnancy here.

We’ve had a couple of recent births in the BigBirthas Facebook Group. With permission, here’s a birth story from someone who just did it four days ago! Hopefully this will give a bit of information and reassurance on what to expect if you’re nearing your due date:

Kay’s birth story

I gave birth to my little legend on Friday 27th March.

newborn wearing a hat and clutching a finger -
birth in a time of Covid-19

I was induced at 37+5 due to obstetric cholestasis. (OC is a liver condition which affects 1 in 140 pregnancies in the UK. It is characterised by excessive itchiness, often on the palms of your hands and/or soles of your feet. A bit of itchiness in pregnancy is normal, particularly on a stretching tummy, but always worth getting checked out. – Big Birtha)

He came at 38+1. They kept me in hospital due being high risk with OC and high BMI and the midwives were absolutely amazing. They really put my mind at rest. The consultant and the anaesthetist were pushing for a c-section because of my size, but I rejected and carried on. I knew that I could do it.

In the end I managed all but the last hour without any pain relief at all and the last hour I allowed myself some gas and air. He was born at 2.10am on the 27th weighing 7lbs 14oz and is perfect.

My advice to everyone is to not let them put time pressure on you. If you choose a c-section, that of course is your choice and I am fully supportive, but I am so glad I didn’t let them hound me into one. The ward they put me on (postnatal) I was the only one that had a natural birth. It was so hard watching everyone else struggle even picking up their newborns, whereas I was up and walking about straight away.

Birth in a time of Covid-19 – Kay’s experience

They are taking the upmost care due to current situations, and I am generally a bit of a worrier. If you’re like me don’t let it get you down, I cannot express how safe they made me feel!

The midwifes were only allowed in that section of the hospital. Birthing partners were limited to one and had to take their own food etc. Once they were on the ward they couldn’t leave and come back again. It’s reduced the risk and made everyone feel more comfortable. We all washed so much too, mums, dads, and staff.

All in all it was a very positive experience, even in the circumstances.

Good luck everyone, from one very happy mumma. 💜

*****

Thanks for taking the time out to share that Kay, and congratulations!

Birth in a time of Covid-19 – highlights from the RCOG guidance

The Royal College of Obstetricians & Gynaecologists is carefully monitoring all evidence as it’s released. So for up to date information, it is definitely best to read the advice on their page. The below is current as of 31st March 2020:

Generally, pregnant women do not appear to be more likely to be seriously unwell than other healthy adults if they develop the new coronavirus.

Based on the evidence we have so far, pregnant women are still no more likely to contract coronavirus than the general population.

What has driven the decisions made by officials to place pregnant women in the vulnerable category is caution.

It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms.

If you think you may have symptoms of COVID-19 you should use the NHS 111 online service for information, or NHS 24 if in Scotland.

Our advice remains that if you feel your symptoms are worsening or if you are not getting better you should contact your maternity care team or use the NHS 111 online service / NHS 24 for further information and advice.

The most important thing to do is to follow government guidance [to reduce the risk of catching coronavirus].

It is really important that you continue to attend your scheduled routine care when you are well.

If you have any concerns, you will still be able to contact your maternity team but please note they may take longer to get back to you

There is a long FAQ section in the Royal College of Obstetricians & Gynaecologists advice so it’s likely most questions you have may be covered there.

Stay safe, and look after yourselves.

x

Big Birtha

How To Submit an FOI Request for Maternity BMI Policies

If you’re pregnant or trying to conceive, you might want to know how to submit an FOI request (Freedom of Information) to your local maternity providers. It’s worth finding out as much as possible about your likely treatment beforehand, and it’s pretty simple to do.

How to Submit an FOI Request

  1. Find out which NHS Trusts cover your local area

    Quickest way to do this is to use the postcode location service on the NHS website. This will list all the local services, sorted by distance. https://www.nhs.uk/service-search/Maternity-services/LocationSearch/1802

  2. Check out the Trust websites you’re interested in.

    Mostly clicking through to the individual pages will display the website at the top under the name, if not, just Google it.

  3. Find the page on Freedom of Information requests.

    There always is one. Easiest way is to type “FOI” into the search box, usually found somewhere near the top. Somewhere on that page will list the email address you need to send queries to.

  4. Send your questions/request for relevant policies to the FOI email address.

    If you don’t want to write your own, feel free to use/adapt mine:

    “I would like to know with regard to your fertility, maternity, childbirth and post-natal services:
    1. Do you have a policy for the management of larger women? If so, what is the BMI cut off (or other criteria) where this policy comes into use?
    2. Please attach a copy of the above policy.
    3. Please could you attach any other policies/guidelines/protocols relating to fertility, maternity, childbirth and post-natal which address the management of higher BMI women. This could include (but not be limited to):

    Inclusion/exclusion criteria for use of midwife led unit, hospital birthing pool, home birth, IVF etc.
    Glucose Tolerance Testing and Gestational Diabetes,
    Clexane prophylaxis
    Pre-Birth Anaesthetist referral
    Additional growth scans

    Digital copies/pdfs preferred.

    Kind regards”

  5. Wait for a response

    The authority must reply to you within 20 working days.

    Anyone has a right to request information from a public authority. For your request to be dealt with according to the Freedom of Information Act, you must:

    Contact the relevant authority directly
    Make the request in writing, for example in a letter or an email
    Give your real name; and
    Give an address to which the authority can reply (postal or email)

    You do not have to:
    Mention the Freedom of Information Act
    Say why you want the information

    They can charge you for the costs of sending the information, such as photocopying and postage if you request a copy by mail, but not if you request copies by email. They must let you know any cost beforehand.

    By law they must provide the information unless there is good reason not to; e.g. if in the interests of public safety or security to withhold the information or they do not record that information. See the Information Commissioner’s Office page for more info.

  6. Send the documents to Big Birthas for inclusion on the website!

    If you do get copies of your local policies, please contact me via the form on https://bigbirthas.co.uk/about-big-birtha/contact-big-birtha/ to let me know, and I’ll email back (stops me being inundated with spam!). Then you can send me the documents so I can add them/update them here for the benefit of all.

We’ve got to do our own research…

While there is no denying that there are excellent caregivers in midwifery services, there are unfortunately those for whom the magic of childbirth has been subsumed by the sheer hard work and for whom midwifery seems to have become ‘just a job’.

Even the most caring of midwives have procedures and protocols to follow, and delivering truly individualised care amidst the pressures of understaffed units and the highest birthrate for decades is nigh on impossible.

Talk to any woman who has given birth, and there’s usually an element of their birth stories which runs ‘I had to do XYZ / have XYZ / go to XYZ, because of hospital policy on…’

Whether that’s being told you have to go home again for the third time, despite having been in labour for 6 days because you’re not dilated enough (seriously?), or being told you can’t be in established labour because your contractions aren’t regular enough (yet it turns out you’re 4cm dilated), or being told that you need to have your labour augmented because it’s not moving quickly enough (for who?), or you can’t use a hospital birth pool because you’re not thin enough and would be difficult to rescue in the case of a collapse (yet you’re allowed to have as many baths as you like – in tiny room far more inaccessible should the much-feared collapse occur), or your husband/partner/father of your baby can’t be by your side because visiting hours haven’t started yet (don’t get me started on the Bounty lady being there when husband/partner isn’t), most of us don’t challenge what we’re told.

It takes a strong person, while in labour, attended by the experts to say ‘hang on a minute – what are my options here? What if we don’t do XYZ and just wait and see? Or I’m not going anywhere until someone takes me seriously and listens to what I want to happen here.’ It takes a strong birth partner to do it too. I quote this:

The Mule: Stop Googling Your Birth Options, And Hop Up On The Bed, Dear.

If you are faced with a choice about procedures and interventions in childbirth – ask yourself – who is this most likely to benefit, reassure, or make comfortable – me, or my carers? We must not be deterred from learning as much as we can about our rights and our options in childbirth, no matter how much it may inconvenience midwives or doctors. We do not have to comply with their suggestions, unless we wish to. We are allowed to be powerful in childbirth. What’s more, birth is not simply a means to an end – our birth experience matters, and is of primary importance, not just to us, but to our babies, our families, and the whole human race.

The midwives themselves don’t even necessarily agree with the official policy they have to present to us. When I spoke with the Head of Midwifery about my desire for a home birth and my belief that it was a safe, sensible, viable option for me given my previous birth experience (and that frankly, I’d been pushed into a corner because home birth was the only way I’d get to labour in a pool due to their hospital’s policy on BMI) she couldn’t have agreed more. She was very supportive, but still had to sign off my birth plan with ‘against medical advice’ because that was her job, no matter how unfair, discriminatory and ridiculous she felt it was.

She said she felt that midwives hands are often tied these days into following policies they don’t believe in.

But WE don’t have to follow those policies. It is our right to research, and choose, and question, and challenge, and while some professionals don’t like it, be rest assured others are smiling inwardly because they actually agree with us… they just can’t say it.