PART 3 - PANDEMIC SUPPORT: Experts reveal what it's really like

 Many women are feeling worried or unsure about what to expect during this crisis when it comes to pregnancy support and birthing plans as rules and regulations continue to change during the Covid-19 pandemic. We speak to two birthing professionals, who are currently supporting women through their childbirth journey during the crisis. They tell us how they are adapting, what new concerns new mums might have, how to offer additional support and we discover that, despite a few additional hurdles, it’s pretty much business as usual, these babies still need to come into the world!

 

 Helen Nightingale, The Midwife

 Helen Nightingale is a registered nurse and midwife who has been working in the field for over 10 years. She works as a midwife and also as a lecturer of midwifery students and a researcher.

 Helen talks to us about some of the changes to antenatal care and support for new mums during the pandemic.

 Changing times…

 Many health facilities have moved to limit the number of people attending their services. This means women are encouraged to attend pregnancy appointments alone, and some pregnancy appointments have been modified to telehealth (via phone or video call) consultations.

 Antenatal care is vital in contributing to good pregnancy outcomes for mums and bubs. You should still be scheduled to receive at least 6 face-to-face visits. Your support people can also attend appointments via video call, if needed.

 Maternity wards vs homebirth…

 I still work clinical shifts in maternity care. Hospitals have worked very hard to make necessary adjustments for COVID-19 and are currently well-placed to care for women due to Australia's fantastic response to physical distancing and restrictions 'flattening the curve', so to speak.

 Although I do not work in a service that offers homebirths, through my social media profile I have seen an increase in women with queries around homebirth now and for the future.

 Questions from mums…

 The two biggest concerns have been 1) partner support at birth and 2) should I be trying to conceive during this time. Globally and in Australia, organisational guidelines support your rights to a choice of birth support. There are absolutely no indications in Australia that this will be restricted in response to COVID-19. You should be very reassured that you will have a support person of your choice with you during labour and birth.

 In regard to trying to conceive, this requires consideration on a case-by-case basis. If you have medical conditions that put you at high risk in pregnancy and also for coronavirus, it may be beneficial to delay conception until a safer time. However, delaying conception may also impact negatively on your fertility - or other things, such as mental wellbeing. The answer to this concern is - do what is right for you. What is right for you, might not be the same as what is right for another woman. If you have concerns or queries, don't hesitate to reach out to a GP, midwife or obstetrician for pre-conception discussions. We are here to support you!

 Virtual support for expecting mums….

 I run an Instagram maternity-care related platform (@reallifemidwife), alongside my contributions to the bubapp as resident midwife. Women are much more engaged with both spaces at this time. Initially there was a lot of fear and uncertainty, this has shifted to support and questions now.

 Give yourself permission to feel….

 Allow yourselves to feel what you are feeling. If you are feeling lucky because you are home with a newborn and not being interrupted by visitors - well, enjoy it! Soak it all up! But if you are feeling isolated, frustrated, angry, emotional about being isolated, or your job, or kids, or finances...that's very expected as well. Just know that there is a lot of support out there - especially in the online space. Lots of us are very well experienced and trained in helping to develop strategies for you to work with at this time.

 You can find out more about Helen and her work at reallifemidwife.com

Samantha Gunn, The Doula

 Samantha Gunn is a Birth & Postnatal Doula and Childbirth Educator based on Sydney's North Shore. She holds qualifications in Doula Support, Childbirth Education, Hypnotherapy, Acupressure, Aromatherapy, and Optimal Maternal Positioning Techniques.

 Before having her own children Samantha was an accountant but through her own experiences of birth and parenting she became passionate about the support and education that parents receive as they start their family. She has 4 children (now all teenagers) and she loves her 2 jobs - being their mum and working with families during their pregnancy and postpartum. We talk to Samantha about the unprecedented changes that families are facing and how women are finding comfort and support during these times.

 A mixed picture…

 The changes in antenatal care during this time have been a mixed picture. Many hospital and birth centre appointments have been reduced in their frequency, some are being held as telehealth appointments and some testing protocols have changed (for instance a blood test is now being recommended for gestational diabetes by many care providers). But it isn't consistent across the board.

 The care that I provide as a doula has changed a little too, in general I am holding virtual appointments until my clients are around 34 weeks pregnant when we switch to in-person care. I am also working more with my clients, especially the partner, to make sure that they are truly prepared for birth during this time.

 Physical presence…

 A second support person is not currently allowed in Sydney hospitals, so I haven't been able to attend any births in that setting since the new regulations.

 I have attended a beautiful homebirth which was supported by independent midwives. This went ahead as usual with no changes apart from fewer hugs as we all left. For upcoming clients who are birthing in a hospital or birth centre it is our plan that I join their labour at home, as usual and remain available for contact once they've transferred.

 I have some clients who no longer have access to the environment and facilities they were hoping for, so I am advising my clients to check with their care providers about any changes in facilities, pain relief options or staffing levels during their birth.

 Homebirths…

 More women are asking me about homebirth. This seems to be partially because of concerns around the virus and partially because of perceived or expected restrictions at their chosen place of birth but also because they are unhappy with the limited antenatal care.

 Finding some stability amongst the uncertainty…

The most common fears for expectant mums stems from lack of consistency and support both during their pregnancy and in the postnatal period. They are worried that things will be missed during their pregnancy, they're more uncertain than ever about how their birth will be and they're concerned about the additional isolation once their baby is here with mother's groups being cancelled and health centre appointments being pared back to reduce people waiting.

 While a doula does not in any way replace medical care I do provide a consistent form of support throughout this time, encourage and support my clients by helping them understand how to navigate the system, where additional forms of support and information might be found and helping them to feel nurtured, confident and prepared as they start their parenting journey.

 Silver linings…

 My advice for expectant parents is to look for the silver linings - yes, we are more distanced from each other right now, but this means that you have a golden opportunity to rest and bond with your baby without interruption.

 Have a mindfulness practice - it's easy to be stressed and feel out of control right now. Developing a mindfulness practice will give you some great tools to manage these feelings and it will pay dividends as you become a parent.

 Listen to your instincts and don't compare yourself to others.

 Know where support is available. Some support isn't available right now but there are lots of new avenues that are springing up online (Facebook groups, Live video chats, educational content etc) as well as people who can work with you individually.

 Remember - this too shall pass, and you'll be wiser and stronger for it.

 

 You can find out more about Samantha and her work at samanthagunndoula.com