MAKING SURE YOU'RE INFORMED
Hearing that you are part of a vulnerable group when pregnant, must have been scary, and it can be easy to get lost and overwhelmed in the sea of information online. It is so important to be informed so that you can prepare for your birth in a calm, confident way, and still working towards the birth you envisaged. Here, I will lay out up to date the latest advice and guidelines according to the RCOG for pregnancy and birth during Covid-19, lay out up to date information for Bristol Trusts and look at what aspects of birth we can still control.
The majority of women who become infected will experience mild or moderate cold or flu like symptoms, cough, fever and shortness of breath. Individual responses are different for individual viruses and strains, and a small number of women in the last trimester, may have a more severe reaction, if their immune system has been impacted through pregnancy. This is something midwives and doctors have known about for a long time and are used to looking out for signs. If this happens to you contact your midwifery support team, NHS 111 or local medical alternative.
If you have no symptoms
You will still have mid-wife led care, be able to birth in a Birth Pool and have your Birth Partner present (providing they are also symptom free). You will likely need to give birth in a hospital setting, as Bristol is reducing the number of home-births, but remember you can take your environment with you wherever you birth. Your birth partner will still be there at the birth, but will not be able to stay with you once you transfer onto the labour ward or visit until you are ready to come home.
If you do have symptoms
If you think you might have or do have Covid-19 and have gone into labour, you will stay at home during the latent phase, as normal. Your births will now be in a hospital setting, to ensure increased monitoring for you and for baby. You will be in an isolation room with the number of people coming in and out being limited. So far, there is no evidence showing that the virus can pass from mother to baby in utero or during the birth process and there is no impact on baby’s development, even if you have the virus. This means vaginal birth is still encouraged, but you will not be able to use a birth pool, to reduce the risk of passing it to your care providers.
After baby is born
There is no evidence to suggest that Covid-19 can be passed from mother to baby in the womb or through breastmilk. Any media reports to the contrary are based on false evidence. Unlike China, the UK is not separating infected mothers and their babies for 14 days and they are advising that the benefits of breastfeeding outweigh the risk of infection; in fact breastmilk protects against infectious diseases. Some precautions you may wish to take include regular handwashing, wearing a facemask and avoiding coughing or sneezing whilst baby is on the breast. To further reassure you, infants who have contracted Covid-19 have displayed very mild symptoms.
What's happening in Bristol?
St Mikes have resumed their Home Birth Service. Southmead are not yet in a position to follow suit
Birth partners are able to be present for all of active labour, which is normally the duration in the MLU. In the CDS birth partners will need to leave once Mum transfers to the ward a few hours after giving birth although Southmead are starting to relax this
The use of baths and birth pools are still available and encouraged, providing you have no symptoms
PREPARING FOR A CALM, CONFIDENT BIRTH
‘Pregnant women with a suspected, probable or confirmed COVID-19 infection, including women who may need to spend time in isolation, should have access to woman-centred, respectful skilled care, including obstetric, foetal medicine and neonatal care, as well as mental health and psychosocial support, with readiness to care for maternal and neonatal complications.’ WHO
Although things look different from how they normally do, there is still a lot that you can control.
Dim the lights, bring in your favourite pillow, have music playing and maybe some essential oils. Wherever your location, you can take your environment with you to create a calm, peaceful space where you feel comfortable. A good tip is to ask the midwives or doctors to leave the room for a few minutes when you first arrive, this allows you and your birth partner to 'claim your space' and invite them back in. Remember, if you don't have any symptoms you can still have a midwife-led, water birth.
We produce the most Oxytocin on the outbreath, so taking long, slow deep breaths, where the exhale is longer than the inhale, will help you remain calm and 'in your zone'. Check out the audio for some simple, effective breathing techniques.
Active, calm birth
As well as your breath, how else can you make sure you are comfortable during labour? Birthing in water, a tens-machine, hot water bottles or cold flannels, as well as massage and movement can all contribute to an active, calm birth. In our pregnancy yoga classes we do lots of funny walks and preparation for you to use movement effectively during your birth. You can find out more and book onto Pregnancy Yoga and here.
We know that a positive birth experience is rarely the result of one thing, but a multitude of things layered on top of each other. Use all of your Hypnobirthing techniques and anchors to get in a calm, relaxed, positive headspace. Earlier on in birth you are likely to be more active, but as birth progresses you will increasingly come inside your own head. Use your Hypnobirthing techniques to ensure that your head is a great place to be, that you are calm and in control and excited to meet your baby. There is currently 20% Hypnobirthing courses. with code 'thiscalmmummy', for more information or to book onto a course, click here.
You and your birth partner are a team and whilst the Corona virus is a new scenario in the birth world, you have the same choices during birth remain the same. You will still want to decide whether to have vaginal examinations, interventions including inductions and C-sections, delayed cord clamping, injections for delivering the placenta and vitamin K and anything else that is important to you. Use the BRAINS acronym to help you:
B - what are the benefits of doing or not doing whatever choice you are being given?
R - what are the risks of doing or not doing whatever choice you are being given?
A - what alternatives are there?
I - what is your instinct telling you?
N - nothing, how long do you have to make this decision, an hour, overnight, a week?
S - smile and get in a positive headspace before you make any decisions, never make decisions from a fear-based place
Check out the free relaxation at the top of the page to feel calm and relaxed about your birth in these uncertain times.