31st March 2020
A few weeks ago, I really didn't think I would be sitting here writing this. No one could have predicted the uncertainty and fast-moving changes around maternity care. It is therefore so important to focus on ‘controlling the controllables’ and preparing for birth in a way we have never had to before! During these unprecedented times, things are certainly going to look a little different (I sound like Boris now)! The changes are hard, just as hard for the caregivers as it is for pregnant women. Understandably anxiety levels are rising and everybody is upset, disappointed and very peed off!!
So have those feelings, rant, rage and cry if you need to (I know I have) and then allow yourself to settle and ask yourself - WHAT NOW?
You can still have a positive birthing experience, the key is in the preparation.
Here are my top tips to plan and prep for the wonderful day you are going to meet your baby, and throughout it all remember that it’s the day you are going to MEET YOUR BABY.
Guidance is rapidly changing, but I hope the below will be of some use and bring some much-needed comfort and reassurance.
1) Take virtual antenatal and hypnobirthing classes
Yeah, yeah Steph, of course, you are going to recommend this - but hear me out!
There has never been a more important time to understand what your body and mind need to give birth safely and effectively. Being fully prepared for all kinds of birth really can make a huge difference to your birthing experience. In some units, home births have been postponed and Midwifery led units have been closed. The option now is to birth on a consultant-led unit. Learn how to make this environment home from home. Learn how to feel safe, relaxed and unobserved and how these are fundamental for birth. Learn life skills such as breathing techniques that will not only help you birth but also help bring peace and reassurance during the postnatal period. Learn how to cope with early labour, so when you arrive at the maternity unit you are in established labour and therefore allowing your birth partner to remain by your side.
Now there are many amazing teachers offering their antenatal courses online. It is all about finding the right one that suits your learning style and needs. There are both group and private video call classes. The main difference between the two will be cost, personalisation and tailoring the content and the opportunity to connect with other parents.
The best bit about classes going online is that you can do them in your pj’s from the comfort of your own home!
You can read more about Birth Nerd Courses here:
2) Choices at the moment!
As mentioned above in most units across the UK Labour Ward (consultant lead) may be the only available birthplace. Care is being centralised due to staffing numbers and resources are being pooled.
Water birth may be unavailable due to the possibility of CoronaVirus being transferred through water. Therefore hospitals are restricting access to water birth for women with confirmed or suspected COVID-19 (as per RCOG guidance 28/03/20). Birth pools should still be available if you are asymptomatic but availability will obviously be less.
Most maternity units are allowing 1 named birth partner to accompany you but may not be allowed in the hospital before established labour and birth. Now let’s put this into perspective. In spontaneous labour (ie not an induction) you shouldn't be in the hospital for this part anyway. CoronaVirus aside, hospitals would encourage you to stay at home for the early part and only admit you to the hospital when you are in ‘established’ labour and your partner would be allowed anyway. Maternity care is one of two areas in hospitals currently accepting a named visitor. The RCM and RCOG have highlighted that having this emotional support from someone you know and trust is a very important part of the process and safety of birth. They are trying to maintain this wherever possible. It is worth mentioning here that you have a back-up birth partner just in case your number one is unwell and symptomatic of COVID-19.
If you are having an induction, there will obviously be a part of this when your birth partner can’t physically be with you. But have your phone handy and you can virtually communicate and support each other. I know it is far from ideal - but it is better than nothing. What I have also talked to other mums about in this situation is that all of you in that bay will be in the exact same boat. Maybe you could talk and support each other!
Partners may not be allowed to be on the postnatal ward. Many hospitals have now limited visiting to one birth partner and maybe even none. This is to limit the spread of the virus - and this is important to protect you all. Again I know it really isn’t ideal but video calls will help.
Midwifery led care is still available - even on the labour ward! If you are classed as low risk and everything is going tickety boo, then no doctor should be needed. This is standard on the labour ward anyway - even before CoronaVirus. We know that midwife led care improves outcomes for women with ‘low risk’ pregnancies.
Mothers and Babies should not be split. Even if a mother has confirmed COVID-19 (except in very rare circumstances - eg baby needs admitting to the neonatal intensive care unit), 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 and spreading of COVID-19 in the family unit ( see RCPCH guidelines here).
3) What can you control?
Environment - A labour ward room doesn’t have to look like a hospital room. This space is yours for the duration of your birth - so transform it. Here are some ideas:
Turn off the lights (this is a biggy)
Set the scene - battery powered candles and fairy lights
Play the music you want to listen to
Use essential oils/ nice smells ( you will have to be careful which oils and I always recommend you put it on a cotton ball or a cloth, rather than pumping it into the room).
Bring a pillow, blanket, cushion from home
Put up birth affirmations
Keep conversation to a minimum
Move the bed out of the middle of the room/ focal point
Ask for a birth ball, mat, stool etc
Consider your home environment whilst at home in early labour. Snacks, where you can rest/ move, turn down the lights, watch a funny film and light some candles.
Comfort measures
Hot water bottles
TENS Machine
Eye mask and earplugs
Essential oils
BREATHING TECHNIQUES
Massage
Hypnobirthing
Movement
Water - not just birth pools but what about a bath or shower. If the birth pool is free you don’t HAVE to birth in it - just use it as a comfort measure.
4) Try your very best to be flexible with your birth plans
Maternity care guidelines are changing almost daily, but always know and find comfort that you and your birth team are the very best for you and your baby. The Positive Birth book by Milli Hill is amazing and I recommend all pregnant women read/ listen to it. It also has brilliant tips on writing your birth plan and handy icons to accompany it.
5)Decision making
Whilst at the moment it may feel like a lot of decisions are being made for you and some things are out of your control PLEASE remember that in terms of the actual birth itself, your rights are exactly the same. Whether or not to accept routine vaginal examinations, induction of labour, breaking of the waters in labour. Whether to consider an instrumental birth or caesarean section. These have always been your choice and they still are now!!!
A useful tool to use when it comes to decision making is called: Using your ‘BRAIN’. Gather the information needed and you can be confident that the choice you make is fully informed and right for you and your baby at that given 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 can they offer?
Instinct - what does it feel like you should do?
Nothing - What if we did nothing for 10 minutes? An hour? A day? A week?
6) Be mentally prepared.
In hypnobirthing, the main mantra is where the mind leads the body will follow. If you head into birth full of fear and self-doubt - the body will follow. But if you can have the mindset of “I control what I can and let go of what I can’t” it will start to change everything. Reframe - you may no longer be able to have the much-wanted home birth or birth on the midwifery-led unit BUT you will still be cared for primarily by midwives and change that birthing room environment with the tips above.
7)Get to grips with virtual video calling and download the apps to your phone. It is better to be prepared for every eventuality in advance. ZOOM and HANGOUTS MEET by google are very good and simple to use.
8) Following the birth.
Breastfeeding is still encouraged for both women with and without suspected/confirmed CoronaVirus. Breastfeeding is still encouraged for those who want to do it.
Sign up to an online food delivery service in advance or batch cook big style. I don’t know about you but online delivery from the big supermarkets is next to impossible for the next few weeks. But small independent shops will deliver. We are signing up to a local delivery fruit and vegetable box and milk and bread are coming from the local dairy.
Postnatal information online
I can highly recommend the expert help and guidance from @komu online. They have a comprehensive kit that will take you through all aspects of prepping for the postnatal period and parenthood.
Many doulas and lactation consultants have also gone virtual. There are also many awesome Instagram accounts out there @imogenibclc @mindfulbreastfeedingcoach @MilkMakingMama to name a few.
Breastfeeding support helplines
National Breastfeeding helpline 0300 100 0212
La Leche League GB 0345 120 2918 - there is a charge for this helpline
You can do this
You will do it
You ARE doing this
You are not alone
Love Steph x
