For most women, pregnancy is a special time filled with joy and anticipation about the changes ahead. However, the current Covid-19 outbreak has brought another aspect to all our lives, adding fear and anxiety to many women's journeys.
Since this is a new, more virulent disease, research is still ongoing and changing and this information is based on the current recommendations by the president of the International Confederation of Midwives, Franka Cadee (UNICEF, May 11th 2020)
In the interview I am referring to, Ms. Cadee talks about homebirths in the Netherlands and here I’m going to add the Irish (Cork) perspective, based on my experience of nearly 40 years working in the community to her insights.
Is it safe to attend your Health Care Provider (HCP) for antenatal check-ups?
While many people are advised not to go to their GP practice here, it is important to check the pregnancy at recommended intervals. Cadee advises mothers to find out what options are available in your circumstances. Social distancing isn’t always possible when doing vital checks, like establishing how the baby’s presenting, or checking your blood pressure.
However, your HCP is trained to provide the safest way to protect you and your baby during those appointments.
In our home birth service here in Cork, for instance, we offer one-to-one appointments, clean our equipment according to Covid-19 protocol and protect you by wearing a mask, gloves and an apron during heartbeat checks and other antenatal checks. During a home birth, we wear protective equipment once the birth is imminent and make sure an individual and personal approach are maintained always. In a service where touch and non-verbal encouragement is so very important, we had to change a lot and I very much miss the closeness to mum and baby that was taken from us by this virus. However, I am grateful for the fact that I have met my women and couples before the birth, we’ve been through this pregnancy together and have already established a relationship. And like our colleagues in the hospital, we smile with our eyes and convey our confidence that all is good through other channels.
What should I do if I, or someone I was in contact with, had symptoms? Although research is still ongoing, the COVID-19 virus has not been found in vaginal fluid, in cord blood or breastmilk, which is very reassuring. However, if you are having symptoms, or someone in your family is suspected of an infection, your baby should be born in a hospital and a home birth is not possible.
Can my birthing partner be present at the birth?
Policies vary in this regard but Cadee strongly recommends a birthing partner present and to keep mums and babies together after birth. I am very happy to say that our service keeps the family unit safe at home and you have your birthing partner by your side. How can I protect my baby and myself from and infection with Covid-19 The advice is simple: stay at home, keep social distancing, wash your hands. Visitors can only see the new baby at a safe distance, very hard but absolutely vital for now.
Other recommendations are:
Avoid contact with anyone displaying symptoms of coronavirus disease (COVID-19).
Avoid public transport when possible.
Work from home, where possible.
Avoid large and small gatherings in public spaces, particularly in closed or confined spaces.
Avoid physical gatherings with friends and family.
Use telephone, texting, or online services to contact your midwife, obstetrician, and other essential services.
Can I safely breastfeed my baby?
Yes, as far as we know. The virus has not been detected in breastmilk to date and the mother and baby dyad should not be disrupted. If you are positive with Covid-19 wash your hands and wear a mask. Some research suggests, washing your breasts with soapy water might be beneficial also. If you are too ill to breastfeed, expressing breast milk might be an option also.
The importance of breastfeeding can not be overstated and the pandemic has highlighted another positive aspect. Breastfeeding mothers don’t have to worry about formula supply in shops.
Please contact me if you have questions relating to the HSE home birth service or Private Midwives Ireland.