A time of worry and uncertainty

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AIMS Journal, 2020, Vol 32, No 2

By Felicity Miller

I am currently 36 weeks pregnant with my third baby. I have had a straightforward, low-risk pregnancy and I am booked in with the Leicestershire Homebirth Team.

I was 32 weeks pregnant when the UK went into lockdown at the end of March, and the following weeks were really stressful, and I felt quite anxious and upset. My initial concern was of the virus itself and what this could mean for the health and safety of my baby, as well as for myself and the rest of my family. The information and guidance was changing by the day, and pregnant women were considered high-risk and advised to self-isolate, but very little was known about the virus at this point and the impact on pregnant women and newborns was unknown.

I was glad I had already booked a homebirth, as keeping away from the hospital and limiting contact with other people at this time seemed like the safest option - not just for me and the baby, but also for my partner and other children.

In the weeks that followed, many NHS trusts started to suspend their homebirth services and midwife-led birth centres also appeared to be in jeopardy. I felt extremely concerned and anxious about this, and worried that it was only a matter of time before homebirth provision in my area would also be pulled. It seemed like quite a knee-jerk reaction to suspend all but the very basic maternity services, putting pregnant women and babies at risk of reduced care provision, when birth is not something that can be rescheduled.

I emailed my local Head of Midwifery to express my concerns, asking her not to suspend homebirths, and to ensure all other options were considered to keep the service running - such as using independent midwives to help support staffing levels, and making alternative arrangements for hospital transfers in case the ambulance service was overstretched. I received a very quick response to reassure me that homebirth provision was continuing at the moment, and it would be reviewed as the situation progressed, and alternative arrangements were being considered to support this.

The following day it was announced that the midwife-led birth centres at both the Leicester hospitals had closed until further notice, and that the birth pools would be unavailable at the hospitals. I was very distressed to hear this, as it meant that if the homebirth service was suspended or I was unable to have a homebirth for any reason, my only option would be to go to the hospital labour ward to have my baby. At this time, there were also concerns being raised about birth partners being restricted and women facing giving birth alone.

I am keen to stay away from hospital as much as possible, so the thought of having no choice but to go to hospital to give birth during the pandemic is very frightening. It seems to go against everything we had currently been advised, and I was concerned that low-risk women would be forced into a high-risk environment, not just of the virus itself, but also if all women had to go to the labour ward, there may be capacity and staffing issues which could inadvertently impact on the care provided.

This also brought up other logistical issues around social distancing - if I had to go to hospital to give birth, then who would look after our other children, as we are not able to call upon friends and family as normal? Our parents are all over 70 or have health issues that put them in a higher risk category so would be unable to help. If my partner had to stay home to look after our other children, would I have to give birth on my own? How would I get to hospital - would my partner have to drive me there with our other children in the car and drop me off at the door? I felt very worried about who would look after me and my baby. My partner is asthmatic, so he is more vulnerable and at higher risk from the virus, so it would not be ideal for him to be in a hospital environment either. I also have my other children to consider, and would be concerned that by being in hospital I may risk bringing the virus home to them.

Due to these concerns, I have considered the possibility of unassisted birth (freebirth) and although I would not be totally comfortable with this, I would have to consider the risks of freebirth against the risks of being in hospital during this time.

Fortunately, my local homebirth service is currently still available and I have been advised that as it is a large team with a large caseload, they would be very reluctant to suspend this and any reduction of service would be reviewed on a weekly basis.

The changes to maternity services have had a significant impact on my pregnancy, causing a lot of stress and anxiety at an already emotionally vulnerable time. I have rescheduled appointments over fears of going to hospital clinics, and several appointments have now also been conducted over the phone. When I have gone to hospital-based clinics, I have felt very nervous and vulnerable, despite taking all safety precautions and NHS staff reassurances. What would usually be a happy, exciting time has been overshadowed by worry and uncertainty.