Birth in a time of Covid-19

I think most people are a bit anxious right now. There’s a lot going on and a lot to get your head around. But if you’re pregnant, it must be especially worrying. Particularly if it’s your first and you already don’t know what to expect. Pregnancy and birth keeps you on your toes at the best of times, but birth in a time of Covid-19 comes with further considerations.

You can read the Royal College of Obstetricians & Gynaecologists advice on coronavirus infection and pregnancy here.

We’ve had a couple of recent births in the BigBirthas Facebook Group. With permission, here’s a birth story from someone who just did it four days ago! Hopefully this will give a bit of information and reassurance on what to expect if you’re nearing your due date:

Kay’s birth story

I gave birth to my little legend on Friday 27th March.

Newborn baby wearing a hat and clutching at a finger. Birth in a time of covid-19

I was induced at 37+5 due to obstetric cholestasis. (OC is a liver condition which affects 1 in 140 pregnancies in the UK. It is characterised by excessive itchiness, often on the palms of your hands and/or soles of your feet. A bit of itchiness in pregnancy is normal, particularly on a stretching tummy, but always worth getting checked out. – Big Birtha)

He came at 38+1. They kept me in hospital due being high risk with OC and high BMI and the midwives were absolutely amazing. They really put my mind at rest. The consultant and the anaesthetist were pushing for a c-section because of my size, but I rejected and carried on. I knew that I could do it.

In the end I managed all but the last hour without any pain relief at all and the last hour I allowed myself some gas and air. He was born at 2.10am on the 27th weighing 7lbs 14oz and is perfect.

My advice to everyone is to not let them put time pressure on you. If you choose a c-section, that of course is your choice and I am fully supportive, but I am so glad I didn’t let them hound me into one. The ward they put me on (postnatal) I was the only one that had a natural birth. It was so hard watching everyone else struggle even picking up their newborns, whereas I was up and walking about straight away.

Birth in a time of Covid-19 – Kay’s experience

They are taking the upmost care due to current situations, and I am generally a bit of a worrier. If you’re like me don’t let it get you down, I cannot express how safe they made me feel!

The midwifes were only allowed in that section of the hospital. Birthing partners were limited to one and had to take their own food etc. Once they were on the ward they couldn’t leave and come back again. It’s reduced the risk and made everyone feel more comfortable. We all washed so much too, mums, dads, and staff.

All in all it was a very positive experience, even in the circumstances.

Good luck everyone, from one very happy mumma. 💜

*****

Thanks for taking the time out to share that Kay, and congratulations!

Birth in a time of Covid-19 – highlights from the RCOG guidance

The Royal College of Obstetricians & Gynaecologists is carefully monitoring all evidence as it’s released. So for up to date information, it is definitely best to read the advice on their page. The below is current as of 31st March 2020:

Generally, pregnant women do not appear to be more likely to be seriously unwell than other healthy adults if they develop the new coronavirus.

Based on the evidence we have so far, pregnant women are still no more likely to contract coronavirus than the general population.

What has driven the decisions made by officials to place pregnant women in the vulnerable category is caution.

It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms.

If you think you may have symptoms of COVID-19 you should use the NHS 111 online service for information, or NHS 24 if in Scotland.

Our advice remains that if you feel your symptoms are worsening or if you are not getting better you should contact your maternity care team or use the NHS 111 online service / NHS 24 for further information and advice.

The most important thing to do is to follow government guidance [to reduce the risk of catching coronavirus].

It is really important that you continue to attend your scheduled routine care when you are well.

If you have any concerns, you will still be able to contact your maternity team but please note they may take longer to get back to you

There is a long FAQ section in the Royal College of Obstetricians & Gynaecologists advice so it’s likely most questions you have may be covered there.

Stay safe, and look after yourselves.

x

Big Birtha

Birth Story – Twin Home Birth at 42+2

I love a good birth story. And a twin home birth story? Double the fun!

I read this one recently on Chilled Mama, and knew I wanted to share it with you. It’s not a plus-size birth story, but I do think there are some relevant messages about it being the woman who does the allowing, and about how important it is to get the right support. So thank you to Cathy from Chilled Mama, and Laura for sharing this story.

Twin home birth - Caitlyn and Evelyn
Caitlyn and Evelyn

I’ll let Cathy from Chilled Mama take over from here:

Many women are told ‘you’re not allowed to …’. Not allowed to have a home birth with twins. No water birth with twins. Not allowed to have a home birth after 42 weeks.

This birth story comes from Laura, who knows it is women who do the allowing. Supported by AIMS and local consultant midwife, to have a positive home birth previously, finding herself pregnant with twins, she knew she was the one making the decisions about their birth. Her body. Her baby.

Here’s her twin home birth story:

Upon finding out out at the 12 week scan we were expecting twins ( 2 sacs, 2 placentas) I was told ( yes told!) at the time I would be attending the twin clinic at the hospital from now on for all checks etc. This immediately set me on edge. I hate hospitals; many bad experiences including the birth of our first left me traumatised even more. When I fell pregnant with our second I went through AIMS and was put in touch with the consultant midwife, previously known as supervisor of midwives, who came out to the house to talk through everything that happened first time and put me at ease about planning a home birth. Having our little lady at home went perfectly and was so cathartic for me restoring my faith in my ability to birth. 

With twins I knew a home birth would go against the grain so back to this wonder lady I went explaining I didn’t want to have my antenatal checks at the hospital, I wanted to stay with the community team and treat this twin pregnancy as a normal pregnancy until such times as we had evidence to suggest otherwise. This was arranged and we followed the normal schedule of antenatal checks. We had the anomaly scan as normal at 20 weeks showing everything was as it should be so for the time being I declined further scans as babies now just needed to chub up. 

Roll on to November we started to prep for the home birth. We discussed how early we were prepared to stay at home, for the midwives it was 37 weeks, for me I was happy at 36 but I also knew my history was long gestations so I just had to hope we’d make it to 37… we did! Everything in place, pool up, equipment here, team on call, we were all ready to go. That was 19 Dec! 

So we waited and still no babies and carried out the normal antenatal checks at the community clinic once a week, everything always as it should be so no concerns. I was always worried how I’d cope over Christmas and new year with our older two with nursery and play groups etc being off and it was definitely hard with them in the house so much. Hubby was due back to work on 1 Jan so in the absence of babies off he went not wanting to waste his leave. Getting to 40 weeks was quite surprising but again every check showed happy babies and my health remained stable. 

At 40 weeks I did start going down to the hospital to see the consultant midwife and each time we would do a trace of the babies, check BP etc everything always perfect. At 40+3 we did a scan to check fluid levels and placental flow. We also tried a sweep in the hopes of moving them along, generally I would always decline a sweep and have in the past but felt I wanted to try something. We followed this pattern checking on the babies on a Tuesday and Friday each time to check we were safe to wait a few more days. 42 weeks came… and went!!!

At 42+1 (Wednesday) the dream team midwives were coming to the house to check on the babies and discuss next steps… one had a weekend away booked, the other had commitments on the Friday and Saturday so while medically there was no reason to do anything, should the babies not be here by the Thursday night the midwives who would come would not be those I had been working with and trusted which did make me nervous. As it was in the 10 mins before the midwives arrived I thought I had had 2 contractions… one midwife had been awake 36 hours at this stage attending the birth of her grand child so she ran off home to bed. 

Contractions didn’t come to much while seeing to our older two, by 9.30pm they were starting up again so I tried to go to bed and rest. By 11 ish I had to get up, I had a feeling the pool needed started and things organised. At 12 I messaged our doula to say no rush yet but head over, I had the pool filling and the bath so I could get some relief while waiting for the pool. Not long after this I also messaged the consultant midwife feeling terrible that she wouldn’t have had much sleep but knew I couldn’t leave it any longer.

Our doula arrived about 12.30 and just quietly sat with me in the bath as things picked up. After maybe 20 mins I asked her to call the midwife just to make sure the team were on the way, unknown to me they had snuck past the bathroom door and were getting organised. Around 1 I got into the pool at last and got the gas and air going, which felt so much better. That was me in place, I could get my earphones in and my hypnobirthing CD on and go away. 

The sensations had familiarity this time and I could feel as the first baby came through my cervix and felt able to pull back and let it come slowly. Baby crowned relatively easily and again I felt able to hold and breathe while she turned. One final surge and there she was… at 01.35 such an incredibly tiny baby! I don’t think I’ll ever forget or forgive the midwife’s next statement… “Don’t tell me we have undiagnosed triplets!!!” 

One thing was for sure though, this was no overdue baby! Immediately I was so glad I’d stuck to my guns and declined induction, this wee one looked like she needed a few more weeks in the oven. 

As it was we got very little time to dwell as contractions started up again within about 4/5 minutes, seemed like no time at all. I tried to leave baby with her cord and bless them the midwives tried to hold her to me as the contractions were full on straight away but I just couldn’t cope with her there, I was worried I was going to squash or drop her. Quickly we got her cord cut and she went off for cuddles with daddy. 

I could feel the midwife trying to feel for twin 2 position, we knew it had been head down but also that it now had a lot of space to play. As it was the contractions were just coming too fast and I heard her say we’ll just need to be surprised. Again I could feel baby coming down and again tried to hold back and let it come slowly. At 02.10 we had another little lady… who behaved impeccably and stayed head down, born in her caul no one even realised she was out until I sat back and got her out the water. Obviously much bigger than her twin, she was the carbon copy of her older brother and sister, daddy has genes of steel! Again with little time to dwell contractions came back with a vengeance for the placentas.

Again I tried to hold on to baby but these were massive surges that took all my focus and again we had to cut her cord tho I think she got about 5 minutes with it. I always said I wouldn’t want a managed third stage but I did feel after maybe 10/15 mins that I was just so wiped I just wanted it done. Asking the midwife for the injection she was a bit taken back knowing I hate needles but got it sorted quickly and thankfully it was over. I have honestly never felt so depleted I couldn’t even open my eyes.

Soon after the midwife started to get a bit anxious saying she could smell the iron in the room and was concerned over blood loss and wanted me out the pool so I made it out and set up camp on the sofa. At this stage I think I downed two bottles of Lucozade in an attempt to get myself back up. The after pains were also horrific and I was sucking on the gas and air as much as I had done through their births. However after a while I really wanted a bath and the lead midwife started to look like she was hitting a wall she must have been so tired now part of me was keen to show her I was okay to give her the peace of mind to be able to go home. Sadly this is where I’d went a bit haywire….

I got up and made it through to the bathroom but was starting to feel faint so sat down in the toilet seat thinking I’ll be fine in a minute. Sadly I wasn’t, my blood pressure dropped dramatically and I blacked out… the next thing I knew I was aware of a phone call for an ambulance and they were getting me on to the floor to stabilise me.

By the time the paramedics arrived and they exchanged the information needed I was feeling a bit better again, I think lying on the cold floor actually helped me. So much so the midwives were actually saying they didn’t think it was a medical event, more a lack of sleep, not eaten and yes a little more blood loss than ideal but I had stopped actively bleeding so she said if I wanted to stay at home she was happy for me to do so as long as I could make it up to pee as my bladder was really full. However as soon as I tried to get up again I could feel how weak I was and even though I hate hospitals, even I said I think I should go in. So off we went…. two babies, daddy, 3 midwives and our doula.. we were quite the cavalcade!

Thankfully in the end all they really had to do was feed me and give me some stronger pain killers. They checked my iron levels which had dropped 3 points so they said to start taking the iron tablets again but otherwise I’d be fine with time and chance. Again the consultant midwife had made sure I was looked after and had a room to myself and all the midwives on the ward had been asked to leave me alone unless I called to give me a chance to rest. By mid afternoon I felt strong enough to make it home so it wasn’t too bad in the end. It was more of a visit to hospital rather than delivering there which I would have struggled to cope with. 

So that’s how it came to pass that we had our twins delivered at home at 42 weeks and 2 days. I’m forever indebted to the consultant midwife who could not have done more to support me and orchestrate everything to make sure my wishes were carried out right to the last. And all from a supposedly failing NHS…. it just goes to show what patient centred, evidence based care can achieve. 

Laura, Caitlyn and Evelyn

I’m in complete agreement with Cathy here. I love this story because it shows what is possible. You have to ask for it. You may have to talk to the right people. But it is possible. It also shows the value of patient centred evidence based care, as Laura says.

If you have a birth story you’d like to share with the Big Birthas audience, we’d love to hear it! You can contact Big Birtha here.