Some of this post could be triggering to those who have experienced birth trauma. Please be mindful of this if you choose to read it.
I need to stop following covid case numbers. They aren’t changing anything for me beyond a creeping anxiety that every slight cough my children make is a sign that something is amiss. And today, oddly, the announcements about changing hospital policy and pauses to elective surgeries have me thinking about hospitals, expectant mothers, and the heightened probability of trauma from birth and early motherhood in covid times. I’ve found myself today going over my own births, wondering what they would look like in the current outbreak.
If I believed in a god of some kind, I’d pray whispered wishes into the ether like my grandmother would always do for the expecting mothers waiting, swollen and exhausted. I suppose this post is my version of that — some sign to the world that I’m wishing them well in the only way I know how. Those final days are meant to be calming, time to let the body and brain prepare for the change to come. Time to help the body feel safe.
It is a difficult time to feel safe.
How many women are waiting at home, wondering if their hospital trip will lead to infection? How many are wondering if they will have the support they need, between staffing issues, restrictions on support people, and the massive and unprecedented changes going on with our healthcare system right now? How many will decide to simply stay home? To birth where it feels safer, somehow? What traumas will these mothers take on even before their labour starts?
I think back to my own births. With my first–breech–those final days were filled with monitoring, arguments with doctors, procedures, my midwife’s calm support, and my simultaneous stubbornness to accept that the child would not turn. All of it replaced, at just under 42 weeks, with a resignation that there were no more options. I had a c-section then, ‘elective’ even though I had no choice in the matter; my eldest wasn’t coming any other way and time was up. I assume these situations are exempt from the pause on elective procedures, but wonder anyway when I see the news. About that and all that comes with it. The support people that might now need to Zoom in rather than hold the mother’s hand. The mother, bloody and immobile after surgery, pliable in the hands of successive midwives who are mostly lovely and mean well but are also strangers that have sometimes forgotten that birth is not a daily practice for those in their care. The doctors, who also mean well, but sometimes let their own unprocessed trauma get in the way of their bedside manner, and who also may be short staffed and exhausted in the face of the ongoing pandemic.
In these moments, mothers need advocates more than ever — people who will speak for them when they are not able to, people to pick up slack at home, to hold the crying baby, to change nappies, fetch food, keep well-meaning visitors out when it’s time to rest. To make them laugh, bring them cups of tea and ice packs and coconut rice pudding and lanolin cream and tell them that yes, it is normal to cry for no reason. Mothers need this, yes, but in this time, thanks to covid, this kind of support is impossible for many to find.
With my second birth, closed borders meant we strung together a patchwork of local support as well as we could. A babysitter who was ok with being on call. A doula in case the babysitter fell through and my partner had to stay home to look after my eldest, who wouldn’t be allowed in the hospital. A series of ‘what ifs’ sketched on paper, three copies of birth plans in plastic with my partner and doula both clearly named in bold and underlined as support people, and a suitcase packed and ready. In the final days, each midwife and doctor I saw had different interpretations of the ‘covid-safe’ hospital policy at hand. I remember wondering why people weren’t wearing masks in the waiting room and being told my doula would only be allowed if the doctor on call said it was ok on the day (and good luck). More ‘what ifs’ to sketch out on paper. More calls to make. On the day of my second’s birth, luck was in my favour. The babysitter showed up; my amazing doula (nearly due to have a child herself) was able to attend and allowed in; there were plenty of empty wards and a team of doctors and midwives that were, to be frank, the best I could have hoped for given my ‘high risk’ VBAC category. And yet. 15 hours after my water broke, 7 hours after arriving at the hospital (and still 4 more before the birth), I realised it wasn’t enough. And yes, there were consequences — but again, I was lucky, and I am grateful. We were all ok in the end.
What would have made it better?
Being able to bring my eldest to the hospital. Having family my child knew come to stay. Knowing everyone (myself included) was safe.
That was then, this is now, and the risks are very different–both to the mother, the child, her supports, and to the healthcare team. I get that. But I wonder how we manage this better. If this is indeed ‘covid normal’, and we are meant to find a way to adapt, how can we arrange things so the system is safer AND provides sufficient support to mothers–and to families more broadly? Are there people thinking about this? Is this considered when hospital policy is set?
It’s too easy to let the traumas pile up, to simply leave it to the mother (and her child, and possibly her child’s children, and perhaps one more generation after that) to deal with the very real long-term consequences that lack of support can bring in this particularly vulnerable time. It is easy because these things are often unspoken, often unrealised, and the extent of the impacts are not easily quantified. Not in the same way that infection rates and room occupancy numbers and mortality and (physical) morbidity are. They are also scars mostly borne by women, but perhaps I should save that rant for a different post.
Do I have the answers here? No. I can only say that I’m not sure we’re asking the right questions if someone’s experience in birth depends so precariously on who’s on call that day. I can also say to any new mothers out there that these times are unprecedented and you are not alone. My advice? Be kind to yourself. Get support in any way you can. Know you are most likely going to have to advocate for yourself and what you need, so practice it, plan for it, and figure out how to get others to advocate for you when you can’t — even if they can’t be there by your side, in person.
I’m keeping all my fingers crossed that you have luck and the right people on call when the day comes.
Feature photo by Barbara Ribeiro on Pexels.