As we enter another lockdown, still in the shadow of the first, for many life is only just beginning. Babies continue to be born and many new mothers are facing an additional challenge from Covid-19 amidst the turbulence of pregnancy and birth.
The constraints of the pandemic have resulted in major changes to antenatal and perinatal NHS and community services. Some new mothers say this has left them experiencing mental health challenges, negatively affecting their first steps into motherhood.
However, two of Bristol’s charities supporting pregnant women and new parents, Bluebell Place and Mothers for Mothers, have continued to work hard throughout this extraordinary year to provide mental health and wellbeing support for new parents most in need.
Twenty-one-year-old Sarah* gave birth to twins in September, at St Michael’s Hospital – one of Bristol’s two main maternity units, along with Southmead Hospital. Sarah says she feels her pregnancy, birth and postnatal mental health were impacted by the sudden limitations brought by the pandemic.
“Midwife appointments were being done over video call and my partner was not able to attend appointments with me,” Sarah says. “When I went to the hospital with labour symptoms, I had to attend alone.” During her stay in hospital once her twins were born, Sarah’s partner was not able to visit as often due to Covid-19 restrictions, leaving her feeling “overwhelmed, isolated and low” while caring for premature twins. “Had I had my fiance with me for more time during the day, it could have helped,” she says.
Despite the difficult physical and mental experience of her hospital stay, it was eased a little by the dedication of “amazing midwives and nurses, who bent over backwards for us”. She adds: “I think the strain of the measures in place is just as frustrating for them as it is for us.”
Sarah believes she has now developed postnatal depression as a direct result of the coronavirus restrictions on her antenatal care and hospital stay, and has sought help from perinatal mental health services and charities. But she believes there is still a backlog of parents waiting for support.
Another new mother, Emma*, 29, also says the pandemic restrictions negatively affected her birthing experiencing and perinatal health. She was thought to be positive for Covid-19 during her induction process, due to a mildly raised temperature, which she believes was due to environmental factors. Her partner was allowed to visit for just two hours at the start of the induction, and had to wear a mask and apron. The couple was not allowed any physical contact.
“I was already a bit wobbly about the induction and as lovely as the midwives were, it wasn’t the same as having someone close to you there,” Emma says.
Because of her potential Covid-19 status, Emma remained in isolation on the delivery ward, spending the night on a delivery bed. “It was horrible, I had no idea what was going on,” she says. Her partner was allowed to join once her waters had broken but had to wear personal protective equipment (PPE) for the 14-hour labour. Emma says he was not allowed to leave the room at any point. Despite being repeatedly tested throughout her induction, Emma only received a result – negative for Covid-19 – after her son had been delivered.
The reverberations of the pandemic continue, with Emma receiving her first postnatal checkup with her GP over the phone, rather than in-person. “I find it frustrating as recovering from birth is obviously a physical process as well as a mental one,” Emma says. “The biggest impact has been the feeling of isolation.”
At the beginning of the pandemic, the Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) worked with NHS partners and service users to formulate Covid-19 guidance, modifying maternity care in NHS Trusts. In their most recent winter planning statement, they note that these modifications were widely adopted and “included temporary reduction of in-person appointments, the increased adoption of virtual appointments, and consideration of a reduction in birthplace options”.
The statement goes on to identify some challenges Covid-19 has caused to maternity services, and acknowledges that “the need to wear adequate PPE creates barriers to communication”.
According to the statement, some NHS Trusts have found it difficult to restore full maternity services, such as birth partners at appointments, scans and early labour. The RCM and RCOG acknowledge that this has led to distress for some women and birth partners and that the pandemic has “created new anxieties for pregnant women and their families”.
This tumultuous time has been recognised by charity Bluebell Place, based on Quay Street in the city centre. Their staff have been working throughout the pandemic to continue to provide support for new parents.
“Being a new parent in a pandemic was going to bring a new set of challenges,” says Bluebell’s operations manager, Jodi Dowse. When the first lockdown began in March, began delivering flexible ‘buddy’ support sessions via telephone. Another support outlet was the Mums Comfort Zone group, which previously ran as a drop-in meeting at the charity’s hub – supporting around nine mums at a time by offering advice and social support. This group was adapted into an online Zoom session to continue to deliver much-needed social interaction for new mothers.
New dads were not forgotten either, with the Dads in Mind support group moving online and the continuation of one-to-one support calls.
On Facebook from March to August, Bluebell reached almost 330,000 people. Their most popular posts were about self-care and managing anxiety. Jodi says the Bluebell team has noticed a “new level of anxiety and isolation” in new parents and believes this can be attributed to being unable to meet with friends and groups like they used to.
The charity has also experienced an increase in self-referrals recently. “Knowing you are not alone with your feelings and knowing someone is at the end of the phone is so important,” says Jodi.
Mothers who gave birth in the months preceding the lockdown have also borne the brunt of its affect. Rachel*, who gave birth in January 2020, feels her mental wellbeing was affected by the unexpected restrictions brought by the country locking down, which directly impacted her first months of motherhood.
“There was none of that reassurance you get from family members and groups who have been mothers before,” says Rachel. “You get so much from seeing other people – I just couldn’t get out and about, couldn’t travel, couldn’t see them. I was anxious about what I was and wasn’t allowed to do. I will never know what could have been.”
The challenges that these new mothers have all been facing is at the forefront of the support offered by Withywood-based charity Mothers for Mothers, which specialises in antenatal and perinatal care. The charity began preparing before the first lockdown to move its face-to-face services online, and its helpline, which has been operating for nearly 40 years, continued to be open for referrals.
Support phone calls, messaging and Zoom video calls were all available with a member of the peer support and health visiting team, as well as doorstep deliveries to families most in need. During this second lockdown, many of these services have continued.
Maria Viner, CEO of Mothers for Mothers, feels the challenges of the past six months are very apparent: “Women who were already experiencing isolation, anxiety and depression in pregnancy or after birth were left without the support networks they relied upon. The restriction of being unable to see family, friends and attend supportive activities added to their distress.”
Viner says she is concerned for pregnant women and new mothers, highlighting that women face attending important appointments alone, not having the birth experience they planned, a lack of face-to-face care with health professionals, not to mention anxiety about the virus affecting their new baby.
“This makes for very challenging times when managing either a pre-existing mental health condition or the onset of a new illness,” she says.
As of November 9 2020, in line with NHS England guidance, University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) will now allow non-symptomatic partners from the same household or bubble to attend 12-week scan appointments. For any additional routine scans, expectant mothers must attend alone. Full details of visiting guidance can be found on their website.
In a statement, UHBW chief nurse Carolyn Mills said: “We fully recognise that these changes may be upsetting for many of our pregnant women and their families as they journey through their pregnancy and approach delivery. However, we hope they will understand that these temporary changes are necessary to protect all women and their babies and the dedicated staff committed to providing the best care possible.”
*Names have been changed
Main image by Marcin Jozwiak via Unsplash
Julia Victor is reporting as part of Bristol24/7’s Community Reporter Scheme, a project that aims to tell stories from areas and communities of Bristol traditionally under-served by the mainstream media