'I had a panic attack in labour': Mums of pandemic babies reveal their struggles

More than two years after the first lockdown, Jen Stevens speaks to mums who gave birth during the height of Covid restrictions. For many, loneliness was the most difficult part of a challenging experience

Fri, 08 Jul, 2022 - 02:08

Jen Stevens

As the first babies born during the global pandemic turn two, it’s time to look back on the altered healthcare mums of newborns had to navigate.

Hospital restrictions, lockdowns, limited postpartum care and difficulty getting into GP surgeries meant new mums often felt abandoned during their most vulnerable time.

I had my second daughter six weeks before the first lockdown in 2020 and experienced first-hand how those changes affected our early months together. From a six-week caesarean check-up that had to be done over the phone, to a limited public health nurse service, the difference between the early care my first daughter, born in 2018, and my second received, was marked.

Over the past two years, I have spent a lot of time speaking to mums who gave birth during the pandemic. In early 2020 while things were new, scary and uncertain, it felt like we were all just trying to get through it.

But as the pandemic continued, and following more discussion around maternity hospital restrictions, the conversation opened up.

Like me, I have built up an online community of mums who struggled through those first months. I put up a poll on Instagram (see the sidebar) asking how they felt about the restrictions in the run-up to the birth, during their time in hospital, when they got home, and now, hoping to reach more pandemic mums.

More than 400 responded, many following up with direct messages.

Some didn’t mind the time alone in hospital, but one in five are still feeling the effects of their births and are only beginning to realise now how hard it was, and others are left with continuing problems because of restrictions.

More than anything else, almost half (48%) of the respondents found the experience of returning home from hospital with a new baby incredibly lonely.

Even if their partners were home with them, not being able to spend time with grandparents and other family members, not being able to share the exhausting mental load of the first 12 weeks over coffee with friends, and not having the usual post-birth supports, was upsetting.

Having concentrated on the restrictions around labour and the birth for so long, the loneliness and lack of support in weeks and months that followed were a real shock.

Others spoke about the change in public health nurse care (46% said they received either no, or limited, support from their PHN) and the difficulty in accessing breastfeeding support.

A woman, whose story echoes my own, tells me on Instagram: “I had a baby in November 2019, so all was normal in hospital, but my god, did I struggle from March onwards.

“No support from GPs and public health nurses. No development checks etc, and we could barely get appointments for the GP when she was sick. She was my first, so I had no clue and was googling everything.

“I have a lump in my throat writing this because I remember how lonely I was in 2020 with her. I can’t imagine how bad I would have been in hospital on my own.”

Jen Stevens with her daughters Molly, who was born in 2020, and Mae who was born in 2018.

The impact on maternity care

Professor Valerie Smith, from the School of Nursing and Midwifery at Trinity College Dublin, has been researching the impact of Covid-19 on maternity care. She has published three reports based on her research, with more to come.

Smith and her team received funding from the office of the Dean of Research at Trinity College, which resulted in a two-phase study. They first looked at the clinical outcomes in pregnancy, childbirth, and postpartum for the four months before after March 2020. The second study interviewed 19 women in The Coombe Hospital about their experiences of maternity care.

The first phase was an audit of almost 2,500 women who gave birth in the four months before March 2020. “While we found that there weren’t significant changes overall in clinical outcomes, there were a couple that did surprise us. The first was that, though the caesarean section rate didn’t rise or change, there was an increase in caesareans in women who had had babies before. It was a rise of 5% for multiparous [more than one child] women, and that was a bit unexpected. There was a slight decrease in caesarean section rates in first-time mums by about 2%,” says Smith.

“For us to interpret that data, we would need to do a deep dive on individual records, which we can’t do. But thinking about it from a clinically logical sense, the fact that multiparous women are having more caesarean sections, it may be that rather than planning for a vaginal birth after caesarean, they opted or were advised to opt for an elective caesarean section. In those early days, there was a lot of control over footfall into the hospital, and women were only coming in when necessary, and there was a lot of fear, both on the women’s part and the clinicians. That probably explains or could go some way to explaining some of those changes.”

Smith also found changes in the treatment of women who were ten days or more overdue. “More women were being left later for induction perhaps rather than being brought in a bit earlier for induction. Maybe women weren’t coming in with the same concerns, and that might have led to being induced a little bit later.”

The issue of ‘control’

When reading Smith’s research, the word, ‘control’, comes to mind. When, where and how a woman was to give birth and how that could be planned out seemed to be an issue in the early months of the pandemic. When the TCD team spoke with the women who had recently given birth, the need for control played out.

“Yes, that word, ‘control’, came up a lot in the qualitative research where we interviewed women. There were comments like opting for an elective caesarean section because it did give some control over knowing when the baby was born. That came out in the global evidence as well. We found that what women in Ireland were saying was very much resonating with hospitals coming out across the world.”

The researchers also found a marked increase in the augmentation of labour, where labour starts spontaneously for women and is speeded up by either the waters being broken or oxytocin.

“We found that increased significantly, particularly in the first month after or during Covid phase,” says Smith. “It could be related again to control. Sometimes, particularly for first-time mums, there is a latent labour phase that’s quite lengthy. They’re having contractions, but they’re not in full established labour, and then their partners are outside in the car park or waiting to be called in. Again, I can’t read this conclusively, but it makes sense from a clinically logical perspective.”

The pandemic dramatically changed the HSE’s delivery of pregnancy care. “Those alterations to how care was structured were quite unsettling for women navigating systems that were very changed and particularly postpartum with public health nurse services, GP services and breastfeeding support services.“

But the most significant change women had to deal with was not having their partners by their side during labour, says Smith.

“The overriding thing, which again very much comes across in the global evidence, was the lack of partner presence. There were mixed views around restrictions in general and some people were happy with visitor restrictions, but nobody wanted partners excluded. That was very hard and came across in all the research.”

The arbitrary nature of restrictions

Loneliness in hospital and during the weeks at home afterwards, the immense sadness at being kept apart from a baby in NICU, a perceived lack of postnatal care, postnatal depression and anger are the overriding themes that come up time and time again in our online conversations.

Many mums I spoke to were upset at the arbitrary nature of restrictions. As in Smith’s research, they didn’t want visitors, they just wanted their partners with them.

“I ended up having a panic attack in labour and am currently starting to wean myself off medication for PND, which I didn’t have with my first child. I wasn’t once tested for Covid, and my husband wasn’t either. When he was allowed in, he couldn’t use the bathroom on the labour ward but was allowed to wander around the hospital alone to find one. None of it made sense. We didn’t want visitors, just our partners. My husband wanted to be there with me and support me. We still get very upset talking about it,” a mum who gave birth early in the pandemic tells me.

Things were unimaginably difficult for women whose babies were sent to NICU shortly after their birth. Time with their babies was restricted and had to visit alone at a time when they needed more support than ever.

“We had a healthy full-term baby who went into NICU for nine days at 24 hours old. That was the hardest part of being a pandemic parent, I was discharged home without him. I got five hours of visiting time for seven days, my husband got to see him for one hour a day on those seven days. We weren’t allowed to be in the hospital building at the same time as each other. It was an incredibly challenging seven days for my husband and me. I feel new parents/expectant mums were really let down by health officials during the pandemic,” says a mum whose baby was born in 2020.

Then there are the women who were alone when they had to receive devastating news. No one should ever have to endure the silence of an ultrasound with no heartbeat without someone at their side, and yet it happened up and down the country during the pandemic.

“Along with having a pandemic baby in 2021, I also had a miscarriage at 11 weeks in July 2020. This was horrific. I found out at my booking scan that it was a missed miscarriage. I had no husband there; it was such a shock all on my own.

“I had another scan seven days later, followed by a D&C a few days later. All alone. Partners weren’t even mentioned. It was so traumatic and lonely. It felt like my husband didn’t even feel that it happened. I felt angry about that, and he felt lost,” a mum who lost her baby tells me.

One woman points out that we often dismiss women’s trauma during birth as something we should immediately be fine with because we have a healthy baby at the end of it, that a happy outcome is enough reason to keep quiet and not complain.

Professor Smith plans to continue her research into post-pandemic maternal health and follow parents who had a baby during that time to see how they fare in the years that follow. It is refreshing to see the focus on parents.

As restrictions return to certain health care settings because of the latest wave of Covid-19, it is hoped maternity hospitals will take the research of experts like Smith on board and remember the mothers who hope to never again labour, recover or face loss alone.

Poll: Mothers have their say

Instagram poll (400+ respondents)

Was this your?

First baby -30%

Second baby -51%

Third baby or more -19%

How are you now?

Great -32%

Fine - 32%

Some lasting effects -20%

Still processing -16%

Did you get support from your PHN?