Maternity and pregnancy services during COVID-19

Hannah Tweed reflects on her experience of pregnancy services in 2020.

This month the ALLIANCE and Engender launched a survey on people’s experiences of pregnancy (and everything after) during the COVID-19 pandemic.

To be frank, reading through early drafts of the survey was distinctly uncanny. I was pregnant with my daughter when the pandemic started, and she was a #LockdownBaby of 2020 – which, as a larval human with binary needs, probably did her no real harm. I’m not sure I’d say the same of my experiences as a new parent (and particularly one who spent my second and third trimesters immersed in public health policy).

COVID-19 restrictions affected everyone, but key groups were disproportionately impacted – including disabled people, people living with long term conditions, unpaid carers, and parents. It’s easy to forget now, but in the early days of the pandemic there was considerable concern that COVID-19 could harm pregnant women and children (as in the 2009 outbreak of Swine Flu).[1] It’s difficult to shift that kind of fear and anxiety, particularly when a good portion of it is warranted. Pre-vaccines, people who contracted COVID-19 in the third trimester of pregnancy were more likely to have premature births, with the ensuing health complications that can bring. I’m not at all surprised that rates of peri- and post-natal depression and anxiety spiked during 2020-21.

For those of us lucky enough not to catch COVID-19 while pregnant (I didn’t, thankfully – separate rant available about how few painkillers are considered safe to use in pregnancy), the restrictions surrounding COVID-19 risk mitigation carried significant and adverse impacts. Having a kid is both stressful and extremely uncomfortable, and anyone who tells you otherwise is either lying or currently high on Entonox (or both). To do so with reduced information and access to services, and – for many – no partner or support network available, was extremely difficult. Government advice was also frequently confused and confusing, both for pregnant people and medical staff.

Like many people, I was not allowed to have a partner with me after I was admitted to hospital. I was asked to wear a mask during labour (against recommended advice – but in line with the misinformation given to midwives on my unit). Prior to “active” labour (FYI, everything previous to that point provides a wealth of sensory experience and effort) I was not allowed to leave the bed I was allocated in order to walk or seek out food or water. After giving birth, I was also not allowed food or water until 9am the following day due to restrictions on kitchen access in my unit (rather than for medical reasons) – so I went more than 24 hours without food. I could summarise this experience in significantly fewer words, but it then wouldn’t be fit for publication.

So far, so 2020 normal; but I would argue that the difficulties of the above were compounded by a different type of disinformation and stress. As a result of COVID-19 restrictions, all antenatal classes were cancelled in my health board, and at that stage (spring/summer 2020) online substitutes had not been launched. Antenatal checks were also curtailed, with stretched and overworked staff and fewer opportunities to ask questions, which in my case led to some health issues being missed. Community groups stopped, so informal sources of information and social networking were not available. As someone who had held a grand total of five babies prior to giving birth (only one for longer than two minutes – and they still cried), this meant I was totally at sea with regards to the basics of childcare and how to keep my kid alive (or even hold her). Contrary to public perception, “maternal instinct” is not an automatic qualification handed out with your MATB1 form. Fortunately, my kid and I have survived a very steep learning curve (and she’s both hilarious and kind of awesome).

More seriously, while many of the mitigations placed on society during COVID-19 were important and necessary to allow time for vaccine development and to limit the spread of the virus, there was no requirement to cut thousands of parents off from basic information sources. Some of the onus of responsibility for that lies on national communication patterns; individuals and overstretched health boards should not have had to develop online resources on the fly, with inefficient replication of work, when a national approach would have provided some consistency and spread the workload. And anything would have been better than being directed to resources that talked at length about how important it is for parental bonding for both partners to be part of the birth process, read in the full knowledge that your partner is unlikely to be able to be present.

It is vital that Scotland learns from the experiences of people who were disproportionately affected by the COVID-19 pandemic. This includes engaging with the problems with inconsistent service delivery and advice, proactively seeking input from people who were pregnant during the pandemic, and considering how as a country we prepare and support new parents. Plenty of folk can and did “go it alone” – but we shouldn’t have to.

[1] Devi Shridhar, ‘Preventable: How a Pandemic Changes the World and How to Stop the Next One’ (2022), p. 128.

The Health and Social Care Academy in partnership with Engender (this link will take you away from our website) are undertaking a survey to find out about experiences of pregnancy and maternity services during COVID-19. This survey will be used to support our work on COVID-19 and our work to improve women’s health and wellbeing. 

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