How will we count the cost of having a baby during a pandemic?


Eva Wiseman

Sun, 1 May 2022, 8:00 am

<img src="https://s.yimg.com/ny/api/res/1.2/oN9JzvK.3ZeDv7SDQQii7Q–/YXBwaWQ9aGlnaGxhbmRlcjt3PTcwNTtoPTQyMw–/https://s.yimg.com/uu/api/res/1.2/hDpcQYNVjEDufmJIOLS8Hg–~B/aD02MDA7dz0xMDAwO2FwcGlkPXl0YWNoeW9u/https://media.zenfs.com/en/theguardian_763/45f6d62893601a263490b94e18835af6&quot; alt="<span>Photograph: Alamy
Photograph: Alamy

Two years ago today a good witch came very close and looked into the blacks of my eyes and said: “Look around, this is not your first birth. Everything’s different, it’s going to be OK,” then a few minutes later slid a new baby on to my chest and this was how our pandemic began.

Everything was different. Lockdown had started the week I went on maternity leave, and I gave birth in a time of PPE shortages and hands cracked from soap, and the prime minister leading the government from his hospital bed. There were no lateral flow tests then. The nurses who so elegantly looked after me were figuring things out as they went along – grappling with latex gloves, their plastic gowns man-sized, too long and too large. Soldiers had converted an exhibition centre in east London into one of the world’s largest hospitals; in Liverpool council bosses were discussing how to “grease the mortality highway” to prevent backlogs in mortuaries. Refrigerated shipping containers were accommodating extra bodies. Outside the hospital, I eyed a blacked-out coach with a livid kind of dread.

I’d worked hard, by then, to try to move past the traumatic “first birth” that Deborah, that magical midwife, was talking about – a lot of mental admin and planning to try to avoid similar shocks and glumness, but no amount of planning could have prepared me for this, this weightless fear, this fog of unknowingness. Across the country people were going to scans alone, partners only allowed into the hospital during “established labour”, with all postnatal visits cancelled. The Care Quality Commission found a significant fall in the use of pain relief, a rise in caesareans and fewer women being offered support as they recovered from childbirth. There was a low sort of ringing in the air.

Two years later, free testing has ended, my baby can count to 17, and maternity and neonatal services are having to adjust quickly once again. In University College Hospital this January, a woman who was testing negative was kept apart from her baby for days because her husband had Covid – . After the charity Birthrights challenged the hospital it changed its policy on neonatal visiting. Last month, they wrote to three English hospital trusts urging them to also review their visiting restrictions and in March threatened a Welsh maternity service with legal action, arguing they must weigh the evidence of trauma inflicted on families separated at such a significant moment against the need for infection control. Why could partners stay for one hour and not more? Were the risks of two, or six hours so much greater?

The legacy of this pandemic must be services that are shaped around mental health as well as physical health

Maria Booker

Another charity, Pregnant Then Screwed, has marked two years since lockdown with a film warning that the rise in postnatal depression will be huge; a mental health epidemic yet to come. People who gave birth during the pandemic shared their experiences, one saying she’d left the hospital with PTSD.

As someone who thought a lot about their first birth for many years after, and only now has the distance to judge my flimsy mental health in the time that followed, I can feel that threat keenly. We’re yet to see exactly what this mental health epidemic might look like, what it will do to families born out of those sanitised months, rich in banana bread, low in comfort. So, “The legacy of this pandemic,” says Maria Booker of Birthrights, “must be maternity services that are shaped around protecting mental health as well as physical health.” She’s concerned whether hospital trusts have learned the lessons about taking the widest view of safety and incorporating human rights into their decision making, regardless of whether a pandemic is raging.

The crushing thing, I realise now, about giving birth in lockdown, was that many of the common and regular anxieties about having a baby were realised even before we’d left the house. What if something goes wrong? It already has! What if I can’t do this by myself? Good luck! What if, in the long days that follow, I’m excruciatingly lonely? You will be! Nobody’s dropping round, nobody’s coming to hold your baby while you shower off the dried blood, no professionals will be popping in to quantify your sadness. I mean, there were lovely things, for me, about having a baby in 2020, but I think largely it’s been a shitshow, with women in the UK (as reported by the Maternal Mental Health Alliance) experiencing a combination of lockdown, job insecurity, the impact of the virus itself, and a reduced ability to gain access to perinatal health services and mental health services.

Though this morning my two-year-old was more interested in breakfast cake, which is a thing now, I found myself telling him the story of his birth. The endless early lockdown deliberations about whether it was safe for my mum to drive us to hospital, about who was allowed to look after our daughter while we were gone, the empty streets, the newness of face masks, and how everything was different. And how for the first time in a month, that idea – that everything was different – was suddenly and briefly, amazing.

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