The report states “that changes [to standard maternity care] are proving to be inconsistent, confusing and stressful”. While, of course, that is very worrying I think this report provides overwhelming support for the concerns I expressed in this blog on the 16th of April namely that what is happening in maternity care provision during the Covid-19 pandemic will inevitably result in an uptick in stillbirths and other poor pregnancy outcomes. This increase in stillbirths. Has already been noticed in some countries, like Scotland. Reading quotes like this [some with my emphasis] are enough to make us all lose sleep about the unintended consequences of changing maternity care on Australia’s stillbirth rate:
Lack of access to information:
I have been having a hard time getting access to information as I have been told to stay away from the hospital and to go to private places for my scans and test which is costing me a fortune. I have felt so alone because my GP has become overwhelmed with appointment and I feel like I have to rely on google for answers.
My antenatal classes were cancelled and I have received no resources or information instead even after asking multiple times. Very disappointed with the level of care I am currently receiving.
Concerns re telehealth
How can a telehealth appointment check vital signs such as blood pressure, heart rates, feeling where baby is, thyroid checks etc. Just feel there is a lack of care for pregnant women right now.
I am 20+4 with high blood pressure high risk pregnancy. I was told I have a high chance of losing the baby any day from 20 weeks onwards. But due to covid 19 I’m only allowed phone appointments. I don’t see how that eases my anxiety and helps me stress less over this baby, when I can’t be thoroughly checked over the phone.
The lack of face to face and ‘rapid assessments’ is very impersonal. I feel pretty unsupported during these especially vulnerable times for pregnant women.
I haven't been allowed to have any face to face appts at the hospital, I haven't had any physical assessments/routine antenatal care performed, I haven't been able to meet any of the midwives to build trust, hospital tours have been cancelled and it sounds like caseload midwifery isn't really happening. The phone appts are less than 10mins and feel like a quick box ticking exercise to make sure their paperwork is in order. It's not contracting Covid-19 that worries me. It's giving birth in an unfamiliar environment with restricted care provided by total strangers that scares me.
Knee jerk policy and practice
I am concerned non-evidence based knee jerk reactions are becoming policy without
consideration to more favourable alternatives and without any consultation or regards to birthing mothers. And no care for the consequences... Excess stress is being imposed on pregnant mothers due to hospital policies for "everyone’s" health but no regard for the known health impacts of that stress on mother and baby.
A lot of the policies are irrational and cruel and have irrational rigidity with regards to enforcement (eg. Children cannot come, and you don't have childcare options? Too bad no care for you!). I'm also concerned many aspects may become normal practice after the pandemic is done. Scientific evidence is not being used to make policies. Unintended consequences are not being considered or even heard. Mothers are being treated like leapers and like their needs are luxuries and they are idiots.
Worst care during this pregnancy. They stuffed up my initial appointment then gave me one 2 weeks later. Now there’s no plans to have any appointments until after 28 weeks and they are over the phone so I had to arrange all my blood tests including glucose tests otherwise they would have been missed. No one has checked fundal height etc.
Removing choices from pregnant/ birthing women is a gross negligence of care which will result in many negative consequences and adverse outcomes for women and babies. There is nothing remotely acceptable about what is currently happening in antenatal, birth, and postnatal ‘care’.
No partners in scans, what if there was no heartbeat? No one should be alone for that.
I understand and support the restrictions however they are causing me a lot of grief and sadness. I am still breastfeeding my first. He will not be allowed in the hospital and I will not be allowed out to feed him (eg in car or something). Not being able to see my firstborn while in the hospital is awful. We also have no family support here so I am terrified I will deliver and be in the hospital all alone.
So if women are not getting the usual access to information, are not being physically assessed nor emotionally supported and they know their care is not of a high standard it doesn’t take much to figure out that the impact on pregnancy outcome is likely to be very poor. I for one am holding my breath to see just how poor!
I’ll finish with this quote that seems to sum the report up pretty well!
The standards and quality of care has gone to complete crap since coronavirus. The required support no longer exists in preference for 'the basics' in order to preserve health and fight the virus, forgetting entirely that midwifery care and the support needed around pregnancy birth and postnatal is so much more than ensuring a basic minimal level of physical wellbeing.
What about holistic health and wellbeing? Maternity care has been stripped back to if you’re alive and so is the baby, that'll do. Communication in particular is suffering, phone calls are insufficient to be 90% of care, we communicate with so much more than words.
Understanding, openness and a two way conversation that facilitates empowerment and informed choice is not something we are used to doing completely over the phone and so it's
not done well at all. I'll stop now because I could go on forever, but know this, women and babies are suffering as a result of the lowered standards of care. And the question really needs to be asked, is it worth it? You hold in your care not only my current health and wellbeing, but that of all my future pregnancies and births as well as setting up the lifelong
health of my child. I've entrusted that to you, don't let me down.
Surely, given the seriousness of this report the changes made to maternity care have NOT been worth it AT ALL!!!!!