Put the Safe Delivery App in the hands of midwives in PNG
Put the Safe Delivery App in the hands of midwives in PNG
New mothers can usually rely on a ‘whole village’ of support in their maternity journey. The COVID-19 pandemic changed that course and shone a light on newfound ways of ‘going it alone’.
Routines and practices in pregnancy such as regular antenatal care, partners attending birthing classes and baby showers were replaced by uncertainty, reduced social support and the impact of rapidly changing restrictions to perinatal care, which changed the maternity experience for Australians in unique ways.
A world-first study published in the journal Midwifery describes what it was like to become a mother in Australia during the first wave of COVID-19 in 2020.
Speaking to 27 women around the country, researchers led by Professor Linda Sweet and including Burnet Institute’s Dr Alyce Wilson, sought to find out the impact the changes had on these women’s health and wellbeing.
“Little is known about the impacts of COVID-19 on childbearing women in Australia”, Dr Wilson, a Public Health Registrar and Senior Research Fellow with Burnet’s Global Women’s and Newborn’s Health Group, said.
“What we achieved in this study is new evidence describing women’s experiences of becoming a mother during the pandemic, and recommendations for practice, policies and health services, to ensure support of these women and their families as part of preparing for the next pandemic or public health crisis.”
Constantly changing restrictions meant constant adjustments to the maternity experience and the need for resilience and resourcefulness, not only from women, but their partners, families and friends.
With no single source of advice at the beginning of the pandemic and having to deal with contradictory information and even fear mongering from well-meaning friends, mothers turned to a variety of sources.
These included social media groups and engaging with other mothers online for information about the virus, protecting themselves and their babies before and after birth, accessing services, and giving and receiving emotional support.
Women who have had children were particularly concerned for those having their first baby and played a key role in supporting new parents.
“I think if I had been a first-time mum it would have been a lot harder. This time I knew what I needed and where to get that from. I think definitely not knowing what services were around, how to access them and how they were being delivered differently – that would have been a huge barrier.” (Participant)
With a diminished circle of supporters, some women had to turn to new acquaintances who volunteered practical support such as looking after children when they needed to be out for their ultrasound appointments.
To manage the stress of constant unknowns, women sought reassurance from trusted sources. Face-to-face healthcare was one of the helpful supportive measures, showing the critical role of maternal health workers not just in physical assessments but in also providing wellbeing support.
“It was all negative, kind of how you had to deal with everything and the stresses of all of that. I think seeing a maternal nurse in person and having a chat is very important.” (Participant)
Problem-solving became a key feature of families’ adjustments from how they would be going to hospital, to dealing with not having partners present at the birth, to how to get help caring for the newborn.
Participants spoke of taking control to get the care they needed amid the constant changes occurring in the health system, such as “pushing hard to get appointments”, following up test results and, in a novel case, a woman preparing for her own birth in case there was no hospital that was open to go to.
“I felt like I always had to be on top of everything, and if I wasn’t going to be on top of it then things were going to get missed.” (Participant)
The first wave of the COVID-19 pandemic in 2020 resulted in prioritising protective measures to contain the virus’ spread. The consequences, however, included severe mental, emotional and psychosocial health impacts, and uniquely changed the parenting experience of women and their support persons. The original study by these researchers found that nearly 9 out of10 women felt anxious about the impact of COVID-19 on their wellbeing, and 7 out of 10 felt isolated from their supporters.
Personal resilience and resourcefulness enabled the women in this study to innovate as they steered through disruptions and new directions in their maternity experience that were enforced by the pandemic measures.
“In the best of times, becoming a mother can be both a joyous and challenging experience,” Dr Wilson said.
“The findings of this study have highlighted the need for multiple sectors from health services to all levels of governments to work together to address the unique challenges that will come from future pandemics or health crises such as bushfires, and to listen to what women and their families have said about the greater support they need for their emotional, mental and physical health and wellbeing.”
Dr Alyce Wilson is a Public Health Registrar and Senior Research Fellow at Burnet Institute working in global maternal, child and adolescent health. She is a medical doctor with expertise in public health, obstetrics and gynaecology, and nutrition and dietetics. She works clinically at the Royal Women’s Hospital, Melbourne.
This qualitative study was part of broader research involving more than 5,000 participants from five key stakeholder groups that provided or received maternity care during the first wave of the COVID-19 pandemic in Australia – women, their partners or supporters, doctors, midwives and midwifery students. Led by Dr Zoe Bradfield, it combined the maternal and newborn care expertise of researchers from Curtin University, Deakin University, Burnet Institute, the University of Melbourne and the Centre for Quality and Patient Safety Research (Western Health).