As the coronavirus pandemic is predicted to continue for at least six months, expectant parents across the country are preparing for deliveries under a cloud of uncertainty.
With many unknowns about COVID-19, there’s some anxiety about how the illness could affect pregnancies and the health of newborn babies.
Support people allowed in hospitals is limited to one person and no visitors are permitted in maternity areas during the pandemic.
For Indigenous women, the birthing process has strong connections to country and culture.
Like many other facets of life, holistic pregnancy plans have become impossible under the era of COVID-19.
Senior midwife at Waminda - an Aboriginal women’s health and welfare service on the NSW south coast – Melanie Briggs, said the virus is impacting mothers, front line workers and the entire profession.
“When you're in labour and birth, you want strength around you to push you through one of the biggest days of your life and that's just not going to happen now.
“We have to reduce our face-to-face contact with women for an anti-natal or a postnatal visit to be done under 15 minutes,” Ms Briggs explained.
“lt’s really difficult, going in and quickly doing the physical check with a horrible face mask and gloves on.
“It’s so disconnected from who we are,” she said.
A call for help
One of Waminda’s main initiatives is the ‘Birthing on Country program,’ that takes women through their maternity journey in a culturally safe way.
Waminda is calling on the state and federal government for extra funding to extend their three-person midwifery team and provide more personal protective equipment.
The need for holistic services such as theirs is clear through some terrifying statistics.
The 2020 Close the Gap report shows infant mortality rates for Aboriginal and Torres Strait Islander people are twice the rate for non-Indigenous children, with Indigenous babies more than twice as likely to be born at low birth weight compared to non-Indigenous babies.
Ms Briggs said health professionals are currently being re-deployed to hospitals to help tackle the spread of coronavirus, leaving gaps in community maternity health.
Waminda is prepared for further restrictions on their front line workers.
“The hospital guidelines are down to one support person whilst you're in labour... But they're thinking of reducing it to none so that that's a big thing for us,” Ms Briggs said.
“We love mob around and babies and celebrations and it's not going to happen because of the virus, it's as simple as that… And we have to accept it because it's the hospital rules and that's the only place our women down in this area can birth at the moment, we don't have home birth options.”
For many Indigenous mothers, the added complication of chronic health conditions rule out the chances of a home birth.
Continuity of care
The Australian Health Protection Principal Committee (AHPPC) advised that there is limited evidence at this time regarding the risk in pregnant women.
Generally, pregnant women are at higher risk for some infections because pregnancy suppresses the immune system… but for these midwives, a large portion of their current workload is reducing fear and calming increased anxiety.
Ms Briggs said ensuring on-going support by a known primary midwife, otherwise known as ‘continuity of care,’ is key to having good birth outcomes but with current social distancing measures and plummeting resources, it isn’t possible in many cases.
“If they don't implement that now, women might have no care provider in labour and birth, and you just don't know what the outcomes can be if they don't have the support people around them enough,” she said.
“Women at the moment are really fearful of birthing in the hospital because of this virus because hospital is for sick people and pregnancy is not an illness, it's a wellness.”