The pandemic also generated negative experiences for women during childbirth

Throughout the pandemic, pregnancy and childbirth have been associated with anxiety and uncertainty for many pregnant women and their partners due, in part, to the changing landscape of the healthcare system and increasing demands from health providers. This has led to the neglect of a number of best practices supported by the World Health Organization (WHO), as evidenced by reports of women giving birth alone and imposing restrictions on childbirth options (for example, the impossibility of water or home birth, extended practices in the United Kingdom), in addition to the separation of the baby from its mother shortly after birth.

Government guidelines aimed at curbing the spread of the virus also created a number of suboptimal conditions for expectant parents when giving birth. These are the findings of a study on women's childbirth experiences in England during COVID-19, published in the journal BMC Pregnancy and Childbirth and conducted by researchers at the University of Cambridge.

The information that the scientists drew from was collected through an online survey between July 2020 and March 2021 of 477 families, as part of a larger study conducted in the United Kingdom called “COVID-19 in the context of pregnancy, childhood and parenting” (CocoPIP).

The survey asked parents living in England with a baby aged 0-6 months to report on their recent experience of giving birth. Forty-seven percent of them expressed discomfort in their birth experience. “Many mothers-to-be said that the constant changes in government orientation caused them greater anxiety and distress, particularly because they did not know if they could count on their partner or a companion with them during labor and birth,” explained Sarah Lloyd-Fox, specialist in the Department of Psychology at the University of Cambridge and lead author of the article. “Choice and control are very important in women's childbirth experience, and the lack of both during pandemic restrictions in 2020 had an adverse effect on the experiences of many pregnant women in England.”

Parents, for their part, reported mixed experiences of communicating with hospitals and midwives before the birth of their children: some received almost no communication, which increased their anxiety, while others said they had obtained very clear information about what to expect in childbirth while related restrictions with the pandemic they were in force.

Forty percent of respondents said they weren't sure if their partner would be allowed to deliver their baby. Despite this, only 2.3% had no partner present at the time of delivery due to COVID-related restrictions. 25% of respondents reported COVID-related changes in the delivery of their baby. The suspension of home births and birthing pools commonly used in local health facilities, during the restrictions of early 2020, reduced parental control. Some women reported difficulties in accessing care and analgesics.

“This study highlights the importance of good communication to give women a sense of control over their childbirth experience and to alleviate the anxiety they feel at that key moment in their lives,” warned Ezra Aydin, of the Department of Psychology at the University of Cambridge, the first author of the article.

When restrictions due to the pandemic changed from one moment to another, some healthcare systems created Facebook or WhatsApp groups where people could ask questions, and that helped future parents feel a little more calm at such an uncertain time. “When families were supported and involved in birth decision-making, they reported a more positive experience, with reduced levels of anxiety and stress,” Aydin added.

In March 2020, the UK's first national shutdown in response to COVID-19 was announced, and the UK's health systems began to suspend home delivery services as resources diverted into the pandemic. Each medical facility was required to develop its own guidance on access to maternity, partner and birth services, according to government guidelines.

The authors say their findings show “the need for clear and consistent guidance for pregnant women who give birth during future closures and public health crises to remain in control of this moment. This should include allowances for the choice of delivery methods and the availability of constant support during labor and birth.”

The CoCoPip study was developed to explore how COVID-19 and the cascade of changes in healthcare, social restrictions and government guidance affected the lives of families who were expecting a baby or had recently given birth. The results reported in this paper focused on parents' experiences of giving birth during the pandemic, including ways in which communication and counseling provided by hospitals may have influenced these experiences.

In early September 2020, NHS England (the British National Health Service) issued guidance for medical facilities to reintroduce access to English maternity services for couples, visitors and other supporters of pregnant women; however, this was adopted inconsistently.

In December 2020, this guidance was revised again to explicitly allow in-person support for pregnant women throughout their maternity journey, including antenatal visits, ultrasound scans, and during childbirth. The researchers acknowledge that “the experience of the pandemic in 2020 was a unique period of difficulties for all. The aim of our study is to give voice to future and new parents during this time.” The CocoPIP study will continue to monitor infants until they are 18 months old to follow their development into childhood.

According to recommendations from the World Health Organization (WHO), the health system must ensure a respected birth and enforce pregnancy times, even in the context of the COVID-19 pandemic.

According to the agency, the care of pregnant women infected with the coronavirus is not a reason to recommend cesarean sections, nor for the suppression of breastfeeding, whose nutritional value is essential for the health and proper development of the newborn. “Unlike what some believe, this approach to comprehensive motherhood and humanized childbirth can be experienced in health centers and sanatoriums thanks to the advancement of health paradigms that merge technology, science and medical expertise to achieve harmony in the life process of birth.”

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