Adapting to the pandemic: midwives and maternity services

Midwives are trained in both the art and science of birth. The art is being with a woman and supporting her at her most vulnerable time. And the science is learning maternal and neonatal physiology from pre-conception, through antenatal, labour and delivery (intrapartum), postnatal and neonatal.

Midwife means 'with women' and it is a very privileged time to be a part of this life-changing event for the woman, her partner and the wider family.

Midwives are no strangers to working through epidemics over the years, all of which have impacted on the care provided for mothers and babies.

The pandemic has affected maternity services and midwives have adapted while still maintaining a normal service. After all, women are still having babies!

Skilled communicators

Midwives need to have good non-verbal communication skills to reassure and encourage women when they are in labour. This has become even more important with the use of PPE (Personal Protective Equipment), which is essential to stop the spread of Covid-19. Midwives now, more than ever, need to rely on talking with their eyes!

Antenatal support

Attending scans can be an extremely anxious time for a mother-to-be. Part of the midwife's role is to offer support. This is particularly important if the mum-to-be receives bad news. During the pandemic, more women have had to attend scans on their own. Sometimes they feel very alone and frightened. Midwives are doing everything they can to support women in these circumstances.

Effects of passive smoking

Midwives are trained to monitor carbon monoxide levels throughout pregnancy. High levels can result in pre-term labour and stillbirth. This is usually a motivation for women to stop smoking when they are expecting. This monitoring role for midwives has become ever more crucial during lockdown. Women are spending more time indoors and, if they live with a smoker, the effects of passive smoking on the foetus can be significant.

Domestic violence

It is well researched that pregnancy is a trigger for domestic violence. This does not have to be physical, it can be financial, psychological, coercion or intimidation. Effects of domestic violence are harmful to women's mental health long term and, if there is physical violence, this could bring an increased risk of harm to the foetus. Midwives are highly trained to detect domestic violence and signpost to women's refuge or similar services. This has always been a vital role for midwives, and the incidence of domestic violence has escalated as a result of lockdown.

Foetal movements

Midwives have always been - and remain - the first point of contact for pregnant women. However, during the pandemic, midwives have seen the amount of contact with women seeking advice reduced. In these circumstances, sharing and understanding information quickly is an important part of the communication between midwives and mums to be. Many women contact maternity services if they are worried about their baby's movements. Kicks Count (NHS) is an app that has been developed to help women get to know their baby's normal pattern of movement. If women are concerned by any changes in movement, they should contact their midwife.

Postnatal contact

It is well documented that restricted visiting is in place in all areas of maternity inpatients due to the pandemic. Women are discharged home as soon as they and their baby are clinically safe to do so. In these circumstances, the midwife's role in ensuring mum's and baby's wellbeing is increasingly important.

Whatever midwives face during the pandemic, they have to make sure that they can provide the best, most positive experience for women and their families.