• Holly

Birth Support and Companionship during Covid-19

Updated: Dec 7, 2020

Studies have shown that birth partners can provide practical and emotional support during labour and contribute to women having positive birth experiences, and the presence of continuous labour support improves the well-being for both mothers and babies. Sadly, as of this past Monday (November 30, 2020), the Hospital Authority (HA) in Hong Kong has again suspended the Husband Accompanying Labour service in the delivery wards, i.e. they've banned birth partners from being with moms during birth and labour. This goes against WHO recommendations which clearly state that ALL women have the right to a companion of choice, and should be treated with respect and dignity, whether or not they have a confirmed Covid-19 infection.

The Royal College of Obstetricians & Gynaecologists and the Royal College of Midwives also issued important advice on birth partners as shown below:

How can Birth Partners/Companions support women? Quoting the WHO - "[birth partners/companions] provide informational support about the process of childbirth, and bridge communication gaps between clinical staff and women. Companions also provide practical support, including encouraging women to remain mobile during labour, providing emotional support and non-pharmacological pain relief such as massage and meditation. Companions act as advocates for the women, speaking up in support of her and her preferences. Labour companions also help women feel in control and build their confidence through praise, reassurance, and continuous physical presence." It's important to note that even though the husband commonly takes on the role as birth partner - it can be anybody that the mother chooses and feels supported by, e.g. a family member, friend, doula, midwife or healthcare professional.

For further reading on the impact of the absence of birth companionship on women, please refer to the following:

- BMJ Blog: "Birth partners are not a luxury"

- Research published in the HK Medical Journal: "Effect of COVID-19 on delivery plans and postnatal depression scores of pregnant women"

- A story told by a mother: "Without my partner there, my past trauma was triggered"

- A Unicef article on Navigating pregnancy during the COVID-19 pandemic

- A New York Times article on the reversal of the birth partner ban in NY hospitals If you're delivering in a private hospital - as of this writing, you should still be allowed your birth partner of choice during labour. If your birth partner is at a loss of how he/she can support you, I recommend these two books for his/her reference:

- Juju Sundin's Birth Skills: Proven Pain-Management Techniques for Your Labour and Birth

- Penny Simkin's The Birth Partner: A Complete Guide to Childbirth for Dads, Partners, Doulas, and All Other Labor Companions

If you're delivering in a HK public hospital and are wondering what you can do, here are my suggestions:

1) Advocate for your rights to have a birth partner of choice with you. One way to do this is to file a complaint to the Hospital Authority. See this document on the various ways to do so: https://www.ha.org.hk/.../v3/doc/complaintsys_eng_cs1.pdf

2) Raise awareness by talking about it and sharing info with potentially impacted families.

3) Join our "HK Birth Partner Advocacy" Whatsapp group to contribute ideas and resources and receive updates

4) Prepare yourself for the potential situation of giving birth alone, so even if you find yourself having little or no support, you still feel adequately prepared to make your labour experience as comfortable and empowering as possible. See below for some helpful resources:

- Mom Body Soul Podcast: The Power of Mindset - Birth & Quarantine during Covid-19 with Dee Cheung

Mom Body Soul Podcast is produced by two HK moms, Lindsay and Ziggy, who are both passionate about supporting women pre- and postnatally. On the podcast, they chat about everything pregnancy, birth and parenting related. In this episode, they invite another HK mom, Dee Cheung, to talk about her experience of birthing alone in a public hospital as she got induced on the first day the rules on limiting birth partners kicked in - give it a listen to hear what helped her stay calm in spite of the unexpected situation. If you prefer reading about Dee's experience, you can also check out this SCMP article.

- Birth Kweens Podcast: Comfort Measures for Labour & Birth

Karly and Ali, a midwife and a doula, provide a variety of non-medical pain management coping tools and techniques to help during labour and birth. They explain why the 5 elements of birth (darkness, privacy, silence, safety, and warmth) are important, and suggest helpful tools in labour including the use of eye masks, birth balls, cooling towels, heat pads, essential oils and TENS unit. They also discuss techniques to achieve the 3 R's during labour: Relaxation, Rhythm, Ritual - which include breathwork, mantra, vocalization, movement/changing positions, water therapy, massage, music, mindset... This is a very informative and practical podcast that I've saved and listened to over and over again!

- I mentioned this book before, but it's my absolute favourite go-to book for birth prep so it's worth mentioning it again: Juju Sundin's Birth Skills: Proven Pain-Management Techniques for Your Labour and Birth

Written by an obstetric therapy professional Juju Sundin, it offers a comprehensive explanation of what labour pain is and the hormones at play - I like that Juju doesn't shy away from discussing the intensity of the sensations, because anyone who's experienced contractions/surges/whatever you want to call them would tell you they are no joke! As much as I teach the importance of relaxation and breath awareness in labour, I also believe that you need more tools to cope with the sensations than just relaxing and breathing, especially if your labour turns out to be long. Juju offers very practical techniques that you can practise with/without your birth partner.

- Yoga Nidra for Pregnancy meditation

The practice of Yoga Nidra (Yogic Sleep) is intended to help you achieve deep rest and relaxation. The Yoga Nidra meditation that I'm offering uses body sensory awareness to move your awareness inwards and ultimately bring you to a deeply restful state.

- Evidence Based Birth Podcast: Evidence on COVID-19 and Pregnancy and Birth

Being a self-professed geek about everything birth related, I love listening to the Evidence Based Birth (EBB) podcast, produced by Dr. Rebecca Decker who has a PhD in nursing and shares evidence based research on maternity care and birth. This episode covers the research on COVID-19 related to pregnancy - including info on mother-to-baby transmission, pregnant people's risk of infection, maternal and fetal outcomes for those who are infected. On the EBB website, there's a whole page dedicated to COVID-19 resources which you may find useful. Additionally, EBB is offering some free short videos on birthing during COVID-19 - consider it a mini crash course on birthing during exceptional times!

I will update this list as I come across other helpful resources. If there are any books, articles, podcasts or anything you've personally found helpful, please let me know so I can share them with our wonderful community of moms.

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