The COVID-19 pandemic is a difficult time for everyone, but my heart goes out to pregnant women who are trying to create a birth plan during this time of global uncertainty, panic and crisis. Having a baby should be a time of such joy and empowerment, and it must be incredibly stressful for expectant mothers who are having their birth plan pulled out from under their feet.
Whether your birth plan was a natural home birth or an elective c-section, this is a time of such uncertainty for everyone that becoming a mother, either for the first or the eighth time, must raise many questions and issues of anxiety.
Each NHS trust will have their own policies in regards to the COVID-19 crisis, so obviously your first port of call is your maternity provider to see how your birth plan may be affected by the current situation.
If your original birth plan was a hospital or midwife unit birth but you are now in a position where home birth might be your best option, check out my essential guide to giving birth at home. It contains answers to the most commonly asked questions about home birth, a checklist of what you need to have a home birth, and some of my own experiences of giving birth naturally and at home.
Whatever your birth plan and whatever your care provider’s policy at this time, there are some things that can universally be done to help you create an empowered birth plan, and have an empowering birth experience, even when your choices are suddenly limited.
1) Take a deep breath, switch off the news and do your research
Pregnancy can be an anxious experience for some anyway and I’ve seen lots of pregnant women go into panic mode, assuming that their birth plan will be ripped to shreds as a consequence of this crisis. Media stories don’t help, with several articles popping up about women’s birth rights being compromised at the present time. I’m not going to promise you that everything will be fine and your birth plan won’t need to change, but I do recommend that you start by taking a deep breath, ration your news and social media intake if it’s contributing to any anxiety about birth, and put your energy to good use by doing your research instead.
Start by visiting the Royal College of Obstetricians & Gynaecologists’ website for their up-to-date information about how coronavirus impacts your pregnancy, maternity care and birth choices.
Next check with your care providers and your NHS Trust’s website to see what their policies are, what options are available to you and if there is a way that your most precious, bottom-line wishes can actually still be met. It helps if you can first identify what those wishes are – ask yourself what the different levels of birth preferences are in terms of what is absolutely essential to you and what is your ideal. This may help to mitigate any disappointment arising from not being able to get everything exactly the way you planned, so long as the things that are most important to you are still being supported by your care provider.
Remember too that NHS staff are under a lot of pressure right now and midwives have been known to encourage an option that is more convenient for them, but it may not be what you HAVE to do. I’ve read an alarming number of stories from both before and after the current crisis, saying that midwife told them they “had to” agree to something when it turned out that they didn’t.
Always, always ask to speak to someone higher up if you feel you are being needlessly pressured into a birth setting that you intuitively feel is not right for you. Again, I can’t promise that you’ll get the outcome you want but you might be surprised at what being a little bit pushy and asking for a higher authority opinion might lead to.
2) Visit the Birth Rights website
Speaking of being a bit pushy, if your research leads you to believe that you are not being given the full range of choice or support that you should be able to access, head over to the Birthrights website to see what you are legally entitled to. Birthrights is an amazing organisation that offers support to women in making sure their legal rights are upheld during childbirth and they will be happy to talk to you if you need help in making sure that your fundamental human rights are protected at this time.
3) Investigate independent midwives
Note: this tip assumes you are living within the context of the UK healthcare system
At the time of writing, independent midwives are still functioning and taking on new (albeit generally low risk) clients and, if this is an option that may be financially viable for you, it’s one that I personally would be pursuing if I were due right now. The idea of going private might initially seem unnatural to someone in the UK who is so used to the NHS and I appreciate that the cost is no small barrier to many, but you might be surprised by how relatively accessible it is. I’ve seen midwives offering packages starting from £3,000, which wasn’t nearly as much as I would have thought. You could consider asking family members to help support the cost instead of the over-the-top baby outfits and giant teddy bears they might otherwise be planning!
You can search for a local independent midwife HERE. You may even find some who are reducing rates to make their services more accessible as plenty of birthing professionals are trying to do what they can to support pregnant women in this time of crisis.
4) Investigate doulas
If an independent midwife isn’t an option for you (and even if they are) then take a look at getting a doula instead, or in addition. A doula is there to provide support to you and your family prenatally, during birth and postnatally too depending on the service you pay for. They may be a wonderful option for those who have been advised by their midwife that a home birth is their safest option but who feel anxious about that not being in a hospital. They’re also a great option for women who were planning a home birth but are now having to switch to a hospital birth and need either birth support so that older children can be looked after by a partner, or help in getting the more natural, low-pressure environment that home births offer. Whatever your situation, having extra one-to-one support from a dedicated birth practitioner will help you to feel that your birth plan choices are still being supported and nurtured as much as they can be in the current climate.
Again, finances may not necessarily be a barrier for you. There is an access fund available for those who are in vulnerable groups or on a low income, as well as a number of mentored doulas who have completed the essential Doula UK training but work on lower fees while they gain enough hands-on experience to become recognised doulas.
5) Get support and advice from the Positive Birth Movement
The Positive Birth Movement was set up by the pioneering Milli Hill, whose mission it is to help women have a positive birth experience, change the cultural narratives surrounding birth, and empower women to make sure their rights, choices and autonomy are always protected. Her Positive Birth Book helped me to change my own perception of what birth could be and is largely responsible for me having a positive birth experience myself, so I very much recommend getting hold of a copy.
There is a dedicated Positive Birth During COVD-19 Facebook group offering support, up-to-date advice and information, as well as a directory of birth practitioners who may be able to offer you one-to-one positive birth support too. Not only that, Milli has teamed up with hypnobirthing practitioner Sophie Fletcher to bring out a special online course called the Positive Birth COVID-19 Rescue Pack, which is available on a sliding scale of payment in order to help as many women as possible (from all over the world) access it. The course includes:
- 11 specially made sections to give you the information and resources you need right now
- 4 specially made hypnobirthing tracks for positive birth in a global crisis
- 10 specially made videos featuring tips and insight from Milli and Sophie
- Dozens of tips, tricks, & techniques and 15 practical exercises to build a positive mindset toolkit
Just in case you were wondering, I’m not affiliated with the course nor have I been paid or otherwise rewarded in return for recommending it. I’m just a huge supporter of Milli Hill and the Positive Birth Movement, and I’d like to do my bit to get this wonderful resource out to women who would benefit from it.
6) Create a clear birth plan using visuals
Earlier I mentioned that it was important to make sure you know what your bottom-line birth choices are so that you are really clear on the important aspect of your experience. Having done your research, gained legal, emotional and psychological support from the organisations above, it’s time to sit down and make a clear birth plan that efficiently communicates your wishes to those that need to know. I love these free visual birth plan symbols from Positive Birth Book publisher Pinter & Martin, which are easy to download and insert into a document that you can then print and keep with your maternity notes. I used them for my birth plan and my midwife was delighted when she saw them, saying they were so much easier for her to refer to than pages of text.
7) Make sure your birthing partner knows your wishes and feels confident in advocating for you
The most important person to understand and feel knowledgeable about your birth plan is your birthing partner, whoever that may be. They need to know what is important to you, why it’s important, and feel confident in advocating those wishes on your behalf. Of course there are many medical situations in which it’s important to defer to the knowledge and experience of medical professionals but, COVID-19 or not, it’s absolutely vital that you always feel that you and your needs are being placed at the centre of your birthing experience. The worst birthing stories are always ones where the woman feels that her choices were taken away from her and that things were happening TO her, rather than her being at the centre of the process.
Being in labour puts you into an altered state that often compromises your ability to be rational, fully aware of decisions and consequences, and it sometimes severely reduces your capacity to consciously give or withhold consent. This is why your partner needs to feel like they can be your voice when you yourself may struggle to find it. The BRAIN acronym is a very helpful format here in helping to achieve this:
Add the acronym to your birth plan and go through it with your partner if you have one, so they understand and can easily refer back to it.
8) Tackle your anxiety
I was diagnosed with GAD (Generalised Anxiety Disorder) following a catastrophic house fire ten years ago, so I’ve been struggling with a surge in anxiety levels myself during this time. For me, anxiety is very much related to issues of health, safety and sudden catastrophe, so the current situation is perfect for pressing my particular flavour of anxiety buttons. I can only imagine the extra anxiety that would be heaped on top of that for a pregnant woman prone to anxious thoughts.
If you’re struggling with anxiety surrounding how the current climate will impact your birthing experience, it’s really important that you tackle it and find tools to help you bring it under control. Anxiety and stress are only going to make matters worse when it comes to your pregnancy and ultimate labouring experience, since it’s the release of oxytocin (the love/binding hormone) that makes birth a natural and smooth process. Meanwhile, high levels of anxiety and the subsequent release of cortisol (the stress hormone) may negatively impact your unborn child. It’s also vital for your sense of having an empowered birth, since decisions made out of anxiety usually lead to feelings of disempowerment and helplessness.
The mental health charity MIND has information about what options may be available to you if you are struggling with perinatal anxiety and you can of course talk to your midwife or GP. I did want to share some resources I’ve found though, which may be helpful to those whose anxiety is only mild and who don’t necessarily want to set the wheels in motion for therapy or medication at this particular time.
The first is an excellent podcast on anxiety and “cultivating calm” in a time of global panic, which comes from one of my favourite authors Brené Brown. She became internationally renowned following her extraordinary TED Talk on the power of vulnerability. Given that this global situation is arguably (in her words) a “massive experiment in collective vulnerability”, I personally think she’s the go-to voice of calm, reason and wisdom at the moment.
Another podcast I found incredibly helpful is an episode of a show called Owning It, which is only 8 minutes long but includes some deep breathing, calming music and advice on handling advice during the pandemic from presenter Caroline Foran. She has a lovely reassuring voice and the episode, though short, is one I can see myself returning to whenever I feel the need.
Finally, I wanted to share how much I’ve found gardening and being outside in nature to help improve my anxiety levels. I always make sure Ursula has some outside time every day and, now that we have to stay at or very close to home, that time is mostly limited to our garden. One day I was out there with her while she pottered around with a watering can and, feeling a bit bored, I decided to just tidy up the little patch of pebbles underneath our kitchen window, which had become rather messy over the winter. It took less than half an hour but made a huge difference to the experience of stepping outside. It occurred to me that if I just tidied up that size of patch in our unruly garden every day then, by the end of the three weeks that we’re on definite lock down (before our government reviews the situation) then we could have a really lovely space to spend our summer in. Previously the garden had felt like a mountainous task to undertake, but this new “one day, one step at a time” mentality makes it feel more manageable. Not only that, it makes the whole lock down feel more manageable – if I can just make one small change, one small improvement, whether to our garden, my mindset or our lives as a family, then before too long the three of us will see a huge improvement in the quality of our home life.
I realise that not everyone is blessed with a garden or the ability to tend one, but the power of looking after a small patch of nature is so profound that even just starting and caring for a little window box or bonsai tree can be hugely beneficial for your mental health. If you have older children, it’s a perfect opportunity to involve them in something too, even if you just start growing some cress with them.
If gardening is not for you (if you’re too heavily pregnant to move for example – apparently I just remembered my audience here!) then have a think about what else you might be able to apply the same “one step at a time” mindset to. That’s the main point, really, that you cultivate a daily practice that sees you becoming present, performing one small task, and relieving you from the future-catastophising mindset that is so prevalent in anxiety. If even that seems too much right now, start with one, deep long breath and go from there.
9) Print out affirmations and set up a birth altar
One small step you could take (and a small space you could begin to cultivate one day at a time) is to create a corner of your house that focuses on the kind of positive birth experience you want to have. I’m thinking of a sort of shrine to birth, specifically a shrine to YOUR birth. Of course if you’re planning a home birth then this is something you might have already started to think about doing anyway whilst preparing your home for the big day, but I think it’s a powerful thing to do whatever setting you plan to give birth in.
Not only will creating a birth space give you something positive and empowering to focus on in the weeks running up to your big day, it will provide you with a loving, calming space in which to take some time for yourself during pregnancy, and of course be a wonderful resource when you actually do go into labour.
If you’re religiously minded you can add symbols pertaining to your spirituality, but secular altars are perfectly possible too – really all you need in terms of personal beliefs is a willingness to pursue meaning, to be authentic and free yourself from cynicism.
Pinterest is a gold mine for inspiration on creating an empowering birth space, but I’ve created a Birth Space/Altar Ideas board myself to help get you started. I would say that one essential aspect of any empowering birth space is printed affirmations, and I’ve created 10 free printable affirmations for you to download. Just sign up below and start getting creative with them!
If this post does inspire you to set up an empowering birth space, I’d love it if you’d take a photo and tag me on Instagram @ecofemininstmama, or drop me an email if you’d prefer. I’d really like to create a post filled with all the inspiring birth altars created during this crazy time, so please do get in touch!
10) Accept what you cannot control and own the things you can
My final tip for how to create an empowered birth plan and have a positive birth experience during the COVID-19 pandemic is, once you’ve been through the steps above and done what you can, try to accept the things you cannot change. There may come a point where all the research and pushy emails in the world won’t get you to be in the environment you wanted to give birth in, and you may just need to accept that. In that case, ask yourself how you can take ownership of the small things that you still CAN control in order to still have a positive overall experience. I don’t think anything sums it up quite as succinctly as the serenity prayer (which I’ve securalised for the sake of inclusivity):
Wishing all you pregnant mamas out there a safe, happy and healthy rest of your pregnancy, a positive birth experience, and a truly wonderful, relaxing postpartum snuggled up with your beautiful babies. If you’d like to share your positive COVID-19 birth story with others, get in touch and have your story published on Ecofeminist Mama!