Necessary changes in hospital protocol and general concern about the spread of Covid-19 has seen an increased number of Northland women choosing to give birth at home.
Northland Lead Maternity Carer (LMC) midwives who work in the community are busy grappling with ways to adapt to the increase in home births, as well as developing a new way of working so that women and babies can always receive a service from their midwives.
NDHB LMC and Te Taitokerau New Zealand College of Midwives (NZCOM) chairwoman Priscilla Ford said since Covid-19 broke out there have been significant changes for childbearing women.
While the wider medical maternity team will see all women who have significant needs, non-urgent scan and obstetrician appointments have been deferred until after the lockdown period, which is placing additional demand on LMC community midwives as well. Mechanisms have been put in place to strengthen communication between all maternity healthcare workers.
Women are asked to nominate one support person to be with them during delivery to reduce the risk of spreading the virus in the ward to mothers, babies and staff. Also, if there are no complications from birth, they are encouraged to return home just hours after.
Ford said this is why they are opting for home births because they don't want to leave their homes unnecessarily or break their 'bubble' to get someone in to mind other children so they can go to the hospital.
Home birth is a very safe option for women who have no health complications as long as they receive care from their midwife. But two midwives are required at a home birth, with the second arriving towards the end.
To ensure there is adequate cover for this, some midwives are opting to stay on-call when it is their rostered weekend off.
Community LMC midwives have come up with ways to safely continue providing necessary check-ups for newborns and support for new mums in the community.
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Ford has set up the boot of her car as a newborn weigh station to reduce the risk of transmission by entering a home when she doesn't need to. Everything is covered in polythene and is sprayed and wiped down with alcohol after each newborn check.
"There are some occasions when I need to go into a home, and I take appropriate precautions in that situation. It's about eliminating unnecessary risk," she said.
Justine O'Dwyer is one of six midwives working across the Bay of Islands and says babies arrive Covid-19 or not, so pregnant women can be assured they will be cared for.
She and her midwife colleagues have arranged a support system so that if someone has a particularly busy caseload, others will pick up some of the work. Likewise, if a midwife is unwell, others will step in to look after her patients until she is well again.
"Like us, pregnant women also need to be flexible, and this might mean not having their chosen midwife for a birth; but I absolutely trust my colleagues and know whoever is managing a delivery will follow a woman's wishes and their birth plan.''