Home births and face masks: The lockdown trials of mums and midwives

Christchurch midwife Dani Gibbs with baby Harrison Reid, who she helped deliver in a home birth during New Zealand's level 4 lockdown. Photo / Supplied

Melissa and Andrew Reid faced an anxious choice heading into New Zealand's level 4 lockdown - give birth at home or in hospital.

Plan A had always been the hospital. The Christchurch parents-to-be had barely given thought to a home birth.

But when Covid-19 forced New Zealand into lockdown, hospitals introduced stringent safety rules limiting how many people could enter in a bid to stop the virus' spread.

It meant Andrew would only be allowed a few hours by Melissa's side during their son Harrison's birth.

Afterwards, he would be pointed to the car park and told not to come back until it was time to take Melissa and Harrison home - no visits in between.

The couple deliberated, penned a pros-and-cons list. They wanted Andrew to be present.

"I couldn't imagine missing the first few days of Harrison's life," he said.

So with midwife Dani Gibbs' help, they devised a new home birth plan.

Days later on March 29, baby Harrison was greeted by mum and dad and two midwives in face masks and goggles.

"It was a very empowering experience," Melissa said of the birth and the confidence Gibbs gave them to do it at home.

Harrison was one of about 6700 Kiwi babies to arrive in the first 10 days of the nation's level 4 lockdown.

A NZ Institute of Economic Research found midwives typically worked 17-26 per cent more hours than the standard 40 hour week. Photo / Supplied

And while birth is rarely stress-free, the coronavirus pandemic and nationwide lockdown took anxiety levels to new heights for many parents-to-be, the NZ College of Midwives said.

It was not just those unexpectedly choosing home births.

Other mums decided to give birth in hospital, but then hurried home earlier than normal to be with loved ones and safe back in their bubbles – foregoing some of the after-birth assistance that takes place in hospitals.

Many young parents isolating in level 4 bubbles also fretted without the support and guidance of grandparents and extended family.

Pregnant mums deemed essential workers faced tough choices about whether they should continue working and risk catching the coronavirus.

Mental health issues and family violence were also both up, the NZ College of Midwives said.

And if the lockdown wasn't easy for parents, it also held challenges for midwives, Gibbs said.

Her clinic battled shelf-emptying hoarders in the hunt for supermarket hand sanitisers and waited weeks for personal protective equipment.

At first, her team made their own bleach cleaning solutions before local businesses donated face masks and soaps.

Then after about three weeks, the Canterbury DHB gave supplies to independent midwives like Gibbs.

As essential workers, midwives continued seeing some patients in-person, but also quickly introduced new technologies and safety measures.

Gibbs held online Zoom chats with patients where she could.

When mums and babies visited her clinic, she first had them stay in their car and talk on the phone.

Jacinda Ardern with her baby Neve and midwife Libby Cain in June 2018. Photo / Supplied

"Then I would get them to come inside for less than 15 minutes to do a quick physical examination," she said.

For those mums and babies leaving hospital early, Gibbs estimated she had to make two-to-three extra home visits than was normal.

Other mums fearing coronavirus shunned visits to medical clinics. So Gibbs visited their homes to draw blood samples and dropped it to the laboratory on their behalf.

NZ College of Midwives chief executive Alison Eddy said midwives, across the board, worked considerably longer during lockdown.

Midwives had already been locked in a pay dispute with the Government before lockdown.

The lockdown only amplified their calls for better pay for each job worked, Eddy argued.

On Sunday, June 14 the Government announced a one-off $2500 payment to all self-employed midwives, like Gibbs.

It is aimed at refunding midwives for their out-of-pocket expenses during level 4 lockdown, such as paying for their own personal protective equipment and the many extra tasks they took on, Eddy said.

While Eddy thanked the Government for the payment, she said midwives were still pushing for a better pay funding model.

Midwives not only help Kiwi babies arrive healthy into the world, but they also play a key role in their first weeks of life as a part of the Government's Well Child programme, she said.

The programme provides free healthcare checks to all Kiwi children at milestones up to the age of 4 in order to lay the foundations for future healthy lives.

However, one risk to the Well Child programme was keeping hold of enough midwives, Eddy said.

She pointed to a March study by independent consultants the NZ Institute of Economic Research.

It found midwives typically worked 17-26 per cent more hours than the standard 40-hour, full-time-equivalent contract.

Part of this was due to them caring for more mums and babies at once than was recommended by the Government's health plan, the NZIER report said.

The Ministry of Health didn't reply to questions about the pay dispute.

Charitable health care group Plunket, meanwhile, faced a backlash from some mums after pulling back from offering face-to-face visits during the lockdown.

It delivers Well Child health check-ups to almost 240,000 babies and toddlers aged from 5 weeks to 3 years old.

One mum complained on the Plunket Facebook page her 3-month son was last seen by a nurse when he was 4-weeks-old and had been missing out on important health check-ups.

This was backed by other mums, saying they had been through the same experience.

However, other parents said they talked to their Plunket nurses online during lockdown and had their baby weighed when visiting a doctor for the immunisation shots given at six weeks old.

Melissa Reid (not pictured) said her midwife was the one who gave her the confidence to go ahead with a home birth. Photo / 123rf

Plunket chief executive Amanda Malu said the service - which sees more than 85 per cent of all Kiwi newborns - had kept its 24/7 parent support line open during the lockdown and ensured those with the highest needs had access to its online services.

A Ministry of Health spokesman said ambulance and hospital staff had also been made available during lockdown to meet Plunket mums and babies face-to-face if deemed necessary.

The Reids, meanwhile, believed midwife Gibbs was worth every cent of her salary.

"Dani was the one who gave us the confidence to go ahead with the home birth," Melissa said.

"She gave us all the information we needed to make the decision."

The couple had enjoyed a quiet day on March 29 and were settling in to watch the daily 1pm coronavirus health briefing when Melissa's waters broke.

They had a moment of panic, wondering what to do next and phoned Gibbs.

She told Melissa: "The second you can't have a good conversation with Andrew, it is time to call me".

The couple turned on soothing music and tried to relax. But soon Andrew was frantically boiling water.

All four stovetops burners and two kettles were bubbling away as he tried to bring the 300-litre birthing pool up to body temperature for the birth.

Gibbs and the second midwife arrived soon after and were a picture of calm. They didn't interfere with the couple's routine, just offered timely advice and measured Harrison's heartbeat.

Andrew turned the lights down, Gibbs donned full PPE and Melissa entered "the zone". Harrison arrived at 6pm.

Yet the adventure didn't end there.

At 10pm when Gibbs left, Melissa and Harrison sat together, on the cusp of a new life together, wondering what to do now, Andrew said.

Fortunately, Gibbs had filled them with confidence, saying they could call her anytime, day or night if needed.

"She is that sort of person that would do that for anyone I'd imagine," Andrew said.

Over the next few days, Gibbs was the only other person venturing into the Reids' bubble, making regular visits and saying hello.

She was also open to special favours, Andrew said.

"Like, 'do you mind taking our first family photo?'"