A pregnant woman who is due to give birth during the nationwide shutdown says she fears being forced into having a home birth.
Fili Tagaloa, 27, is almost 38 weeks pregnant with her third child, but worries about whether she'll have to give birth in her home instead of hospital during the nationwide lockdown. Photo: Supplied
Fili Tagaloa, 27, is almost 38 weeks pregnant with her third child and is among many other pregnant women who are gearing up to give birth as the country locks down. She said she was trying not to panic.
"I'm feeling a bit overwhelmed," Tagaloa said. "Usually I'm the type to leave things till the day I feel my contractions but with the lockdown happening, everyone's panic-buying which is starting to make me feel somewhat of a panic.
"But I just need to remain calm and know that there are essentials out there. I just need to remain calm."
Tagaloa said she knew of other pregnant women who had been advised by maternity staff to consider giving birth at a birthing unit if they could or at home if they were well enough to do so.
Ministry of Health guidelines sent out to community midwives this week state that if a woman feels safe to do so, home birth is an option they could consider and to avoid the hospital as much as possible.
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However, Tagaloa said her home was not equipped for it and she was worried she might not have a choice.
She plans to give birth at the hospital where she feels safest but the ongoing uncertainty means she isn't sure how different things will be in two weeks from now.
"I did hear they were trying to speak to pregnant women who were due soon about birthing from home and that was causing a bit of anxiety for me just because it's not our norm," Tagaloa said.
"My home would not be a suitable for a place to birth at. We don't have a bathtub and just with my other kids around I don't feel like it's a safe and sacred space for me to be able to bring my third child into this world."
Eva Neely, a public health lecturer at Victoria University and a member of the governance board for the College of Midwives, said she was aware staff on the ground were advising some women to carefully consider their birthing options during this time.
Dr Eva Neely with her daughters. Photo: Supplied
Dr Neely started a support group on Facebook called "Pregnancy and Birth during COVID", and said many pregnant women would be feeling even more vulnerable right now.
"At the moment, the official government response is women still to choose which of the options they feel most comfortable with, but obviously as this progresses it's important to keep an eye on the capacity that hospitals have and to be aware of whether or not you would like to go into hospital," Dr Neely said.
"It's just that the reasons not to go into hospital are right now a little bit elevated and more on everyone's radar than they normally would be."
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Dr Neely, who is also a trustee for the Home Birth Aotearoa association, said home birth was a safe option for women.
"We know from research, including very robust recent evidence that home birth reduces the likelihood of unnecessary interventions and I think too, that if we want to take pressure off the health system, this is a very simple and safe way to do so because everyone will be under stress and time pressure," she said.
"And the last thing to think about when we talk about home births is to make sure we do continue to support and staff the primary birthing units, because we also know that many women do not have a house that they're safe in to birth, and so we need to make sure that all women can access primary birthing units and stay out of hospitals."
Briar Hale, 36, is 27 weeks pregnant with her first child.
She has decided to give birth at home and said she was relieved that the nation was going into lockdown.
"I'm really glad that we've gone to level four. I feel relieved to be at home and to be in isolation and also as a member of the community, to just be supporting what I can do and what we can do to slow the spread," Hale said.
"Also, I use public transport in Auckland as my way of getting to work and that had started to become unnerving probably towards the end of last week."
As the number of Covid-19 cases continues to rise in New Zealand, Hale said she was glad to be having a home birth.
"I guess for a couple of reasons: one is not to add any pressure on the health system, which I imagine is only going to get more busy and under pressure, and also just for our personal comfort of not needing to go to a hospital where Covid-19 may be present.
"Just the idea of travelling in to where it's all happening doesn't fill me with a great sense of calm."
The impacts of the virus means that Hale's midwife had to stop working because she was immunocompromised.
Now she is seeking another midwife or a locum to help her give birth at home.
Fili Tagaloa said although she would still be able to attend her weekly midwife appointments while in lockdown, the appointment times had now been cut in half in an effort to limit contact as much as possible.
She was nervous about contracting the virus in hospital but would still rather give birth there than at home.
"I'm nervous about birthing at home and at the same time nervous about getting sick at the hospital, but weighing up the pros and the cons, just being at a facility with doctors and nurses - that would be the best place for me."
Protection for midwives and advice
The College of Midwives is advising that a woman can only have a home birth if she does not have any Covid-19 risk factors and is well.
The college's acting chief executive, Jacqui Anderson, told Morning Report that midwives would continue to operate as an essential service and would determine what type of care each person needed.
"They do need to be able to seek advice and get the care they need. So we've been advising midwives around ways to ensure they can make contact with their clients, and also make decisions around which clients need actual face-to-face care, and those that they can actually provide advice and have long conversations with to identify their needs as well."
However, some midwives still did not have protective gear because some district health boards still needed to distribute them, she said.
"But not everybody needs it, we still really are needing to keep our main health messages around washing hands, keeping physical space and distance.
"Midwives [will] be making assessments with women about how they are, have they any risk factors for Covid-19, before they actually decide whether or not a physical appointment is necessary."
She said ministers had outlined there was enough available gear, it was just a matter of DHBs providing access to them.
"What we're hearing from around the country is that it's variable, the College has been in contact with the Ministry of Health on a daily basis around what's happening with the protective equipment.
"We're expected to provide care which midwives want to do and keep doing, then we do need the equipment to be available.
"I know the DHBs are working hard to try and find ways to make sure it's accessible for midwives ... we have some DHBs who have already distributed them to midwives and we need others to focus on how they're going to do that as quickly as possible."
And whether partners will be able to present during the birth will be determined on a case-by-case basis with assessments of risk and exposure, Anderson said.
