THE ART OF MIDWIFERY, AT A DISTANCE The concept of physical distancing does not sit naturally with midwifery – the word ‘midwife’ itself derives from an old English word meaning ‘with-woman’. So when Nelson midwife Rachel O’Hanlon heard that COVID-19 was heading our way she knew there was big change ahead for her colleagues. A community or lead maternity carer (LMC) midwife, Rachel’s initial reaction was to look at what was happening for midwives in other countries. She also did a lot of reading, and followed Ministry of Health updates closely. Finding the situation scary, Rachel decided to make a WhatsApp group to connect with her peers. Before long there were 34 midwives across the district using the social media platform to talk to, support and educate each other. They used email to keep clients up to date with service changes, and started phoning women before their appointments. “For some LMCs that’s meant phoning 10 women in preparation for a clinic the next day, and there’s also a screening questionnaire to fill out. It’s become the new normal for us now,” Rachel says. Other changes included clearing clinic spaces so that walls and surfaces could be disinfected regularly, and learning how and when to use PPE gear. One of the biggest changes was minimising in-person appointment times as part of the infection prevention process. Rachel says that this was difficult for both midwives and women. Before COVID-19 an LMC might spend an hour with a client, and this was whittled down to 15 minutes. “Now we spend a lot of time on the phone before an appointment, talking through any concerns. Then when women come in it’s a quick consult to check blood pressure, urine and the baby’s heartbeat.” Rachel says that midwifery is about being with women, and that the pandemic has distanced LMCs
Above: Midwife Rachel O’Hanlon weighing Navy Tankard, born during lockdown.
from women. Midwives have, however, shown great resilience. “We have gone through huge change but midwives have adapted. They’ve put antenatal classes online, provided virtual question and answer sessions via Zoom, learned how to don and doff PPE, and how to email prescriptions and Medlab forms. They have felt overwhelmed at times but they have pulled together and they are doing it for the mums.” Rachel also acknowledges the support both LMCs and core (hospital maternity unit) midwives have had from Charge Midwife Managers Sylvia Keller and Tracy Botica, midwife Ashleigh Foord and Associate Director of Midwifery Debbie Fisher. “They have put in many hours supporting us, and have included us in everything.”
DURING ALERT LEVEL 4 LOCKDOWN 94 babies were born at Nelson Hospital, 52 at Wairau Hospital, six at the Motueka Maternity Unit, two in Golden Bay and there were 22 home births across the region.
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