tag:theconversation.com,2011:/us/topics/postnatal-care-74121/articlesPostnatal care – The Conversation2023-02-27T12:05:09Ztag:theconversation.com,2011:article/1993462023-02-27T12:05:09Z2023-02-27T12:05:09ZMeeting a friend’s new baby? Here’s what – and what not – to do<figure><img src="https://images.theconversation.com/files/510582/original/file-20230216-28-3o0bko.jpg?ixlib=rb-1.1.0&rect=12%2C4%2C2743%2C1830&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sister-visiting-young-mother-her-newborn-247664557">Mila Supinskaya Glashchenko/Shutterstock</a></span></figcaption></figure><p>A friend or relative having a baby is an exciting moment. You may want to visit to offer congratulations and meet the newest member of your family or social group. </p>
<p>But it can be difficult to know what to do or what is expected, particularly if you have not spent much time with babies, or it is your first experience of meeting and holding a newborn. Here are a few things to know so you can be a great guest. </p>
<h2>Keeping babies safe</h2>
<p>Babies have immature immune systems and find it difficult to fight bacteria and viruses. It’s really important to <a href="https://www.hygienecouncil.org/resources/protecting-babies-from-infection/">wash your hands thoroughly</a> with soap and water before touching or holding them. </p>
<p>What’s more, some viruses that are relatively harmless for us can cause more significant issues in babies. The <a href="https://www.nhs.uk/conditions/neonatal-herpes/">herpes virus</a> can be passed to a baby if you kiss them when you have a cold sore, and this can be very serious for newborns.</p>
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<img alt="Quarter life, a series by The Conversation" src="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em><strong><a href="https://theconversation.com/uk/topics/quarter-life-117947?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">This article is part of Quarter Life</a></strong>, a series about issues affecting those of us in our twenties and thirties. From the challenges of beginning a career and taking care of our mental health, to the excitement of starting a family, adopting a pet or just making friends as an adult. The articles in this series explore the questions and bring answers as we navigate this turbulent period of life.</em></p>
<p><em>You may be interested in:</em></p>
<p><em><a href="https://theconversation.com/five-things-research-can-teach-us-about-having-better-sex-according-to-a-sex-therapist-199360?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">Five things research can teach us about having better sex, according to a sex therapist</a></em></p>
<p><em><a href="https://theconversation.com/parents-can-feel-pressured-to-stop-breastfeeding-their-baby-heres-how-to-cope-189164?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">Parents can feel pressured to stop breastfeeding their baby – here’s how to cope</a></em></p>
<p><em><a href="https://theconversation.com/mens-fertility-also-declines-with-age-heres-what-to-know-if-youre-planning-to-wait-to-have-kids-187498?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">Men’s fertility also declines with age — here’s what to know if you’re planning to wait to have kids</a></em></p>
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<p>Cigarette smoke is harmful to babies and children. Breathing secondhand smoke <a href="https://www.nhs.uk/live-well/quit-smoking/passive-smoking-protect-your-family-and-friends/">increases their risk</a> of developing asthma and chest and ear infections. It also <a href="https://www.nhs.uk/conditions/baby/caring-for-a-newborn/reduce-the-risk-of-sudden-infant-death-syndrome/">increases the risk</a> of sudden infant death syndrome (SIDS). </p>
<p>This means that you must not smoke around babies. Wait <a href="https://www.royalwolverhampton.nhs.uk/services/service-directory-a-z/maternity-unit/maternity-stopping-smoking-support-team/">at least 30 minutes</a> after smoking before holding a baby – and wash your hands first too. Cigarette smoke also stays on clothes, so consider changing your clothes after smoking and before visiting.</p>
<p>Babies don’t have fully developed neck muscles and have a relatively heavy head, so if you’re lucky enough to pick the baby up or cuddle them, it’s really important to support their head at all times. If you haven’t held a baby before, you can ask a parent to place them in your arms while you are sitting comfortably, making it a less anxious experience for you and the baby. </p>
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<img alt="Woman holding baby" src="https://images.theconversation.com/files/510587/original/file-20230216-16-3bvtm9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/510587/original/file-20230216-16-3bvtm9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/510587/original/file-20230216-16-3bvtm9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/510587/original/file-20230216-16-3bvtm9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/510587/original/file-20230216-16-3bvtm9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/510587/original/file-20230216-16-3bvtm9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/510587/original/file-20230216-16-3bvtm9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">If you hold the baby, make sure to support their head.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-mother-cuddling-baby-daughter-home-562381318">Monkey Business Images/Shutterstock</a></span>
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<p>New parents may not appreciate you touching their newborn without asking first. If the baby is asleep and the parents are tired from caring for the baby overnight, they definitely will not appreciate you waking them by touching or picking them up.</p>
<p>Contact with parents is important for newborn development. While it’s tempting to have lots of cuddles with a friend or relative’s new baby, remember that being held by their parents <a href="https://www.nhsinform.scot/ready-steady-baby/early-parenthood/getting-to-know-your-baby/developing-a-relationship-with-your-baby">helps them bond</a> with them. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2046216/">Familiar smells</a> and sounds keep a newborn calm and help them to feel safe and secure. Parents should also be able to be able to observe their baby to see if they want to feed. </p>
<p>If they are breastfeeding, the baby’s mother may want to offer a feed. As well as providing nutrition for the baby, breastfeeding has a <a href="https://www.parents.com/baby/breastfeeding/basics/the-benefits-of-breastfeeding/">host of benefits</a> for both mother and child. If the mother wants to breastfeed, you can help them feel comfortable by asking if they are happy for you to stay, offering to get them a drink – breastfeeding makes you thirsty – and then continue the conversation without staring.</p>
<h2>Take care of the parents</h2>
<p>When caring for their baby, new parents may forget to look after themselves. They are likely to be tired, both from the birth process and feeding the newborn overnight. They may be anxious or in pain. Focus on the parents (and any older children) first, before turning your attention to the baby. Offer to help with small tasks, like making the tea, or – if you are particularly close – bigger ones, like hanging the washing out. </p>
<p>Let new parents lead the way in any discussions of the labour and birth. You may be really interested to hear about it – but they may not want to talk about it, particularly if it was not the experience they hoped for or expected. If they want to talk about those things, they will.</p>
<p>New parents often get questions about how well their baby is sleeping – but babies waking at night is normal. A baby that sleeps through the night is not a “good baby”, just as one that wakes frequently is not “bad”. Nevertheless, parents are sometimes asked “<a href="https://www.huffingtonpost.co.uk/amy-brown/good-baby-damaging-breastfeeding_b_12452336.html">are they a good baby?</a>” </p>
<p>Babies do not choose to be good or bad, and questions like this could cause feelings of frustration towards them. Instead, focusing on the parents may be the best way forward. Start with questions such as: “How are you feeling?” Tell the parents how pleased or proud for them you are.</p>
<p>New parents have often prepared well, and may have already received gifts from baby showers. While it’s tempting to shop for tiny clothes, it may be more useful for you to give gift vouchers so that parents can get what they really need when they need it. You could also consider taking a nice lunch or snacks with you to help them. Newborns do not need much other than love, care, warmth and food, so while they may grow into toys, these may be better left until later on, or even their first birthday.</p>
<p>The first 12 weeks after the birth of a baby is now often referred to as the <a href="https://www.emmasdiary.co.uk/pregnancy-and-birth/postnatal-wellbeing/what-is-the-fourth-trimester">fourth trimester</a> (the nine months of pregnancy are divided into three trimesters). This time, and the time beyond that for some parents, can feel really challenging and overwhelming. Please let you friends know that you are available for continued support if they need it.</p><img src="https://counter.theconversation.com/content/199346/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sara Smith does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Don’t smoke around babies, wash your hands, and pay attention to the parents, too.Sara Smith, Senior Midwifery Lecturer, Anglia Ruskin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1606442021-07-15T08:59:09Z2021-07-15T08:59:09ZGeneration COVID: pregnancy, birth and postnatal life in the pandemic<figure><img src="https://images.theconversation.com/files/411461/original/file-20210715-32900-18qoxcw.jpeg?ixlib=rb-1.1.0&rect=194%2C879%2C2708%2C2769&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Looking to the future: Charley and her baby daughter.</span> <span class="attribution"><a class="source" href="https://www.jckent.com/">James Clifford Kent</a>, <span class="license">Author provided</span></span></figcaption></figure><p><em>What was it like to be pregnant, to give birth and to look after a baby in the middle of a pandemic? For this Insights article, photographer and researcher of visual cultures James Clifford Kent teamed up with developmental psychologist Sarah Lloyd-Fox to write about what they learned from the people they met while conducting their research projects. James begins the story with a very personal take on the issue.</em></p>
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<p>The pandemic made bringing a baby into the world an even bigger challenge for all new and expectant parents. As a photographer and researcher of visual cultures, I realised this would also be a unique opportunity to capture how COVID restrictions and unprecedented lockdowns impacted this life changing experience for me and my partner.</p>
<p>I began photographing our journey shortly after we got a positive pregnancy test in November 2019. The plan was to document Charley’s pregnancy, but the project quickly grew as I explored the effect of COVID-19 on our experience. </p>
<p>Yet it could have been so different. We had planned to have a homebirth because of COVID restrictions on birth partners. But Charley ended up being induced at the hospital and was left to labour alone through the night on the antenatal ward. Our homebirth midwife and I got there just in time to see my baby daughter being born. Charley received support on the phone from her <a href="https://www.nct.org.uk/pregnancy/who-will-care-for-you-during-pregnancy/what-doula-your-questions-answered">doula</a> (a person who supports a mother through labour and birth) and used the birthing techniques she had learned in online tutorials during her pregnancy. She said:</p>
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<p>I felt confused and distressed throughout my labour and counted down the minutes until I would see James and my midwife again. I knew as soon as I saw them that everything would be OK and I would finally receive the support I so desperately needed. </p>
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<p>Moments after our baby was born, the midwife asked me to push the emergency alarm button. A siren sounded immediately and seconds later hospital staff filled the room. Charley was rushed to theatre after experiencing a major obstetric haemorrhage and suddenly we were separated. Fortunately, she had expressed plenty of <a href="https://theconversation.com/breast-milk-is-a-marvel-of-nature-but-that-doesnt-mean-adults-should-drink-it-to-see-off-disease-57913">colostrum</a> (the first form of breastmilk) and I was able to feed our new baby girl using a syringe. </p>
<p>This time in the recovery area is a blur. I received updates from midwives and surgeons dashing to and from theatre as other partners were being reunited with women and their babies. One midwife recognised me behind my mask and reassured me as I cared for our daughter. </p>
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<img alt="Midwife reassuring woman holding a newborn baby in hospital" src="https://images.theconversation.com/files/406041/original/file-20210613-73420-192x26v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/406041/original/file-20210613-73420-192x26v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/406041/original/file-20210613-73420-192x26v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/406041/original/file-20210613-73420-192x26v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/406041/original/file-20210613-73420-192x26v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/406041/original/file-20210613-73420-192x26v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/406041/original/file-20210613-73420-192x26v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Charley, the baby and the midwife – London, 2020.</span>
<span class="attribution"><span class="source">James Clifford Kent</span></span>
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<p>Immediately after the birth I took a photograph of Charley with our newborn baby and our midwife. It was later shared widely <a href="https://www.instagram.com/p/CKTq3vhH9eR/">on Instagram</a> and I began to receive hundreds of messages from other people who wanted to tell their own stories about what it was like having a baby under pandemic restrictions. One woman, Stacey (35, London) told me it felt like she had “given birth to a secret baby, behind closed doors”. </p>
<p>And so the <a href="https://www.jckent.com/pregnant-in-a-pandemic/">Pregnant in a Pandemic</a> project was born: to give a voice to people like Stacey. A visual record of what new and expectant parents living in London were going through and the impact COVID-19 has had on their experiences. They have shared portraits and testimonies about love, loss and survival in the face of adversity, as well as personal experiences of key developmental and family milestones. </p>
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<p><strong><em>This story is part of Conversation Insights</em></strong>
<br><em>The Insights team generates <a href="https://theconversation.com/uk/topics/insights-series-71218">long-form journalism</a> and is working with academics from different backgrounds who have been engaged in projects to tackle societal and scientific challenges.</em> </p>
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<p><em>While James was beginning to document the lives of families through photography, Sarah and her team were conducting surveys and gathering data.</em></p>
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<p>As a mother, and a <a href="https://www.pipkinstudy.com/people">developmental psychologist</a>, the beginning of the pandemic also triggered in me a cascade of concerns. For many, the birth of a baby is the beginning of a web of positive relationships and connections that reach far beyond those within one household. But as the pandemic enclosed us in a new socially restricted world, I wanted to find out what unanticipated worries were being experienced by those going through pregnancies, birth and early parenthood. </p>
<p>And what of the baby? When their entire world became just their household, did this provide opportunity for closer relationships and improved early development, or were there also risks inherent in this changed landscape? </p>
<p>Our research group at the University of Cambridge and Cambridge University Hospitals set up the COVID in the Context of Pregnancy, Infancy and Parenting (CoCoPIP) <a href="https://www.pipkinstudy.com/covid">online study</a> to further understand and support families. Over <a href="https://www.medrxiv.org/content/10.1101/2021.05.22.21257649v1.full">2,500</a> expectant and new parents have participated so far. Many of their stories bear striking parallels with the experiences of the families who reached out to James. </p>
<p>Our work has aligned through our common desire to provide a platform for “generation COVID” families. Here are just some of those voices. </p>
<h2>Bisma – ‘a 1% chance of survival’</h2>
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<img alt="Pakistani woman in red shirt holding her son" src="https://images.theconversation.com/files/406044/original/file-20210613-13-4fmjh9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/406044/original/file-20210613-13-4fmjh9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=901&fit=crop&dpr=1 600w, https://images.theconversation.com/files/406044/original/file-20210613-13-4fmjh9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=901&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/406044/original/file-20210613-13-4fmjh9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=901&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/406044/original/file-20210613-13-4fmjh9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1132&fit=crop&dpr=1 754w, https://images.theconversation.com/files/406044/original/file-20210613-13-4fmjh9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1132&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/406044/original/file-20210613-13-4fmjh9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1132&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Bisma and Azlan – London, 2021.</span>
<span class="attribution"><span class="source">James Clifford Kent</span></span>
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<p>Bisma is 34. Her waters broke prematurely at 22 weeks on the day the World Health Organization declared the COVID-19 outbreak <a href="https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020">a global pandemic</a>. No one else could be with her at the hospital, and having already experienced loss in previous pregnancies, decisions about how to manage this pregnancy were left to her alone. </p>
<p>She was told that she could give birth within 48 hours to a baby that had just a 1% chance of survival. Azlan was born at 32 weeks and is now a healthy one-year-old. Bisma said:</p>
<blockquote>
<p>I was assigned a bereavement midwife at 22 weeks and my husband was not allowed to stay with me. I spent three days on my own in a bereavement labour room. I could still feel the baby kicking and my faith was strong. I refused to take the tablet to induce labour and I carried my baby for another ten weeks. Azlan was in NICU [Neonatal Intensive Care Unit] for seven weeks while I made lifelong friends – they held my hand, wiped away my tears and gave me hope.“ </p>
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<p>Bisma’s sense of isolation aligns strongly with findings from the first <a href="https://www.medrxiv.org/content/10.1101/2021.04.14.21255490v1">500 pregnant women</a> in the CoCoPIP study. During 2020, a common theme was the way in which the changes to healthcare provision increased parents’ anxiety levels and feelings of not being supported. </p>
<p>Repeatedly, women commented on the acute anxiety from having to attend antenatal appointments alone or by phone or video call, and the chronic anxiety associated with the uncertainty of whether they would have to give birth in the hospital without family or friends present. Antenatal and maternity services for expectant parents have been consistently reported as being disproportionately affected by social distancing requirements put in place worldwide (<a href="http://humanrightsinchildbirth.org/wp-content/uploads/2020/05/Human-Rights-in-Childbirth-Pregnancy-Birth-and-Postpartum-During-COVID19-Report-May-2020.pdf">Human Rights in Childbirth, 2020</a>). </p>
<p>For example, there was a <a href="https://jamanetwork.com/journals/jama/fullarticle/2768389">four-fold increase</a> in stillbirths observed in a sample of 1,681 births in London between February and June 2020. This was attributed to a lack of preventative antenatal care. </p>
<h2>Izzy – the miscarriage taboo</h2>
<figure class="align-center ">
<img alt="School teacher standing in front of science equipment in class room" src="https://images.theconversation.com/files/406045/original/file-20210613-79011-it6t9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/406045/original/file-20210613-79011-it6t9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=901&fit=crop&dpr=1 600w, https://images.theconversation.com/files/406045/original/file-20210613-79011-it6t9m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=901&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/406045/original/file-20210613-79011-it6t9m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=901&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/406045/original/file-20210613-79011-it6t9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1132&fit=crop&dpr=1 754w, https://images.theconversation.com/files/406045/original/file-20210613-79011-it6t9m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1132&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/406045/original/file-20210613-79011-it6t9m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1132&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Izzy – London, 2021.</span>
<span class="attribution"><span class="source">James Clifford Kent</span></span>
</figcaption>
</figure>
<p>Izzy (31, London) is a school teacher. She was pregnant three times during the pandemic and is expecting her first child this summer. She told us:</p>
<blockquote>
<p>I’ve always been familiar with pregnancy and baby loss, as my earliest memory is the stillbirth of my sister. Despite this, I could never have imagined getting pregnant three times in 2020 and losing two of them during a pandemic. I found out my first baby had died during a scan. I was all alone as my husband wasn’t allowed in the hospital and there was no mental or physical follow up. Not knowing why was the hardest thing.</p>
</blockquote>
<p>Izzy talked about how miscarriage remains a taboo subject. Most people either didn’t want to talk to her about it or just didn’t know how. She found herself withdrawing from groups but she had to carry on working. She did plenty of research before seeing her GP and he agreed to prescribe <a href="https://www.webmd.com/vitamins/ai/ingredientmono-760/progesterone">progesterone</a> – a hormone that helps maintain pregnancy – despite stating that she had "only” suffered two miscarriages. Now in the third trimester (as of July 2021), she is so grateful that she didn’t take no for an answer. She added:</p>
<blockquote>
<p>I take each day as it comes, holding onto hope that I am just a few months away from holding my healthy baby in my arms.</p>
</blockquote>
<p>Izzy’s comments illustrate how pandemic-related social restrictions have not only generated new sources of anxiety but also magnified existing challenges in society. Her description of miscarriage, loss and the taboo of grief will resonate. </p>
<p>Lots of people will be familiar with this story. Many of us will have female friends and family who have had a miscarriage or have struggled to get pregnant. Yet miscarriage and neonatal death remains a subject shrouded in silence. Inadequate care and support persists across both <a href="https://www.who.int/news-room/spotlight/why-we-need-to-talk-about-losing-a-baby">high and low income countries</a>, even the language used around miscarriage and stillbirth can be traumatic (an “incompetent cervix”, for example). The <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)01020-X/fulltext">stigma, fatalism and inequalities</a> surrounding stillbirths and miscarriages should be a priority for action. </p>
<h2>Nicole – bereavement</h2>
<figure class="align-center ">
<img alt="Portrait of woman standing in front of trees in a park" src="https://images.theconversation.com/files/406047/original/file-20210613-66119-1nrj3nu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/406047/original/file-20210613-66119-1nrj3nu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=894&fit=crop&dpr=1 600w, https://images.theconversation.com/files/406047/original/file-20210613-66119-1nrj3nu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=894&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/406047/original/file-20210613-66119-1nrj3nu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=894&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/406047/original/file-20210613-66119-1nrj3nu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1123&fit=crop&dpr=1 754w, https://images.theconversation.com/files/406047/original/file-20210613-66119-1nrj3nu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1123&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/406047/original/file-20210613-66119-1nrj3nu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1123&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Nicole – London, 2021.</span>
<span class="attribution"><span class="source">James Clifford Kent</span></span>
</figcaption>
</figure>
<p>Nicole (38, London) miscarried as the second wave of the pandemic hit. With her family all living outside the UK, she felt isolated from the people who loved her and ignored by the system designed to support her. </p>
<blockquote>
<p>I went in for an emergency ultrasound. My partner paced the parking lot while I sat in the waiting room bleeding through my tracksuit bottoms. There was one other woman there. We looked at each other, two metres apart, faces obscured by masks but eyes rimmed with tears. Between us passed a silent acknowledgement that we were two women experiencing the same trauma.</p>
<p>The midwife who had seen me once before was there for the emergency shift. Her daughter and I share the same first name, so she remembered me. She told me there was no heartbeat. She asked me if I had questions. I had no way of forming words. Without my partner there, I had no earth beneath my feet.</p>
<p>I could tell she wanted to comfort me but couldn’t risk too much contact, as she wasn’t wearing full PPE. Plus, she didn’t have any time, she had to move on – presumably to the other woman in the waiting room.</p>
</blockquote>
<p>Nicole and Izzy’s experiences of healthcare echo the voices of many parents in both our studies. Overwhelmingly, women have felt <a href="https://www.medrxiv.org/content/10.1101/2021.04.14.21255490v1">inadequately supported</a> with responses largely negative or neutral in tone and only around 20% containing positive comments.</p>
<p>While lack of sympathy from health workers was highlighted often by our parents, many – like Nicole – sympathised with the healthcare staff and contextualised this lack of sympathy as being a consequence of COVID-related restrictions. One parent from the <a href="https://doi.org/10.1101/2021.07.05.21260022">CoCoPIP study</a>, upon hearing she would have to give birth alone, took strength from her midwife’s sympathy. She said:</p>
<blockquote>
<p>This was a shock to me and I had a very emotional response. She was also upset by this. I appreciated that this was out of her control and that there was nothing she could do, I just really appreciated her empathetic response, I felt less alone in that moment.</p>
</blockquote>
<h2>Emily – NHS midwife</h2>
<figure class="align-center ">
<img alt="Midwife standing at the bottom of a stairway with her daughter in a pram" src="https://images.theconversation.com/files/406048/original/file-20210613-73420-dmxxj8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/406048/original/file-20210613-73420-dmxxj8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=887&fit=crop&dpr=1 600w, https://images.theconversation.com/files/406048/original/file-20210613-73420-dmxxj8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=887&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/406048/original/file-20210613-73420-dmxxj8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=887&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/406048/original/file-20210613-73420-dmxxj8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1114&fit=crop&dpr=1 754w, https://images.theconversation.com/files/406048/original/file-20210613-73420-dmxxj8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1114&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/406048/original/file-20210613-73420-dmxxj8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1114&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Emily and Cleo – London, 2021.</span>
<span class="attribution"><span class="source">James Clifford Kent</span></span>
</figcaption>
</figure>
<p>Emily (34, London) described the way her personal experience of having a baby during the pandemic was an opportunity to learn, grow and educate herself as a midwife. </p>
<p>Like millions of other women, she attended scans and appointments alone, waited anxiously for news and results by herself, watched her partner leave the hospital just hours after the baby’s birth and cared for her newborn baby in complete isolation. </p>
<blockquote>
<p>My experience of becoming a new parent during the pandemic has inspired me to educate myself and further develop my practice. Returning to the frontline from maternity leave, I want to be ready to meet the new challenges that COVID-19 has brought about with an understanding of what people have been through.</p>
</blockquote>
<p>One such lifeline that has continued to support women throughout the pandemic is described by Alanya and is open to those suffering severe or acute mental health issues.</p>
<h2>Alanya – finding a community</h2>
<figure class="align-center ">
<img alt="Woman holding her son and standing in front of graffiti" src="https://images.theconversation.com/files/406049/original/file-20210613-72921-r2grbd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/406049/original/file-20210613-72921-r2grbd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=901&fit=crop&dpr=1 600w, https://images.theconversation.com/files/406049/original/file-20210613-72921-r2grbd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=901&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/406049/original/file-20210613-72921-r2grbd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=901&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/406049/original/file-20210613-72921-r2grbd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1132&fit=crop&dpr=1 754w, https://images.theconversation.com/files/406049/original/file-20210613-72921-r2grbd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1132&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/406049/original/file-20210613-72921-r2grbd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1132&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Alanya and Casper – London, 2021.</span>
<span class="attribution"><span class="source">James Clifford Kent</span></span>
</figcaption>
</figure>
<p>Alanya (24, London) lost her partner suddenly just before her 20-week scan and gave birth at the beginning of the first lockdown. She said:</p>
<blockquote>
<p>Just after I gave birth the nurses told me that the country had gone into lockdown. I was alone on the ward with the baby and I was terrified. It was a massive relief to return home with him but that first lockdown was really hard. It was just the two of us. I wasn’t getting any sleep and it became unbearable. </p>
<p>My mental health quickly deteriorated and we ended up spending three months in a mother and baby unit. It was a fairly positive experience. We were surrounded by staff, new mums and their babies from all walks of life. Now I’m living in a new place and I’ve returned to my old job. My baby Casper will go to the nursery down the road and I’m surrounded by friends. The last 12 months have been really tough but I can feel the sun beginning to shine again. </p>
</blockquote>
<p>While the world was rocked, traumatised and turned upside down, Alanya was already going through her own personal trauma during pregnancy. Her partner had taken his own life, leaving Alanya and her unborn baby in an extremely vulnerable position while she dealt with her grief and emotional wellbeing. </p>
<p>Grief in pregnancy may also lead to physical changes such as an increase in stress hormones, sleep issues, physical discomfort for the mother, which in turn have been linked to small <a href="https://www.aeaweb.org/articles?id=10.1257/app.20140262&within%5Btitle%5D=on&within%5Babstract%5D=on&within%5Bauthor%5D=on&journal=4&q=does+grief+transfer&from=j">negative effects</a> on birth (lower birth weight and increased probability of a caesarian section). Some researchers have linked grief in pregnancy to impacts on the <a href="https://www-journals-uchicago-edu.ezp.lib.cam.ac.uk/doi/10.1086/704615#">child’s later mental health</a>, while others have found <a href="https://www.aeaweb.org/articles?id=10.1257/app.20140262&within%5Btitle%5D=on&within%5Babstract%5D=on&within%5Bauthor%5D=on&journal=4&q=does+grief+transfer&from=j">no impact</a> on later life in adulthood. The long term impact for the child is a complex story.</p>
<p>As well as access to additional mental health support, Alanya’s time at a mother and baby unit gave her and her growing baby a near unique experience in the UK during the first lockdown. She lived, for a time, in a communal family of healthcare support staff and mothers and babies – who were therefore able to support, learn from, and socialise with each other at a time when others were isolated and often alone. </p>
<p>The importance of babies having positive bonding, stronger attachments and more positive social interactions with their caregivers for their <a href="https://apps.who.int/iris/handle/10665/42878">survival and healthy development</a> cannot be under-emphasised. Alanya added: </p>
<blockquote>
<p>People tend to see, hear, about what we’ve been through and panic. There have been challenging times but we are doing well – Casper is happy and overachieving developmentally. We’ve been well supported but other people aren’t as lucky.</p>
</blockquote>
<h2>Sarah – mental health</h2>
<p>COVID-19 maternity restrictions have made it especially challenging for new and expectant parents looking to safeguard their mental health.</p>
<figure class="align-center ">
<img alt="Woman holding her daughter on a balcony overlooking a canal" src="https://images.theconversation.com/files/406050/original/file-20210613-23-fijrhu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/406050/original/file-20210613-23-fijrhu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=840&fit=crop&dpr=1 600w, https://images.theconversation.com/files/406050/original/file-20210613-23-fijrhu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=840&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/406050/original/file-20210613-23-fijrhu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=840&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/406050/original/file-20210613-23-fijrhu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1056&fit=crop&dpr=1 754w, https://images.theconversation.com/files/406050/original/file-20210613-23-fijrhu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1056&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/406050/original/file-20210613-23-fijrhu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1056&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Sarah and Bee – London, 2021.</span>
<span class="attribution"><span class="source">James Clifford Kent</span></span>
</figcaption>
</figure>
<p>Sarah (34, London) said she would never forget the bewildered look on her partner’s face as she was briskly wheeled away holding their daughter, shortly after a long and traumatic labour and birth. It encapsulated her experience of the pandemic. She felt lost, alone and without the support she needed due to COVID maternity restrictions and an overstretched healthcare system. She said:</p>
<blockquote>
<p>I experienced a short episode of depression when I first moved to London at 24 years old and was terrified of feeling like that again with a new baby. I did everything I could to protect my mental health and to give us the best possible start as a new family. Despite my best efforts, I could never have predicted the pandemic. I attended midwife appointments and scans alone, spent nights with the baby in the hospital without my partner and had no health visitor checking up on us. </p>
</blockquote>
<p>Sarah was very conscious of the need to support her own mental health
during her pregnancy so that she had a positive experience when her baby
arrived. Her intuitive stance to protect her family was an important step. Being
able to put our mental health front and centre in our lives can enable us to
maintain positive wellbeing. Sarah said:</p>
<blockquote>
<p>I was lucky enough to work with a fantastic doula, without whom I would have
felt very alone during the pandemic. During the first week after birth my baby
was readmitted to hospital with jaundice. NHS services were overstretched and often there was no in-person support. It wasn’t possible to rely on family support due to COVID restrictions.</p>
</blockquote>
<p>NHS doctor Larisa Corda described to us how, during the pandemic, “women
have had to make decisions faced with fatigue, exhaustion, rage, despair and
a level of anxiety we have never seen before. It’s led to many feeling scared
for themselves and their babies, fearful of going into hospital and traumatised
by the sense of isolation”.</p>
<p>Parental anxiety, depression and stress during pregnancy and the postnatal
period have been shown to have far reaching impact. Mental health issues
can trigger both physiological (stress hormones) and social (interactions
between parent and baby) changes in both the parent and foetus, baby or
child. The prenatal environment of babies of mothers with anxiety or
depression has been shown to impact on early brain development.</p>
<p>Studies have shown that babies of depressed mothers may have lower rates
of interactive behaviour, poorer concentration and increased negative
responses with strangers. When older, children of post-natally depressed
mothers are also more likely to experience depression or lower academic
performance by the age of 16.</p>
<h2>Claire – high-risk pregnancy</h2>
<figure class="align-center ">
<img alt="Woman with tattoos wearing a headscarf and holding a baby" src="https://images.theconversation.com/files/406051/original/file-20210613-65156-23c3ef.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/406051/original/file-20210613-65156-23c3ef.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/406051/original/file-20210613-65156-23c3ef.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/406051/original/file-20210613-65156-23c3ef.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/406051/original/file-20210613-65156-23c3ef.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/406051/original/file-20210613-65156-23c3ef.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/406051/original/file-20210613-65156-23c3ef.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Claire and Marnie – London, 2021.</span>
<span class="attribution"><span class="source">James Clifford Kent</span></span>
</figcaption>
</figure>
<p>Being pregnant, diabetic and <a href="https://www.birthrights.org.uk/campaigns-research/racial-injustice/">mixed race</a> meant that the pandemic was a scary time for Claire (36, London) and her partner Phil. Being diabetic meant fortnightly – sometimes weekly – clinic appointments with close monitoring. She constantly tried to avoid getting her hopes up in case they lost the baby.</p>
<p>“By the time we got to the 12-week scan we were in lockdown and I suddenly found myself alone at a scan with my partner waiting anxiously outside the hospital,” she said. The increased risk to her pregnancy was really hard for her partner who had PTSD from being on the Aldgate train in the <a href="https://www.bbc.co.uk/news/uk-33253598">7/7 London bombings</a>.</p>
<blockquote>
<p>I spent a total of two weeks alone at the hospital, from the moment my waters broke to being discharged after the birth. Phil was only allowed to join me during the C-section. During that time, doctors told me that damage to my kidney function meant I might not be able to carry another baby in the future. I was on my own and in a lot of pain but just had to get on with everything. That’s all you can do. I had a little cry and got on with being a mum.</p>
</blockquote>
<p>While there have been positive changes in paternal parental culture, fathers continue to feel <a href="https://www.tandfonline.com/doi/abs/10.1080/02646838.2014.971404?journalCode=cjri20">undervalued and unsupported</a> during pregnancy and their child’s early life. During the pandemic, these feelings may have been amplified given that fathers have been excluded from the majority of pregnancy appointments and some from the birth of their own child.</p>
<h2>Sally – catching COVID</h2>
<p>At Christmas in 2020, Sally (38, London) – who was then 20 weeks pregnant – contracted COVID-19 along with the rest of her family, including her mother and 18-month-old son.</p>
<figure class="align-center ">
<img alt="Woman at home sitting on a sofa surrounded by lamp and plant" src="https://images.theconversation.com/files/406052/original/file-20210613-65156-1xyftfl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/406052/original/file-20210613-65156-1xyftfl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/406052/original/file-20210613-65156-1xyftfl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/406052/original/file-20210613-65156-1xyftfl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/406052/original/file-20210613-65156-1xyftfl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1132&fit=crop&dpr=1 754w, https://images.theconversation.com/files/406052/original/file-20210613-65156-1xyftfl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1132&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/406052/original/file-20210613-65156-1xyftfl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1132&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Sally – London, 2021.</span>
<span class="attribution"><span class="source">James Clifford Kent</span></span>
</figcaption>
</figure>
<blockquote>
<p>I was taken aback, since I didn’t have a high temperature or a cough … I felt numb with fear of the unknown and the harm the virus could cause the baby. There were no answers … Like dominoes, everyone in my household went down with COVID.</p>
</blockquote>
<p>Sally said she was afraid to take pain relief in case it would affect her unborn child. For the next three weeks her entire body was overtaken by surges of excruciating pain, but caring for her toddler was the hardest part. She added:</p>
<blockquote>
<p>He would scream for hours, sleeping only when he was propped up on my already protruding tummy. When he stopped eating and then drinking altogether all the GP could advise was to “try harder” – presumably to keep us out of an already overwhelmed NHS hospital … We just had to wait it out.</p>
</blockquote>
<p>While for many of us the year represents a series of tumultuous restrictions on our lives, Sally’s story highlights the additional strain (both physical and mental) that the pandemic has brought into some households whether due to themselves or their wider family contracting the virus. </p>
<h2>Nichelle – frontline NHS worker</h2>
<p>Nichelle gave birth to her daughter Alaiyah just before the first UK lockdown in March 2020. After returning to work as an NHS midwife, she began to write notes about her experience of the pandemic and its effect on NHS staff.</p>
<figure class="align-center ">
<img alt="NHS midwife sitting on children's play mat while holding her daughter" src="https://images.theconversation.com/files/406055/original/file-20210613-73723-1qufz0z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/406055/original/file-20210613-73723-1qufz0z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=901&fit=crop&dpr=1 600w, https://images.theconversation.com/files/406055/original/file-20210613-73723-1qufz0z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=901&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/406055/original/file-20210613-73723-1qufz0z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=901&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/406055/original/file-20210613-73723-1qufz0z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1132&fit=crop&dpr=1 754w, https://images.theconversation.com/files/406055/original/file-20210613-73723-1qufz0z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1132&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/406055/original/file-20210613-73723-1qufz0z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1132&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Nichelle and Alaiyah – London, 2021.</span>
<span class="attribution"><span class="source">James Clifford Kent</span></span>
</figcaption>
</figure>
<blockquote>
<p>Towards the end of my pregnancy, I was working as a midwife providing support and reassurance to women as the situation worsened. Then suddenly I was in their position, with difficulties accessing maternity services as I prepared to have my baby. </p>
<p>The postnatal experience was difficult. I received excellent support but it was never in person. Friends, family and colleagues stayed away – terrified of passing on the virus. I was thankful for having all this uninterrupted time with my girls but felt so alienated and craved proper human interaction as I witnessed remotely how the pandemic was affecting my peers and colleagues and felt helpless. </p>
</blockquote>
<h2>Learning from the pandemic</h2>
<p>Birth could be thought of as the most dramatic change in environment that a baby undergoes in its lifetime. A pivotal moment on a journey begun months before, where myriad experiences have already affected a baby’s growth and development during pregnancy.</p>
<p>These cascading events are punctuated by birth itself, before a whole new host of experiences and factors continue to shape a baby’s early behaviour. And in the wake of each new life come ripples of changes to the lives of the family that supports them. </p>
<p>Many of the difficulties faced by expectant families having a baby during the pandemic have accentuated existing inequalities in <a href="https://www.ox.ac.uk/news/2021-01-19-parental-mental-health-worsens-under-new-national-covid-19-restrictions">antenatal and postnatal experiences</a> across the UK. </p>
<p>And the UK government’s own <a href="https://committees.parliament.uk/publications/6158/documents/68766/default/">report</a> concerning NHS and social care staff burnout has highlighted that staff shortages have been exacerbated by the pandemic.</p>
<p>Our projects are documenting the real life consequences that stem from these issues, as well as the hardship, courage and resilience that families are showing in the face of adversity. We intend to give “generation COVID” families a voice for months and years to come and we hope these stories, and the research data generated by them, will be a force for change in these most vital areas.</p>
<hr>
<p><em>Editor’s note: A new quote was added to this article on July 19 to better reflect some of the experiences of birth during lockdown.</em></p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/313478/original/file-20200204-41481-1n8vco4.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p><em>For you: more from our <a href="https://theconversation.com/uk/topics/insights-series-71218?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Insights series</a>:</em></p>
<ul>
<li><p><em><a href="https://theconversation.com/cant-face-running-have-a-hot-bath-or-a-sauna-research-shows-they-offer-some-similar-benefits-158552?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">Can’t face running? Have a hot bath or a sauna – research shows they offer some similar benefits</a></em></p></li>
<li><p><em><a href="https://theconversation.com/a-culture-of-silence-and-stigma-around-emotions-dominates-policing-officer-diaries-reveal-152657?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">A culture of silence and stigma around emotions dominates policing, officer diaries reveal</a></em></p></li>
<li><p><em><a href="https://theconversation.com/the-double-lives-of-gay-men-in-chinas-hainan-province-153945?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK">The double lives of gay men in China’s Hainan province</a></em></p></li>
</ul>
<p><em>To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. <a href="https://theconversation.com/uk/newsletters/the-daily-newsletter-2?utm_source=TCUK&utm_medium=linkback&utm_campaign=TCUKengagement&utm_content=InsightsUK"><strong>Subscribe to our newsletter</strong></a>.</em></p><img src="https://counter.theconversation.com/content/160644/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sarah Lloyd-Fox receives funding from UKRI, Horizon 20-20 and The Bill and Melinda Gates Foundation. </span></em></p><p class="fine-print"><em><span>James Clifford Kent does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>First-hand family accounts and photographs trace the difficulties and traumas of giving birth and looking after a baby during a pandemic.James Clifford Kent, Senior Lecturer, Royal Holloway University of LondonSarah Lloyd-Fox, Research Fellow, Department of Psychology, University of CambridgeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1258672019-11-10T13:06:02Z2019-11-10T13:06:02ZMore romantic partners means more support, say polyamorous couples<figure><img src="https://images.theconversation.com/files/306578/original/file-20191212-85397-969fv0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Although polyamorous families provide great support for themselves internally, they report experiencing marginalization within the health-care system and fear of judgment by health-care providers</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Polyamory is the act of engaging in multiple consensual, potentially long-term, romantic or sexual relationships at the same time. </p>
<p>We <a href="http://www.polybabes.ca">conducted an interview study</a> with polyamorous families to <a href="https://doi.org/10.1503/cmaj.190224">examine their experiences with pregnancy and birth</a>.</p>
<p>Our aim was to identify barriers to prenatal, antenatal and postnatal care for polyamorous families and to share results and strategies with health-care providers in the hope of overcoming them.</p>
<p>We found that those in polyamorous relationships benefit from each other but not from the system. Many of our interviewees expressed the view that having more partners garners more support. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-you-might-want-to-rethink-monogamy-88217">Why you might want to rethink monogamy</a>
</strong>
</em>
</p>
<hr>
<p>They told us that although navigating multiple relationships can be difficult, it can also offer greater financial and logistical support when it comes to raising a family. One participant said:</p>
<blockquote>
<p>“There’s extra one-on-one. When the 13-year-old middle child is sad and sick and whatever and just wants Momma, and the three-year-old just wants Dad… great, there’s still another adult to take care of those other kids.” </p>
</blockquote>
<p>Our research participants also expressed difficulty navigating formal and informal social systems — including the health-care system — as we live in a world that tends to privilege monogamy. </p>
<h2>A variety of relationship structures</h2>
<p>The concept of polyamory, which is one type of non-monogamy, is poorly understood and it can mean different things to different people. </p>
<p>Generally speaking, polyamorous relationships are long-standing, romantic or sexual in nature, and involve more than two individuals. However, this is not true for everyone engaging in polyamory. <a href="https://vanierinstitute.ca/polyamory-in-canada-research-on-an-emerging-family-structure/">There are a variety of relationship structures</a> or “polycules” that exist within the world of polyamory.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/300711/original/file-20191107-10919-1kipopy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/300711/original/file-20191107-10919-1kipopy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/300711/original/file-20191107-10919-1kipopy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/300711/original/file-20191107-10919-1kipopy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/300711/original/file-20191107-10919-1kipopy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/300711/original/file-20191107-10919-1kipopy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/300711/original/file-20191107-10919-1kipopy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Polyamory is an increasingly common relationship choice.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Some polycules are structured hierarchically where two individuals (or more) of similar (or different) gender identities live together (or separate) and prioritize their relationship but engage in other romantic or sexual relationships outside of this dyad.</p>
<p>Other polycules are non-hierarchical and all relationships are considered priority. In some cases, all individuals in a polycule are engaged in romantic or sexual relationships with all parties, but this is not always the case. </p>
<p>Each polyamorous relationship is unique in structure, arrangement and definition.</p>
<h2>More common than people think</h2>
<p>Because polyamory means different things to different people, it is a hard thing to quantify. All the participants in our study described being polyamorous as part of their identify. However, debate exists as to whether polyamory should be considered part of one’s sexual orientation or rather a relationship practice. </p>
<p>As such, prevalence estimates are also limited by individual willingness to disclose their polyamorous status.</p>
<p>The most recent estimate suggests that <a href="https://doi.org/10.1503/cmaj.190224">one in five single adults have practised some form of consensual non-monogamy</a>. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/300713/original/file-20191107-10940-mchw5k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/300713/original/file-20191107-10940-mchw5k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=499&fit=crop&dpr=1 600w, https://images.theconversation.com/files/300713/original/file-20191107-10940-mchw5k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=499&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/300713/original/file-20191107-10940-mchw5k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=499&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/300713/original/file-20191107-10940-mchw5k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=628&fit=crop&dpr=1 754w, https://images.theconversation.com/files/300713/original/file-20191107-10940-mchw5k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=628&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/300713/original/file-20191107-10940-mchw5k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=628&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Polyamorous research participants put a lot of effort into dialogue around family planning.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>If only 10 per cent of these practise polyamory specifically, that would still represent two per cent of the entire single population. </p>
<p>Furthermore, this number does not account for married individuals engaging in consensual non-monogamy. </p>
<p>One Canadian based survey <a href="https://doi.org/10.1080/0092623X.2016.1178675">collected information from 547 self-identified polyamorous individuals</a>. This survey reported that the number of polyamorous folks is growing. It also showed that the majority are of childbearing age (25 to 44 years) with greater than 20 per cent having at least one child under the age of 19. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/wish-you-were-in-an-open-relationship-so-do-many-canadians-115284">Wish you were in an open relationship? So do many Canadians</a>
</strong>
</em>
</p>
<hr>
<p>Despite the limitations of research to date, we can conclude that polyamory is more common than most people think and that folks engaging in polyamorous relationships are having children.</p>
<h2>Discussion of parenting roles</h2>
<p>The polyamorous families we interviewed expressed a great deal of deliberateness in their decision-making, specifically around family planning. </p>
<p>They put substantial efforts into communication around whether children were desired within relationships, when to have children, who in the relationships would be biological parents and what parenting roles individuals would have.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/when-you-have-2-lovers-the-holidays-can-be-tricky-108392">When you have 2 lovers, the holidays can be tricky</a>
</strong>
</em>
</p>
<hr>
<p>Although this was not always the case, many of our interviewees also reported difficulty disclosing their polyamorous status due to fear of judgment. This was true for disclosure to family, friends, colleagues and, in the case of pregnancy and birth, to their care providers. </p>
<p>Even when participants did disclose their relationships with multiple partners, these relationships were not always validated. For example, one participant said:</p>
<blockquote>
<p>“They asked who is allowed to make appointments for your child, and I said me, my husband and my girlfriend. And I had to give her name and her number. And they asked me several times, are you sure? What’s her relationship to the child? I’m like, well, I guess she’s technically his mother. And they’re like, well, we’ll just put down his aunt because we can’t put down multiple mothers when you already have a father, apparently.”</p>
</blockquote>
<h2>Marginalization within health-care system</h2>
<p>Regarding pregnancy and birth, our participants expressed feeling marginalized in the health-care system. They found that health-care providers and the system in general offered little space to acknowledge partners outside of biological parentage. </p>
<p>Our participants expressed facing barriers such as lack of physical space for additional partners, lack of inclusion in medical decision making and facing judgement with disclosures.</p>
<p>Each experience that participants shared with us was unique, however, just as every family is.</p>
<p>[ <em>You’re smart and curious about the world. So are The Conversation’s authors and editors.</em> <a href="https://theconversation.com/ca/newsletters?utm_source=TCCA&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=youresmart">You can read us daily by subscribing to our newsletter</a>. ]</p><img src="https://counter.theconversation.com/content/125867/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Elizabeth Darling receives funding from the Ontario Ministry of Health through the Association of Ontario Midwives' research grants. The opinions and statements expressed herein are solely those of the authors and do not reflect those of the funding source; no endorsement is intended or should be inferred.</span></em></p><p class="fine-print"><em><span>Erika Arseneau was a co-recipient of the Association of Ontario Midwives early researcher grant.</span></em></p><p class="fine-print"><em><span>Samantha Landry was a co-recipient of the Association of Ontario Midwives early researcher grant. </span></em></p>Having multiple romantic partners also offers greater financial and logistical support when raising children, according to research with polyamorous families.Elizabeth Darling, Director/Assistant Dean, Midwifery, and Associate Professor, McMaster UniversityErika Arseneau, Midwifery Student, McMaster UniversitySamantha Landry, Student Midwife, McMaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1202102019-08-07T22:36:01Z2019-08-07T22:36:01Z25 years on: What midwifery in Canada has achieved and what it still needs<figure><img src="https://images.theconversation.com/files/285756/original/file-20190725-136759-p6acls.jpg?ixlib=rb-1.1.0&rect=215%2C5%2C3778%2C2586&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Demand for midwifery services across Canada is now much greater than midwives can currently provide.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>On Jan. 1, 1994, <a href="https://www.ontario.ca/laws/statute/91m31">The Midwifery Act in Ontario</a> was implemented. This was a historic event as Canada was, at that time, the only developed nation in the world without a system of regulated midwifery. </p>
<p>Over the past 25 years, all the other Canadian provinces and territories have followed Ontario by legalizing and funding midwifery — except <a href="https://www.whitehorsestar.com/News/midwifery-rules-on-track-for-year-s-end">Yukon</a> and <a href="https://www.cbc.ca/news/canada/prince-edward-island/pei-midwives-regulation-application-1.4976724">Prince Edward Island</a>, which are planning to do so. </p>
<p>The number of midwives practising across the country has grown remarkably — from 60 in 1994 <a href="https://canadianmidwives.org/category/maps/">to around 1,700 in 2019</a>. They attend nearly 11 per cent of births in the country.</p>
<p>I am a registered midwife in Ontario, as well as an assistant professor in the midwifery education program at McMaster University. I also used midwifery services in the era before legislation and lobbied the Ontario government in the 1980s to include midwifery in the health-care system. And I was accepted into the first class of midwifery students at McMaster in 1993. </p>
<p>I have been a witness to the changes and advances in midwifery over the past 25 years. During this time, there has been great progress in the profession. At the same time, midwives have been on the sidelines of policy decisions. This has made midwives more vulnerable to the whims of governments than those in older, more established health professions, like nurses and physicians. </p>
<h2>From home to hospital births</h2>
<p>Of course, in 1994, we had no way of knowing how much midwifery would grow and how the practice would change. Midwives at that time attended many births at home, while also working to integrate into the hospital setting. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1011389978113388544"}"></div></p>
<p>Each midwife was on-call 24 hours a day, seven days a week, providing care under the principles of continuity of care, informed choice and choice of birth place. Many had to transfer care to an obstetrician if their client needed an induction of labour or wanted an epidural for pain relief.</p>
<p>Now, in the 21st century, midwives manage both inductions and epidurals, and most of the births they attend take place in the hospital. </p>
<p>Many have moved to “shared care” models of care so that midwives can have more time off-call to spend with their families. Some are participating in “collaborative care” projects to serve diverse populations, such as the longstanding <a href="https://www.scbp.ca/">South Community Birth Program</a> in Vancouver.</p>
<h2>Renewal of Indigenous midwifery</h2>
<p>Midwives in Markham Stouffville Hospital in Ontario have developed the <a href="https://www.msh.on.ca/clinics-departments/stollery-family-centre-childbirth-children/alongside-midwifery-unit-amu">new and exciting Alongside Midwifery Unit</a> — the first space of its kind in Canada, offering specially designed birthing rooms for women expecting a normal birth with a midwife. </p>
<p>Other midwives work in freestanding birth centres <a href="http://www.torontobirthcentre.ca/">such as the Toronto Birth Centre</a>. </p>
<p>In Hamilton, a <a href="https://www.thespec.com/living-story/9277470-new-programs-sees-hamilton-midwives-offer-set-it-and-forget-it-birth-control-method/">group of midwives is providing expanded services</a> that include medical abortion and contraception. </p>
<p>Across the country, there has been <a href="https://indigenousmidwifery.ca/">a renewal of Indigenous midwifery</a>, with Indigenous midwives providing care <a href="https://indigenousmidwifery.ca/audio/">rooted in their culture and traditions</a>. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/5vABSuTTrbg?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Spirit of Birth. Produced by MAAIINGAN Productions and Frog Girl Films. Directed by Rebeka Tabobondung.</span></figcaption>
</figure>
<p>Regardless of location, demand for midwifery services is much greater than midwives can currently provide.</p>
<h2>Lack of pay equity</h2>
<p>Although midwifery has made great progress, not all news about midwifery is positive. Midwifery services in many parts of Canada are limited and not adequately funded. </p>
<p>A <a href="https://doi.org/10.1016/j.wombi.2018.10.002">recent study of midwives in Western Canada</a> showed high rates of burnout and mental and physical health problems, causing many to consider leaving the profession. </p>
<p>Many midwives, especially those who are aging or who have young families, struggle with the on-call demands of providing care in a continuity of care, or caseload, model. Evidence suggests that <a href="https://doi.org/10.1016/S0140-6736(13)61406-3">this model results in better outcomes for clients</a> — creating a dilemma for midwives who want to provide the best care but also desire better work-life balance.</p>
<p>In Ontario, lack of increases in pay over the past decade led midwives <a href="https://www.tvo.org/article/the-uncertain-future-of-midwifery-in-ontario">to take the government to the Ontario Human Rights Tribunal</a>, arguing that lack of pay equity had led the almost exclusively female profession to fall behind.</p>
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<p>Although the tribunal ruled in favour of the midwives, the <a href="https://www.nationalobserver.com/2019/07/11/news/new-human-rights-challenge-ford-government-says-workload-not-gender-justifies?utm_source=National+Observer&utm_campaign=d20290dad2-EMAIL_CAMPAIGN_2019_07_12_12_22&utm_medium=email&utm_term=0_cacd0f141f-d20290dad2-276861289">current government is seeking to quash the decision</a>. </p>
<p><a href="https://www.cbc.ca/news/canada/windsor/college-of-midwives-ontario-funding-cut-1.4946081">Funding cuts to the College of Midwives</a>, to which midwives must belong, mean that membership fees have increased, further reducing compensation and morale.</p>
<h2>More investment in midwifery needed</h2>
<p>Evidence worldwide shows the <a href="https://www.who.int/workforcealliance/media/news/2013/midwifecochrane/en/">benefits of midwifery-led care for women and babies</a>. </p>
<p>Although midwives in Canada have accomplished many things since 1994, much more needs to be done to make midwifery a sustainable profession that offers the care women wish to receive.</p>
<p>Integrating midwives into decision making and planning for reproductive care, adequately compensating those who do this work and developing flexibility in models of care and scope of practice: these are all paths to building a strong midwifery profession in the years to come.</p>
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<p class="fine-print"><em><span>Kathi Wilson is an assistant professor in the midwifery education program at McMaster University, Hamilton ON. She has previously received research funding from CIHR and is a member of the New Democratic Party of Canada.</span></em></p>The benefits of midwifery for women and babies globally are clear. In Canada, innovations in midwifery centres and services are tempered by low pay and high rates of burnout.Kathi Wilson, Assistant Professor, Department of Midwifery, McMaster UniversityLicensed as Creative Commons – attribution, no derivatives.