What does corona mean for birth and the postpartum period? Expectant parents are unsettled - not least by the horror scenarios portrayed in the media. Experienced midwife and breastfeeding consultant (IBCLB) Angelika Lessiak is aware of the concerns of expectant mothers and fathers and is convinced that trust is a basic need that helps to alleviate uncertainty in times of crisis. Find out in the interview why the private clinic is a safe place to find peace of mind in uncertain times and what role good information plays in building trust.
Ms Lessiak, you have been a midwife for many years and work as an attending midwife in all of Vienna's private clinics. Is it currently particularly difficult for expectant parents to look forward to giving birth and starting a family?
Yes, definitely. The couples are very insecure. Essential information is missing. When can the partner go to hospital? Does he/she have to take or have a Covid-19 test? What should I do if a Covid test is positive? If I have ruptured my membranes and have not yet gone into labor - can my partner come with me and support me? How long can I stay in hospital? This list could go on and on. Couples currently have a lot of unanswered questions.
How do you prepare the couples you support for these unanswered questions?
By telling them: I will definitely be there. We will enter the hospital together. They don't need to be afraid of sitting alone somewhere for hours waiting for a result. I or an assistant from the clinic will take the test. Once the result is available, we can move around more freely. I am always present in the clinic to alleviate any uncertainty and to give the women giving birth confidence through my presence.
I also play through typical situations with the women. This removes the fear of what is to come: When will I have labor pains? What examinations will take place? Where can my partner be present? Almost everything that you initially see as a problem can be solved. For example: If I can't go into the nursery, the nurses will come into my room for the necessary checks.
During the lockdown, we made the interesting observation in the clinics that many women recovered more quickly after the birth, despite or because of the strict ban on visits, and that breastfeeding also went much more smoothly. Did you also observe this? What could be the reasons for this?
Yes, there was a very positive outcome, especially for first-time mothers. For them, this strict visiting ban also had the positive effect of allowing them to focus exclusively on their newborn and themselves. No friend came and interrupted the breastfeeding or some aunt who wanted attention - the mothers experienced this very positively. Especially for first-time mothers, it was and is a gift to have plenty of time to "learn to read" the newborn. If the breastfeeding relationship can be built up undisturbed because there are no interruptions - and mother and child are cared for very attentively in hospital - then breastfeeding at home also works better. These women go home stronger and more self-confident. In my experience, they have also asked less in the nursery. They were quicker to recognize things for themselves and thus gained self-confidence and competence.
Of course, there was and still is the dilemma with an existing child who had no visiting rights. The mothers were very happy to accept my support so that they could go home as quickly as possible and be looked after by me.
To what extent do women who (have) given birth also have to trust you as a midwife?
This relationship of trust is very important. It is built up during pregnancy. In this exceptional situation of birth, in which fears and worries are intensified by Covid, it is simply important to have a midwife with whom the mother-to-be can be who she is, to whom she can also confide emotionally. It's not just about talking, but also about being there continuously, providing active support, doing things. That I am there, that I am present in the delivery room, that I am present during examinations. The advantage of a private hospital is the "one-to-one care". Women know that the midwife doesn't have to manage two or three births at the same time. A woman giving birth needs someone to "hold on to".
There is a lot of uncertainty about the hospital stay. How can you increase the women's confidence?
By not only reassuring them, but also showing them that the private clinic is a safe place. Due to the significantly reduced outpatient operations, there is less risk of coming into contact with the virus. From individual admission to the delivery room to the puerperium, mother, baby and accompanying person are in a very protected environment. In all the private clinics where I have worked during the Covid crisis, compliance with hygiene measures by all staff is exemplary. This also gives women a positive feeling of safety when they experience this on site. The fact that I, like most of my colleagues, have been getting tested voluntarily since the start of the crisis also reassures the women who come to my practice.
There are also concerns that safety measures such as distancing rules have a negative impact on the birth process. Can you confirm this?
No. Under the birth conditions that we have in a private hospital, every midwife can provide the expectant mother with support, care and attention for an optimal birth process, even if all safety measures are strictly adhered to.
What tips do you have for parents-to-be when it comes to confident birth and arrival?
The most important tip is to inform yourself thoroughly in advance. In the preliminary information provided by the midwife, which in private hospitals is also provided with great care by the midwife on duty in the delivery room when you call, the situation is discussed step by step and what happens and how. Examples of information required during the birth process include the possibility of a coronavirus test for the partner on arrival at the private hospital and the specific visiting arrangements. If you know what happens when and how, you can prepare for it. Information in advance provides security and trust.