COVID-19 emergency and respectful assistance to motherhood and birth

by Claudia Ravaldi

The World Health Organization (WHO) reiterates that in the management of perinatal health during the Coronavirus emergency it is necessary to maintain high attention on respect for the rights of newborns and pregnant women, during childbirth and in the puerperium, and asks that the health of the mother and child continue to be the primary purpose of assistance.

CiaoLapo ApsEts together with the Observatory on Obstetric Violence Italy (OVOItalia) and La Goccia Magica Odv underlines the importance of respectful assistance to motherhood and birth in order to guarantee the best health outcomes of the mother and the person who is born.

“I have given birth for at least 6 hours, the baby was brought to the nursery as soon as she was born and no one is telling me about her and when they will bring her back to my room. I feel pain and heat in my breasts and I don’t know what to do, they tell me it’s normal but this doesn’t reassure me. “

“I came home from the hospital only this morning and I feel so much pain when the baby sucks, they told me it’s normal for the first few days, I’m afraid I can’t resist. I didn’t think breastfeeding hurt so much, plus I have very hard breasts and I also feel shivers “

“In the hospital after giving us the diagnosis of stillbirth we were told that my husband could not enter; they also told us that we will have to wait for the autopsy results but that nothing is ever found. My husband asked to be able to take a picture of our baby’s face but they told him it can’t. We will never see him again. “

It is possible to ensure the best maternity care, even in the COVID-19 emergency

Respect for perinatal rights must also be maintained in the case of COVID-19 positive mothers, which include respect for dignity, having a trusted person alongside, clear communication from health personnel, pain management, freedom of movement and the non-separation of the infant from the mother.

At present, some hospitals are able to distinguish the care needs of women with COVID-19 from the usual management of asymptomatic women, dividing paths and offering all women respectful care that takes into account not only the needs related to birth-puerperium event, but also of the stressful and potentially traumatic effects linked to the pandemic.

The numerous limitations linked to the emergency are inserted in a psychological terrain of potential vulnerability and a cumulative stress load derives from it, which must be taken into account in order to limit post-traumatic damage.

Some hospitals, taking into account the summation effect of the different stresses on the woman and the newborn, have organized themselves from a health-promoting point of view, maintaining an organization centered as much as possible on respect for the mother and the newborn and on the primary needs of pregnant women: in these companies the possibility of having the partner close by is kept active, in compliance with the established hygiene measures, and at the same time the non-separation of the mother-child dyad is guaranteed.

The Emilia-Romagna Region has published the Indications for the professionals of the Emilia-Romagna region birth path which provide for the possibility of access to the labor and delivery room of a single companion (asymptomatic or with mild acute respiratory symptoms in the path for asymptomatic women and without fever). Furthermore, the document specifies that “after delivery, the management of the newborn follows the normal procedures, it must not be separated from the mother, breastfeeding must be supported in compliance with the wishes of the woman”.

The Indications also refer to situations of home birth assistance, in obstetrical-run birth centers and in maternity homes.

The Italian Society of Neonatology (SIN) reiterates: “Whenever possible, the option to be preferred is that of the joint management of mother and child, in order to facilitate interaction and the initiation of breastfeeding”.

In many hospitals and regions, however, the presence of the partner is not allowed, regardless of the situation of infection or not, and newborns are separated from their mothers without a justified reason.

Respectful maternity care should also be maintained in the case of COVID-19 positive mothers, and includes:

  • respect and dignity;
  • a trusted person alongside;
  • clear communication from healthcare personnel;
  • pain management;
  • freedom of movement;
  • the non-separation of the newborn from the mother;
  • the possibility of breastfeeding.

In the present situation of extreme isolation, the needs of mothers and newborns must urgently be intercepted and adequately addressed.

We cannot allow women and newborn babies to be the first to be left behind.

Here you can read the full document and the list of associations that have joined to date.

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