Birth in the time of COVID-19: Midwives’ experiences of providing care during the 2020 Covid-19 pandemic in Aotearoa New Zealand

Introduction: During the COVID-19 pandemic lockdowns in 2020, midwives in Aotearoa New Zealand were classified as essential workers and continued providing maternity services in hospitals, birth centres and the community. Midwives adapted their practice, using virtual care and navigating the restrictions imposed on birthing women/people and their whānau. This paper reports on midwives’ experiences of providing care during the pandemic. Aim: To identify the impacts of the pandemic on midwives providing antenatal, labour and birth, and postnatal care to birthing women/people and their whānau during the 2020 Level 4 and Level 3 restrictions. Method: In-depth exploratory interviews and Braun and Clarke’s (2019) process of reflexive thematic analysis were used to explore impacts on the practice and personal lives of midwives. Findings: Fifteen midwives described their work-related challenges: significantly increased workloads, inconsistent messaging regarding practice guidance between health authorities and others, and limited access to personal protective equipment. Reflections about wider professional interests included these midwives’ immense pride in their profession and their increased agility in the use of new technologies. But these positive elements were juxtaposed against a perceived lack of recognition and financial support for their increased workloads, leaving midwives feeling marginalised and invisible. Midwives’ personal lives were significantly challenged by the stress and fear of facing COVID-19 itself, the juggle of managing their work and whānau lives, and their sense of conflict from feeling unable to practise in ways that aligned with their philosophies of inclusion and family-centredness. Conclusion: Despite challenges, these midwives were committed to whānau in their care and demonstrated resilience, adaptability and resourcefulness in meeting their needs. Health planners should recognise that, as a primary health service, a significant amount of midwifery care is provided in the community setting and future pandemic planning should ensure smooth provision of resources to community-based midwives. Streamlining of information from trusted sources, together with consistency across the country, will assist midwives to respond to health directives confidently.