However, getting to "established labour" is rarely simple and straightforward. One in four women experience miscarriage, and many will find out during a routine scan. Complications can arise at any point: pre-eclampsia, abnormal heart rate of the baby, excessive bleeding and many more.
On September 8, the UK government, after much pressure from women, partners, and groups such as Pregnant Then Screwed and BirthBliss Academy, lifted the previous restrictions on allowing partners at scans and early labour. However, it has largely been left up to hospital trusts to make decisions and implement those new recommendations.
A small number of hospital trusts have lifted restrictions in their entirety. A slightly larger number have lifted some of the restrictions, but not all of them. As of September 13, 67 per cent of hospital trusts still had either all or the majority of restrictions still in place. What is left is inconsistency, confusion and trauma.
Campaigners, pregnant people and their partners emphasise the "nonsensical" nature of the restrictions. Joeli Brearley, the founder of charity and campaign group Pregnant Then Screwed, said the restrictions in place to keep pregnant women, partners, staff and midwives safe all made sense until pubs, restaurants and other social gatherings began opening up.
“If a pregnant woman is attending with her partner, the likelihood is that she lives with that person. So they are likely to have the same Covid-19 diagnosis. The medical staff are only intimate with the pregnant woman, so the risk only comes from that person. The person attending can wear full PPE, they can socially distance, they can restrict the areas they’re allowed to walk through, they can have a swab test."
“There are ways that you can mitigate risk and still have a support system there for a woman”, agrees Amy Overend, a neonatal nurse who gave birth under strict restrictions six weeks ago.
“I wasn’t angry at the NHS, I wasn’t angry at maternity wards, I wasn’t angry at the staff - I was angry that the decision had been made that hospitality was more important than women and their partners. That the business sector was more important than the health sector.
“You could go to the pub, play sports and have your hair done, but you couldn’t have someone to support you through the most important moment of your life”.
Amy, who already has a long-term complicated medical condition, faced a worrying "high-risk" first time pregnancy. She had been shielding since the very beginning of lockdown, as had her partner. Her 20 week scan and every scan after that, to make sure Amy’s medical condition was not affecting the baby, was done alone. “The midwifery team were really lovely and made sure I had someone to talk to if I needed to. But for me, what I needed was my partner to be sat next to me and for us to be able to deal with everything as a family."
Further complications were yet to come. A week before her son was born, there were reduced foetal movements and Amy got rushed into hospital. She was on her own as her partner waited for an agonising three hours in the car to hear if his partner and unborn child were alright.
A few days later, Amy was rushed into hospital again, feeling unwell, and was told she had severe pre-eclampsia (high blood pressure during pregnancy). Amy was then told she had to be induced as a matter of urgency. Again, Amy’s partner sat outside for four hours, leaving Amy to have to make urgent decisions about their child’s birth while in pain (mobile phone use was also restricted due to medical equipment).
Amy’s induction was started, and she was in severe pain. Her blood pressure wasn’t coming under control and she was told she may have to have an emergency C-section. “I remember having to ring my partner and say, I might have to undergo an operation”, Amy said, “The pain was all-consuming. Even just getting up out of bed to get something out of my bag was an effort. I wish he could have been there”.
Amy’s induction eventually worked, and she was taken to the delivery suite - four days after she had last seen her partner. During the birth, Amy ended up having a large bleed and needed an emergency blood transfusion. About three hours after the birth, Amy and her partner were once again separated for another four days, after a rushed goodbye in the delivery suite. After a blood transfusion, and four days of no sleep due to lying under a blue light with a newborn who had jaundice on her chest, Amy was finally ready to go home.
The hospital then told Amy she had to stay one more night. “I remember just ringing my partner at home, and sobbing. I kept thinking, I can’t do this, I can’t be a mum. I thought I was a terrible mum because he had jaundice and he was crying all the time, and I couldn’t breastfeed straight away. I thought I had failed in every way. That night was a struggle. A real, real, struggle.
“The whole experience was isolating, and lonely, overwhelming and exhausting. At some points, I was delirious with lack of sleep, and I wasn’t asking the questions that probably needed answering, like he would have been. I just needed him there to say it was going to be fine, and give me a break.
“Partners are being made to feel like visitors, rather than an actual parent to their child, because every decision about our child, I was making. If you’re not letting them go to scans, you’re not letting them see their child growing, you’re not letting them hear the heartbeat - you’re robbing them of being a parent”.
Joeli Brearley from Pregnant Then Screwed spoke about hearing thousands of stories like Amy’s, and the long-term affect they can have on mental health: “There are lots of women who have previously had multiple miscarriages and going to a scan appointment is terrifying.
“There’s women going to those appointments and sitting in the same room where they had previously found out that their baby had died and having to be scanned on their own with no support whatsoever.
“We heard from a woman who is pregnant with twins, and they did the scan, found severe complications, and had to be rushed into surgery to find out one of the twins had died. Every subsequent scan to make sure the twin that had survived was growing properly was completely on her own.
“We heard from a woman who’s labour progressed very quickly, so the baby was born without her partner there, and the baby was stillborn.
“These stories are devastating, but what is particularly concerning is there is a very well-researched link between stress and anxiety in pregnancy, and severe postnatal depression for women after they've given birth. So this is a mental health epidemic of the future that we're creating.
There's also obvious and well researched information that if a pregnant woman experiences stress during pregnancy, the baby is likely to have low birth weight, and you're likely to have other severe complications during pregnancy.
“So not only are we creating a mental health epidemic, we're also potentially affecting the health of these babies by not allowing these women to have the support that they deserve and that they need.”
Amy also spoke about the affect on the ‘new-mum’ community: “Coming out of hospital after having time with their baby alone, they’re going to feel like they haven’t done the right thing, or they’ve failed their baby if they’ve got frustrated at them.
“The rise of postnatal depression will be huge. I think people will go into a future pregnancy really scared that they’ll have to be in pain alone again. Because of the lack of support systems, the ‘mum guilt’ can really escalate very fast. You can’t go to a new mum group or breastfeeding classes or anything because of social distancing. So you need that support system during the birth.”
On September 19, a letter sent by NHS England showed they wrote to Directors of Nursing and Heads of Midwifery to say, in agreement with the Royal College of Midwives (RCM) and Royal College of Obstetricians and Gynaecologists (RCOG), “we thank you and are grateful the majority of services have quickly implemented this guidance and relaxed visiting restrictions.
“To those that are still working through the guidance, this must happen now so that partners are able to attend maternity units for appointments and births.
“The priority of course remains the safety of all patients, their family and our colleagues. In certain areas of the country the increase in infection rates will require localised responses, and we have included clear steps for how to minimise infection control risks working with your IPC leads, while still allowing the maximum possible safe access.
“Pregnancy can be a stressful time for women and their families, and all the more so during a pandemic, so it is vital that everything possible is done to support them through this time."
NHS England said its "clear" guidance "is that we expect maternity units to allow partners to attend maternity units".
It has also released a document with a framework to assist NHS trusts to reintroduce access for partners, visitors and other supporters of pregnant women in English maternity services.
“The public can help in a number of ways,” says Brearley, “they can email their hospital trust to see if they’ve lifted restrictions. You can also contact your local MP about the restrictions, and tell them your stresses and anxiety. You can tag your stories online with #ButNotMaternity and there is a petition you can sign”.
“Hospital trusts need to be letting birth partners in”, says Amy. “Lockdown or not, you have to let them in. You can’t leave people to do it on their own. It’s barbaric. It’s torture.”