Professional and personal lives collide in pandemic pregnancy

Neonatal nurse Sarah O’Callaghan has been on both the giving and receiving end of maternity care during the pandemic.

She worked through the first 10 months of it, looking after premature babies at Cork University Maternity Hospital, before giving birth to her daughter, Emilia, there in January, at the height of the third wave.

“I fell pregnant just as lockdown one hit; I worked through lockdown one and lockdown two and then had her in lockdown three – bad timing on my part,” she says, laughing.

Her latest pregnancy was very different from when she was expecting her twin boys, Theo and Ollie, who are now three years old. First time around was “full of joy” versus “so much uncertainty” when pregnant with Emilia, at a time of heightened fear both inside and outside the hospital.

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As has been the case for most of the 50,000-plus women who have been pregnant in the past year, she had to go to scans alone. For a while it looked as if her husband, Cormac, might not even be allowed in for the birth.

In hindsight, she reckons it was a blessing they were both too busy as frontline workers – Cormac is in the Defence Forces – to sit down and worry. With childcare services closed, their main concern was to make sure they worked at opposite times, “one of us coming in the door from a 12-hour shift and one leaving to do one”.

Although that baby was born so premature, it was a lovely delivery, if you took the PPE out of the room and everyone's palpable nerves. The mother still got her lovely photos; she got to do a tiny bit of skin to skin

Sarah loves her intense job in the hospital’s neonatal unit and says she normally switches off from her personal life the moment she walks into the hospital. But she will never forget one particular shift during the pandemic when her professional and personal sides collided.

She was 24 weeks into her pregnancy, just past the threshold for viability, and she was assigned to theatre for the emergency delivery of a baby at 24 weeks.

The consultant, knowing Sarah was pregnant, asked her how far on. When he heard she too was 24 weeks, he eyeballed her over his mask, asking “Are you sure you’re okay to be here?”

“I said ‘Of course, ‘I’ve done this for 10 years and I adore it.’” But she couldn’t help thinking that she had a baby exactly the same size in her at the moment.

In theatre that day there was “all the extra PPE, the extra vigilance, the extra concern on everybody’s face: if this little baby gets Covid, it’s game over. Everyone is just so worried for this precious, tiny little infant.”

But you’re trying to balance all the precautions, she explains, with the fact that this is the mother’s first baby, and they want to make this once-in-a-lifetime experience as good as it can be in the circumstances.

“Even in the pandemonium I was, ‘Mum, have you got your phone?’ Dad couldn’t make it on time in the emergency and rush.” Sarah wanted to ensure the mother got “those beautiful photos that she will never be able to get again”.

“Although that baby was born so premature, it was a lovely delivery, if you took the PPE out of the room and everyone’s palpable nerves. She still got her lovely photos; she got to do a tiny bit of skin to skin. Everybody spoke really calmly and there was music in the background.

“We tried, in the middle of a pandemic, to give her her birth experience.”

When Sarah’s time came it was a scheduled Caesarean section as Emilia was in a breech position, just as her sons had been. Cormac, who had to wait in the car outside to be called in at the last minute, was terrified his mobile phone might lose signal and he would miss his child coming into the world.

“The poor men have it very hard as well,” she says. Maternity staff have been under public scrutiny for restrictions on partners’ attendance and, while she understands the upset, she says it makes midwives’ lives easier too when a partner is there to support the woman.

“It is in the staff’s best interest to have that woman more settled, more confident, more secure.”

Sarah believes the increased emotional support role that midwives have had to take on has taken a toll.

We were able to take photos and videos of these teeny, tiny babies and send them to the parents' email address, which I think helped them feel a little more secure as they were terrified at home

“I hate saying the word ‘burnout’, but people are exhausted. I think I was able to appreciate that when I was a patient up in the ward postnatally. The call bells were ringing more than ever before. You could hear first-time mums asking question after question, and they had no one else to ask but that midwife.

“Midwives are there to ‘be with woman’; they are not psychologists,” she says. “You have got women who have been through a really rough time, a really isolating pregnancy. Their fear and anxiety are huge even before they enter the hospital doors to have their baby. They need those midwives more than ever.”

Sarah has experienced something similar in the neonatal unit, where half the staff are paediatric nurses and the other half midwives. A ban on fathers visiting the unit was “traumatising” for parents, she acknowledges, but it helped to protect a highly specialised workforce, as well as the babies.

However, it meant staff needed to update not only the mothers there but also fathers who were ringing from home to be briefed too. To try to bridge the gap, a video-sharing app was rolled out, so “we were able to take photos and videos of these teeny, tiny babies and send them to the parents’ email address, which was amazing and I think helped the parents feel a little more secure as they were terrified at home”.

“As a nurse you are already doing all the drugs and feeds for that baby, and now you’re with colleagues saying, ‘Can I have that iPad? I have to sanitise it to log in to take this baby’s photo,’ because I know it will mean so much to the family. But it’s another extra thing.”

Naturally for Sarah, leaving hospital with a healthy baby and her own good health after a postbirth sepsis scare trumps everything that has happened over the past year.

“The pandemic will just be a tiny blip in our memory in years to come of her coming into the world. She’s here forever.”

Read: Pandemic birthing a ‘fraught’ job for midwives