International Alliance for COVID-19 Community Response
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Iliana Colonna: enabling positive birth experiences in the time of COVID-19

“At the beginning of the epidemic, our initial reaction was fear – fear of getting infected, of how our work may be affected and for the health of the pregnant women requiring our assistance. Our priority became tackling that fear by adhering to guidelines, including those from WHO, and putting a new structure in place that would allow us to continue the vital work we do,” explains Midwife Coordinator Iliana Colonna, from the Infermi Hospital in Rimini, Italy.

Creating safe spaces

“In close collaboration with leaders and experts from other areas, we were able to implement structural changes to our midwifery department infusing new confidence into the midwives under my lead.

“While we are a tertiary-care midwifery unit and are therefore familiar with emergency and intensive care assistance, we had to adapt to the infectious character of the coronavirus. We separated COVID-19 infected women and those who had tested negative. Our 40 midwives were promptly trained in the effective usage of personal protective equipment and infection prevention measures.”

Guaranteeing the right to a safe and positive birth experience

“From an organizational perspective, dividing the space between women with and without COVID-19, also meant readjusting the personnel for each shift and team.

“While some competencies are common to all midwives, such as the ability to use technological tools and programs and provide neonatal emergency assistance, there are also some specialized competencies that require careful allocation, such as the ability to work as surgical instrumentalists assisting doctors during a caesarean birth in the operating room.”

“As midwife coordinator, I have always placed special emphasis on my duty to listen to the midwives under my guidance – now, more than ever. While at first some were reluctant to be assigned to COVID-19 positive women, I insisted on the need for all midwives to go through the personal and professional growth opportunity that the COVID-19 challenge offers.

“Soon, all the midwives felt safe in exercising their duties and their thoughts turned to questions of how to make expecting women, COVID-19 positive and negative alike, feel safe in our hands and offering them the possibility of a positive vaginal birth experience.

Telehealth to support postpartum mothers

“We implemented several steps to this end: COVID-19 infected mothers have their newborn’s crib at a 1-meter distance and they must practice respiratory hygiene, including wearing a mask when breastfeeding, and hand hygiene. The WHO guidance on breastfeeding during COVID-19 has been very useful for us. We know that breastfeeding is particularly effective against infectious diseases, including respiratory diseases, because it strengthens the immune system by transferring antibodies from the mother to the newborn.

“To dispel the mothers’ fears, we also have a psychologist communicating with the women over video calls. The midwives also maintain a direct line of communication with all expecting women over mobile phones, which allows them to maintain a one-to-one relationship despite physical barriers.

“At the moment, we are also preparing informational videos to replace the monthly group meetings the hospital organized for pregnant women. Experts from different disciplines – midwifery, nursing, neonatology, etc. – will outline the steps we have taken to guarantee a safe birthing experience for all.”

Allowing midwives to work to full potential

“The COVID-19 pandemic has proven once again that the role of nurses and midwives is paramount in ensuring public health. It is my hope for the future, that we midwives will be increasingly recognized for our contribution and given more chances to express ourselves and abilities further, allowing us to work to our full potential.”