Birth under restrictions: Exploring women's experiences of maternity care in Aotearoa New Zealand during the COVID-19 lockdown of 2020

Introduction: In Aotearoa New Zealand the COVID-19 pandemic in 2020 resulted in a four-week lockdown in March and April of 2020 with ongoing restrictions for several weeks. Aim: To explore the experiences of women who were pregnant, giving birth and/or managing the early weeks of motherhood during the 2020 COVID-19 alert levels 3 and 4 in Aotearoa New Zealand. Method: This qualitative study used semi-structured interviews to explore childbirth experiences during the COVID-19 alert level restrictions. Reflexive, inductive, thematic analysis was used to identify codes, subthemes and themes. Findings: Seventeen women participated in the study. Analysis of the qualitative interviews revealed four themes. The first of these was: Relationship with my midwife, in which participants described the importance of the midwifery continuity of care relationship, with midwives often going above and beyond usual care and filling the gaps in service provision. In the Disruption to care theme the participants described feeling anxious and uncertain, with concerns about the hospital restrictions and changing rules. The participants also described their Isolation during postnatal care in a maternity facility due to separation from their partners/whānau; they describe receiving the bare necessities of care, feeling they were on their own, and working towards their release home; all of which took an emotional and mental toll. The final theme, Undisturbed space, describes the positive aspects of the lockdown of being undisturbed by visitors, being better able to bond with the baby and being able to breastfeed in peace. Conclusion: Midwifery continuity of care appears to have supported these women and their families/whānau during the service restrictions caused by the COVID-19 lockdown. The partner, or other primary support person, and whānau should be considered essential support and should not be excluded from early postpartum hospital care.