Nearly half of women who gave birth during lockdown at a major DHB left hospital sooner than they wanted - fuelling a rise in those readmitted with complications.
"I felt alienated. Depressed and stressed," one new mother told Waitematā DHB, after the health board surveyed women who gave birth during lockdown restrictions.
"I cried the whole night. Alone in the ward. Felt like I was a prisoner. No support at all. This whole experience of giving birth was traumatic."
DHB leaders will soon write to Health Minister Andrew Little asking for a wide-ranging review into how Covid-19 disrupted different health services, so lessons can be learnt for future pandemics.
"The lack of support people on the postnatal ward was a key factor in early discharge decisions made by women which also resulted in an increased readmission rate," a report on the maternity survey concluded.
"Any future restrictions on support people should be considered in the light of the harms this causes for postnatal recovery and maternal mental health."
Lockdowns stamped out community transmission of the virus, saving the country's hospitals from being overwhelmed with cases, and greatly limiting damage to the wider economy.
However, the pandemic also led to thousands of elective surgeries and procedures being delayed, and severe visitor restrictions.
Waitematā DHB, which runs Waitākere and North Shore hospitals, contacted about 890 women who gave birth during level 4 and 3 restrictions, and 190 took part in the survey.
Most were happy with the care received, and 67 per cent said they felt supported during and after birth in hospital, with many praising hospital staff for the kindness and care they received in trying circumstances.
However, the survey also revealed "clear and heartbreaking" evidence that restrictions left some women feeling "abandoned, alone and devastated", with some saying this had a lasting effect on their or their partner's mental health. Findings include:
- 46 per cent said they left hospital sooner than they wanted, with more than half of this group saying they did so to get support at home. Nearly 9 per cent left because they feared catching Covid-19 in hospital.
- 7 per cent of mothers or babies were readmitted with complications. This is higher than normal, and most women believed this could have been avoided.
- More than half said their stay would have been better had a support person been able to stay with them.
- Nearly one-in-four mothers reported needing more support to breastfeed, and the same proportion had a problem accessing other services like ultrasound, GP or hearing screening.
A woman who was readmitted with her newborn because of pain from a C-section and her baby losing weight told the DHB, "if we both had received checks like we would normally have or support with feeding I firmly believe baby wouldn't have had any issues with weight gain."
Another wrote: "So, so disappointed with our experience and as a result seeking psychologist help to manage the trauma of it".
In a recent meeting Waitematā DHB's hospital advisory committee noted the "mixed feedback", with the main concern being not having a support person during delivery.
The visiting rule in the first lockdown followed national guidelines, the committee noted, and was revisited when the next lockdown happened in August.
The Ministry of Health has asked the maternity service to provide feedback on the experience and lessons from the pandemic, and the DHB will soon write to the Health Minister, "to inquire about undertaking a review of the response to Covid-19 and compiling all learnings by the health sector from the pandemic".
In a statement, Little said the Covid-19 response, including that of the health system, "has been the envy of the world" - but also confirmed services and the workforce "are under considerable stress and our system is complex and fragmented."
The health system needed to be rebuilt, Little said, and the Government had committed to the "broad direction of travel" outlined by the Health and Disability System Review, a two-year review released last June that made recommendations including cutting the number of DHBs.
"We do want to take what the system has learned from Covid-19 to inform the changes. However, I would have to receive the DHB's letter and ensure it is properly considered before forming a view about the best way to do this."
Meanwhile, investigations continue after four women died during or soon after pregnancy last year at Auckland City Hospital, with three happening after level 3 restrictions began on March 23.
One maternal death was recorded in the previous three years.
Reviews into each case are being finalised, and an overarching review will then begin. Auckland DHB says all women had one-on-one care and the causes don't appear related, but it's crucial to identify any systemic problems.
The husband of one of the women who died during lockdown previously told the Weekend Herald of not being allowed at the hospital when they lost their baby at 21 weeks' gestation, waiting at home during and after his wife's surgery - and then being called hours later to learn she was in intensive care.
"My wife would lose her unborn baby and grieve alone. She would then face surgery without family support. What happened to my family should never happen in New Zealand again."
text by Nicholas Jones, NZ Herald