While protocols for birth and delivery during the coronavirus pandemic have been necessarily strict, one group of researchers have drawn backlash for their "Delivery Table Shield" that has been featured in the American Journal of Obstetrics and Gynecology.
The photo, which has been published in the AJOG journal online and was posted to Twitter on Tuesday, shows "effective protective equipment to use in the vaginal delivery of the pregnant women with suspected/diagnosed COVID-19."
The approach has been heavily criticised by clinicians who have called it dehumanising and "like giving birth in a cage".
Or just ensure providers have access to appropriate PPE instead of dehumanizing women giving birth.— Alyssa Burgart, MD, MA (She/Her/Anesthesia) (@BurgartBioethix) June 17, 2020
This is ridiculous we can’t expect women to give birth in a greenhouse. We need to keep touch with reality.— Richard Brown (@RichgBrown83) June 16, 2020
I can’t even look at this without my anxiety going up. Imagine others— Jessi Gold (@drjessigold) June 17, 2020
Oh no no no. SO not in support of this labor cage.— Dr. Jenn Conti (@doctorjenn) June 17, 2020
Dehumanising and appalling. Birth is not an extraction. This is not dentistry. This is a spiritual rite of passage. Imagine having the lack of awareness to even tweet this. https://t.co/VPJ1CS53sx— PositiveBirthMovment (@birthpositive) June 17, 2020
"I"m very disappointed in this," wrote Ob/Gyn Dr Jenn Conti. " Please imagine what it's like to be a black pregnant woman in the time of #COVID19: terrified of bringing a child into this racist world, of hemorrhaging/dying in childbirth, & then of catching coronavirus & being put in a literal cage."
"Giving birth alone during a pandemic is already terrifying & isolating," wrote Nurse, PhD Student & Assistant Professor Jacqueline van Wijen."Let's not further traumatise families by shrouding birthing parents in plastic bags in favour of 'contactless' deliveries. Nurses, midwives, OBGYNs: resist this at all costs."
"As a pregnant physician, I find this to be very dehumanszing," said Dr Randaline Barnett. " I'm perfectly fine taking a COVID test when I come in in labor, and I've accepted that I'll have to labor and push in a mask because I want my colleagues to feel safe. This, however, has definitely crossed the line.
The research letter, published on 15 June, comes from a group of clinicians in Turkey, including the Maternal Intensive Care Unit, Turkish Ministry of Health, Ankara City.
"COVID-19 may be rapidly transmitted by particularly infected respiratory droplets," the authors write. "Thus, healthcare professionals should be attentive to use protective equipment during the management of suspected or diagnosed cases."
The researchers describe the use of their "novel delivery table shield" during the second stage of labor.
"The mentioned shield poses no barrier for respiration of the mother and provides eye contact between the patient and the physician thanks to its exclusive design," they note.
With no available data on the number and rate of the asymptomatic COVID-19 positive pregnant women in Turkey, the team conclude, " the use of delivery table shield and other personal protective equipments would be more reasonable only in the suspected or definitely diagnosed cases."
Turkey has had 181,298 cases of the coronavirus and 4,842 deaths to date,
According to the World Health Organisation (WHO), "All women have the right to a positive childbirth experience whether or not they have a confirmed COVID-19 infection. They also have the right to respect and dignity, as well as mobility in labour and birth position of their choice where possible.
In Australia, Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) note that "a woman's experience of labour and vaginal birth, or caesarean section, should not be significantly impacted and women should be encouraged, and supported, to approach this extraordinary time of their lives without fear or apprehension.
"Medical intervention, other than that specifically related to infection control, should not differ significantly from usual practice."
The controversial photo has since been removed from Twitter, but the original article remains online.
Looks like @AJOG_thegray took down this tweet...does this mean they've had a rethink about suggesting women birth this way or just a rethink about sharing such barbaric practice on twitter? 🤔 pic.twitter.com/zykkR5l2YQ— PositiveBirthMovment (@birthpositive) June 17, 2020
It’s horrific and disgusting. I don’t even have enough words to describe how awful this is...!— Amy Alonso (@AmyAlonsoMW) June 17, 2020
Essential Baby has contacted the American Journal of Obstetrics and Gynecology (AJOG) for comment.