The first case of an Italian contracting COVID-19 was documented on February 21, 2020. "Patient 1" is a 38-year-old man from a small town near Milan whose wife was pregnant. In the turmoil of the breaking news, this detail was often repeated. Our thoughts:as a medical anthropologist and an activist mother engaged in the field of birth:ran to this mother-to-be, who was abruptly separated from her husband when he was confined to intensive care. We felt frightened and powerless, thinking about the health risk to her and their baby. Very little was then known about SARS-CoV-2, let alone about its effects during pregnancy. At that time, we could not imagine that separation, isolation, and loneliness would become trademarks of how we give birth:and die:during a pandemic.
This was also when the national hunt for the "culprit" began. Attempts were made to trace the chain of contagion, in the hope of exorcising the growing fear that it was too late to stop it. Before February 21, the only two confirmed cases of the novel coronavirus in Italy dated back to January 30 and were related to two Chinese tourists on holiday in Rome. Until then, the media portrayed the virus as something lethal but exotic, still distant enough to leave all of us living in privileged old Europe substantially safe. A lethal mix of ethnocentric shortsightedness, structural issues in some parts of the Italian National Health Service, and the imponderability of nature created the perfect environment for the virus to proliferate in the country.
"Patient 1" and his pregnant wife were the tip of an iceberg that would soon reveal its magnitude. At the end of February, a frightening scenario was emerging: thousands of people were exposed to the risk of being infected, including hundreds of women who were soon to become mothers. Hospitals:where 99.9% of births occur in Italy :were quickly identified as dangerous contagion hotbeds. Health services, including the entire birth carepath, required urgent reorganization. Protocols had to be rewritten and interpersonal relationships reshaped in light of the sudden need for social distancing. Drastic measures were to be implemented, as births could not be stopped.
This study looks at maternity care in Bologna, Italy, during the Italian COVID-19 lockdown. To describe this lockdown, an early op-ed in the New York Times was provocatively titled: "Even Mass Is Canceled". From March 9 to May 18, 2020, all citizens not involved in primary activities (such as health care, food production and distribution, vital logistics, law enforcement and security) had to follow one simple rule: stay at home.
From our own domestic quarantines, we observed the turmoil that was swirling around maternity care in Bologna through texts, calls, photos, and accounts coming from "outside." These were the voices of soon-to-be parents and birth providers:hospital midwives in particular:confronting this new Covidian world and enduring its immediate effects. On April 17:a full month into the total lockdown:the association Voci di Nascita sent a formal letter to the local political and healthcare authorities in representation of parents, birth professionals, and birth activists 1 . The goal was to denounce the temporary suspension of women's right to be accompanied by a person of choice during labor and childbirth in the city hospitals. Dozens of parents followed suit, enclosing a copy of the letter in their inquiries to the public relations departments of the hospitals where they were planning to give birth. The authorities responded, opening up a dialogue with the association and its members. Shortly after that, along with the gradual decrease in the emergency and the progressive systematization of the scientific evidence, the most restrictive measures were modified.
This article, like our engagements in the field of birth, is driven by our shared desire to contribute to fostering positive cultural change and social impact. Such an aspiration proves more urgent than ever in times of social distancing and temporary restriction of reproductive rights: timely and informed critique is vital to the constant maintenance process that public health deserves in a democratic setting. This was also the primary driving factor for the social campaign empowered by Voci di Nascita and the reason why we decided to analyze that campaign and its repercussions on the community and on maternity care.
Anthropological work normally requires prolonged participation in the research field and direct engagement in relationships with interlocutors and research collaborators. Given social distancing measures, this was not possible for us. Therefore, we designed a short-term ethnographic research plan, which included two online questionnaires, in-depth conversations between we two authors, informal exchanges with local birth providers, participation in relevant webinars, and a review of the latest literature on the topic. Our study combines the analysis of data derived from such sources and unfolds on the basis of previous engagements in the field:both Daniela's as an activist mother and Brenda's as an anthropologist.