mumborneveryminute@hotmail.com


 mumborneveryminute@hotmail.com

 
 

COVID-19

The information on this page was obtained on Monday 5th October 2020 from the RCOG website. Guidance may have changed since this date. Please be aware that if you have any concerns about COVID-19 then you should call your Midwife.

 

Antenatal care

Q. How will the coronavirus pandemic affect my routine antenatal and postnatal appointments?

We understand that it could be a stressful and anxious time if you are pregnant or have recently given birth during the coronavirus pandemic. The NHS is working to ensure that you, your baby and your family are supported and cared for during these uncertain times. This means that there may be some changes to how, when and where you attend essential routine appointments and how safe, personalised care and support are given to you. Any changes implemented by your local maternity service should be discussed with you.

Antenatal and postnatal care is based on years of evidence to keep you and your baby safe through pregnancy, birth and beyond. Antenatal and postnatal care should therefore be regarded as essential and you should be encouraged to attend, while adhering to social distancing measures as far as possible.

Your local maternity team may reduce routine appointments, provide more home visits or deliver some care and support over the phone or by video to reduce the number of times you need to travel and attend hospital/clinics. Any changes to your care will be discussed with you in advance.

Q. Why are changes to antenatal and postnatal care necessary during the coronavirus pandemic?

These changes are a way of ensuring we deliver the best care without overloading our NHS services, which are crucial during the coronavirus pandemic. This helps us to:

  • Reduce the number of people coming into hospitals where they may come into contact with other people and spread the virus
  • Ensure staff are not overwhelmed and stretched too far by the additional strain on services, which could be due to staff sickness and self-isolation as well as the higher numbers of patients needing care and overnight hospital stays due to coronavirus

This allows us to care for you and protect you from coronavirus while also ensuring we protect NHS staff and services.

Q. Who should I contact about my antenatal and postnatal care appointments?

If you have been allocated a local health continuity team or a named community midwife

You should continue to contact your continuity team or community midwife by telephone to discuss any questions or concerns you might have and to check on arrangements for all scheduled and future appointments.

If you have not been allocated a local health continuity team or a named community midwife

You should contact your GP surgery or local maternity unit in order to be connected to an appropriate continuity team or named community midwife so you can discuss any questions or concerns you might have and to check on arrangements for all scheduled and future appointments. If you are unsure when your next appointment is you should make contact as above to help us care for you.

Q. Can I still attend my antenatal/postnatal care appointments?

Your antenatal and postnatal appointments remain an important part of your maternity care to provide checks and screening on your health and your baby’s health. A member of the maternity team looking after you may call you before your appointment, and/or carry out an assessment at the entrance of the clinic/hospital to check whether you have any symptoms that are suggestive of coronavirus.

If you are advised to attend an appointment by your local maternity team, this is because the need for the appointment to help reduce the risk of complications for you and your baby is greater than your risk of being exposed to coronavirus.

If you are well, you should be able to attend your appointments. You may be asked to attend alone to protect your household from the risk of coronavirus. Your local maternity team will discuss this with you in advance. If you are asked to attend your antenatal appointments alone, you should be advised where possible to have a discussion with your partner, or other supportive companion, about any questions they would like you to ask your maternity team on their behalf.

If you are currently self-isolating with suspected or confirmed symptoms of coronavirus and you have an appointment scheduled in the coming days, you should telephone your continuity team, community midwife, or local maternity unit, to inform them.

Your upcoming appointment will be reviewed by the maternity team looking after you and your baby. You will then be advised whether your appointment is urgent and a home appointment is required, or whether your appointment can be safely delayed for a period of 10 to 14 days until you are well.

Q. How many antenatal appointments will I have?

You will have at least six face-to-face antenatal appointments in total. Where possible, essential scans/tests and routine antenatal care will be offered within a single appointment. This is to prevent multiple journeys and visits to clinics/hospital, and will involve contact with as few staff as possible to prevent the spread of coronavirus to you, your family and other patients/staff.

This may mean that your initial ‘booking in’ appointment will take place at the same time as your 12-week (dating) scan.

You should be asked about your mental health at every appointment, whether in person or via phone/video.

In the third trimester, you should be asked about your baby’s movements at every appointment, whether in person or via phone/video.

All pregnant women should be provided with information about Group B streptococcus (GBS) in pregnancy and newborn babies.

Sometimes, you may need additional antenatal appointments and medical care. This will depend on your individual medical needs. These appointments may be carried out over the phone or via video, provided a physical examination or test is not required. This will enable partners and other family/household members to join you for support and allow social distancing to protect you and your baby from coronavirus.

Q. Will I need to wear a facemask when I attend hospital for antenatal appointments, or to have my baby?

To reduce transmission of coronavirus in hospitals, the government has announced that from 15 June 2020, face masks and coverings must be worn by all NHS hospital staff and visitors in England. All visitors and outpatients, including pregnant women attending antenatal appointments or scans, must wear face coverings at all times to protect other pregnant women and patients and staff from coronavirus. This should be communicated with you through your appointment letter, local Trust websites and social media outlets. At present hospital inpatients, including women giving birth, are not required to wear masks.

Pregnancy scans

Q. Will I be able to bring someone with me to scans?

Visiting is now subject to local discretion by Trusts and other NHS bodies – please check with your maternity unit for their policy on visitors to the antenatal and postnatal wards. It is important that any visitors follow guidance in hospitals about social distancing, wearing a face covering and regular handwashing.

Restrictions around visiting inpatients and accompanying outpatients to appointments, including pregnancy scans, are now being eased but this happening differently in the four nations of the UK. The RCOG welcomes advice in ScotlandEnglandWales and Northern Ireland to help services with reintroducing visitors to maternity services including antenatal and postnatal appointments, and pregnancy scans.

This is an important step not only for the health and wellbeing of pregnant women, but also their partners and families whose mental health has been affected by missing out on these appointments and bonding time with their babies.

There is a possibility that visitor restrictions may be reintroduced in response to an increase in the local or national transmission risk. If you are still unable to bring someone with you to your scan, we encourage units to allow women to share the ultrasound scan experience with their partner (or other family members and friends) by saving a short 10–30-second video clip of the baby at the end of the dating scan and/or anomaly scan.

Scans are an essential part of pregnancy care and it is important that you continue to attend them for your and your baby’s wellbeing.

Childbirth choices

Q. Will my childbirth choices be affected by the coronavirus pandemic?

We understand this must be a stressful and anxious time if you are pregnant and due to give birth in the coming months. Maternity units have been working to manage additional pressures and facilitate women’s choices.

Like all areas of NHS care, maternity services have been affected by the pandemic but units are working to ensure services are provided in a way that is safe, with the levels of staff that are needed and the ability to provide emergency care where necessary.

In some areas of the UK, some Trusts and Boards have had to pause their home birth service or close their midwife-led unit. Most of these services have now been reinstated.

Birth partners

Q. Will I be able to have my birth partner(s) with me during labour and birth?

Yes, you should be encouraged to have at least one well birth partner present with you during labour and birth. Your birth partner(s) must wear a mask in hospital.

Having at least one trusted birth partner present throughout labour is known to make a significant difference to the safety and wellbeing of women in childbirth.

If a birth partner has symptoms of coronavirus or has recently tested positive for coronavirus, we do not recommend they go into the maternity suite, to safeguard the health of you, other women and babies and the maternity staff supporting you.

In some hospitals and maternity units, restrictions on visiting remain in place which might mean that birth partners or other supportive companions are not able to attend routine antenatal appointments, or stay with women on antenatal or postnatal wards. However, this should not impact on your birth partner’s presence during your labour and the birth, unless they are unwell with coronavirus symptoms or have tested positive for coronavirus.

We know that for some women, their chosen birth partner(s) may be from a different household due to their individual circumstances. You should be supported to have them with you, unless they are unwell with coronavirus symptoms or have tested positive for coronavirus.

Q. Will I be able to have my birth partner(s) with me if I am being induced?

At least one birth partner without symptoms should be able to attend your induction of labour where that is in a single room (e.g. on the maternity suite). Whether a partner can visit you if the induction takes place in a bay on a main ward, will be dependent on the local NHS Trust/Board assessment of safety, including whether it is possible to maintain the necessary social distancing measures.

On 5 June 2020, the suspension of hospital visiting in England of inpatients was lifted. This means that visiting is now subject to local discretion by Trusts and other NHS bodies – please check with your maternity unit for their policy on visitors to the antenatal wards. It is important that any visitors follow guidance in hospitals about social distancing, wearing a face covering and regular handwashing.

Restrictions around visiting inpatients and accompanying outpatients to appointments are now being eased but this happening differently in the four nations of the UK. The RCOG welcomes published advice in ScotlandEnglandWales and Northern Ireland to help services with reintroducing visitors to maternity services including antenatal and postnatal appointments and pregnancy scans.

There is a possibility that visitor restrictions may be reintroduced in response to an increase in the local or national transmission risk. We understand this must be a very worrying and anxious time if you are pregnant and your birth partner(s) cannot be with you while you are being induced. However, this guidance is in place to protect other pregnant women and babies and birth partners themselves, as well as maternity staff.

Please be assured that if your birth partner(s) is unable to be with you on a ward during your induction, this will not impact on your birth partner’s presence during labour and the birth, unless they are unwell with symptoms of coronavirus or have tested positive for coronavirus. At the point you go into active labour, you will be moved to your own room and at least one well birth partner will be able to join you.

Q. Will my birth partner(s) be able to stay with me if I have a caesarean or instrumental birth that occurs in an operating theatre?

We fully support women having at least one birth partner with them during labour and birth, unless they are unwell or have tested positive for coronavirus.

Around one in four women in the UK has a caesarean birth. A caesarean birth may be recommended as a planned (elective) procedure for medical reasons or as an emergency – for example, if doctors and midwives are concerned that your baby is not coping with labour and needs to be born immediately.

Furthermore, around one in five women in the UK has an instrumental birth (ventouse or forceps). Some instrumental births may also be recommended to occur in an operating theatre in order to allow the maternity team to modify plans and undertake a caesarean birth if necessary.

Most caesarean and instrumental births in theatre are carried out under spinal or epidural anaesthetic, which means you’ll be awake, but the lower part of your body is numb and you cannot feel any pain. In this situation, everything will be done by the clinical staff – midwives, doctors (obstetricians) and anaesthetists – to keep your birth partner with you.

Due to the coronavirus pandemic, staff in the operating theatre will be wearing enhanced personal protective equipment (PPE) to prevent the spread of infection, which will make it more difficult for them to communicate. To enable the clinicians to assist in the birth of your baby safely, it is very important your birth partner(s) follows the instructions from the maternity team carefully and quickly.

Occasionally, a general anaesthetic (where you are put to sleep) may be used, particularly if your baby needs to be born urgently. During this type of caesarean birth, even under usual circumstances (before the coronavirus pandemic), for safety reasons it is not possible for birth partners to be present during the birth.

While the maternity team will do all they can to ensure that your birth partner(s) is present for the birth, there will be some occasions when there is a need for an urgent emergency birth with epidural or spinal anaesthetic in which it will not be possible for your birth partner(s) to be present. This is because, during an emergency, operating theatres are more high-risk environments for the potential spread of coronavirus to anyone who is present.

If it is the case that your birth partner(s) will not be able to be present during the birth, your maternity team will discuss this with you and will do everything they can to ensure that your birth partner(s) can see you and your baby as soon as possible after the birth.

Q. Will I be able to have a birth partner with me on the postnatal ward?

Visiting is now subject to local discretion by Trusts and other NHS bodies – please check with your maternity unit for their policy on visitors to the postnatal wards. It is important that any visitors follow guidance in hospitals about social distancing, wearing a face covering and regular handwashing.

Restrictions around visiting inpatients and accompanying outpatients to appointments are now being eased but this happening differently in the four nations of the UK. The RCOG welcomes published advice in ScotlandEnglandWales and Northern Ireland to help services with reintroducing visitors to maternity services including antenatal and postnatal appointments and pregnancy scans.

There is a possibility that visitor restrictions may be reintroduced in response to an increase in the local or national transmission risk. We understand that not having a birth partner with you on the postnatal ward after you have given birth may be upsetting for you both but these restrictions are in place, where necessary to reduce the risk of transmission of coronavirus to you, your baby, the maternity staff and birth partners themselves.

Please be reassured that during this time, midwifery, obstetric and support staff will do their best to support the needs of all women and the practical challenges of caring for newborn babies after birth. Where visitors are permitted, it is important that they follow guidance in hospitals about social distancing, wearing a face covering and regular handwashing.

Q. What is the advice for birth partners during the coronavirus pandemic?

We are asking you to follow the guidance below to keep yourself, your family, other families and NHS staff as safe as possible during the pandemic:

  • During the coronavirus pandemic, all hospitals have been restricting visitors, but there has always been an exception for a well birthing partner during active labour and birth.
  • Birth partners will be required to wear a mask or face covering when entering a hospital under new NHS guidance.
  • Every woman should be able to have at least one birth partner stay with her through labour and birth, unless the birth occurs under a general anaesthetic.
  • To help prevent spread of coronavirus to other women, their babies and key front-line healthcare staff, it is very important that you do not attend the maternity unit if you have any symptoms of coronavirus or have had any in the previous 10 days.
  • If you are unwell, protect your family and NHS staff, and stay at home. To prepare for this, women and their current birth partner(s) are being encouraged to think about an alternative birth partner(s), if required. This person does not need to be from the same household as you.
  • If you are supporting a woman during labour and birth, please be aware of the strict infection control procedures in place to prevent the spread of coronavirus to other pregnant women and their babies, as well as other people within the hospital and the maternity staff.
  • Please wash your hands regularly with soap and water and use hand sanitiser gel in clinical areas as available.
  • If you cough or sneeze, please cover your mouth with a tissue and dispose of it in a bin immediately.
  • If you are asked to wear any additional personal protective equipment (PPE) in addition to a mask or face covering during the labour or birth, please follow the instructions carefully and take it off before you leave the clinical area.
  • If you are accompanying a woman to her birth in an operating theatre, please be aware that operating theatre staff will be wearing PPE and it may be more difficult for them to communicate with you:
    • A staff member will be allocated to support you; please carefully follow their instructions and approach them if you have any questions.
    • To enable the clinical staff to do their job, it is very important that you do not move around the operating theatre as you risk de-sterilising sterile areas.
    • The maternity team will do everything they can to enable you to be present for the birth. However, if there is a particular safety concern, they may ask that you are not present in the operating theatre. If this is the case, the team should discuss this with you and explain their reasons unless it is an emergency.
  • We understand this is a stressful and anxious time for pregnant women, birth partners and their families and we thank you for your cooperation during this time.
  • Please be assured that the maternity team will do all they can to provide information, guidance and support to you and the woman giving birth.

For more informartion about pregnancy and coronavirus you can head to...

https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/ 

https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/pregnancy-and-coronavirus/