We are taking all possible precautions to limit the spread of COVID-19, including swabbing all ladies who come and use our maternity services to reduce the risk of transmission. We have, therefore, put in place the following restrictions to safeguard and protect our new mums and newborn babies.
In the case of all appointments/attendances staff, birth partners, visitors and family members in the home are kindly asked to follow all infection control procedures such as hand washing, wearing masks, maintaining social distancing.
First and foremost, please ensure that you continue to observe social distancing guidelines at all times.
This applies whether you need to visit our services, go out shopping or are generally out and about. We have experienced very few cases of COVID-19 during pregnancy and this is down to the vigilance and cooperation of you all. It is easy to assume that with the relaxing of some guidelines during lockdown that we could become complacent but please don't. You have done a tremendous job so far so let's continue the effort together and keep up the social distancing.
We would like to reiterate that the evidence we have so far is that pregnant women are still no more likely to contract the infection than the general population. What we do know is that pregnancy can alter how your body handles severe viral infections. This is something that midwives and obstetricians have known for many years and are used to dealing with. Occasionally Coronavirus can therefore cause more severe symptoms in a small proportion of women, therefore pregnant women were placed in a ‘vulnerable group’ by the UK Government.
What has driven the decisions made by officials is the need to restrict spread of illness because if the number of infections were to rise sharply, the number of severely infected women could rise and this could put the lives of pregnant women in the third trimester in danger.
Our general advice is that:
- If you are infected with COVID-19 you are still most likely to have no symptoms or a mild illness from which you will make a full recovery.
- If you develop more severe symptoms or your recovery is delayed, this may be a sign that you are developing a more significant chest infection that requires enhanced care. Our advice remains that if you feel your symptoms are worsening or if you are not getting better you should contact your maternity care team, NHS 111 or local alternative straight away for further information and advice.
The Royal College of Obstetricians and Gynaecologists has issued guidance which can be found here.
Advice regarding your appointments during pregnancy
It is extremely important that during the Coronavirus pandemic, all pregnant women continue to access regular care throughout their pregnancy and following the birth of their baby. We are continuing to provide routine antenatal care in community midwifery and hospital settings.
Some of your appointments during pregnancy will be by telephone with your community midwife. However, you will still have face to face appointments for your dating and anomaly scans, and at 28, 32, 36 and 40 weeks, either at the hospital or with your community midwife. If this is your first baby you will also have a face to face appointment at 38 weeks.
If you have a hospital appointment you will be contacted the day before by a member of staff and asked some screening questions and advised if you still need to come to the hospital. For hospital appointments taking place on Monday, you will be contacted on the previous Friday.
When you arrive at Antenatal Clinic in the hospital you will be asked some more screening questions before you enter the clinic. We ask for your patience with this.
Your baby’s movements matter
If you notice that your baby is not moving or the movements have changed or reduced, you still need to call the hospital you are booked to give birth at immediately. Even if you think you may have COVID-19 symptoms you must contact the hospital and we will arrange for you to be seen in an isolation area to check you and your baby are healthy. Do not wait for your next appointment.
Advice regarding social distancing and self-isolation while pregnant
The UK Chief Medical Officer has decided that, given the limited information currently available about how COVID-19 could affect pregnancy, it would be prudent for pregnant women to increase their social distancing to reduce the risk of infection.
All pregnant women, regardless of how far through their pregnancy they are, should observe the social distancing guidance available on the Government website. Advice includes the avoidance of contact with people who are known to have COVID-19 or those who exhibit possible symptoms:
1.For all vulnerable people including pregnant women: view here
2.For individuals and households of individuals with symptoms of new continuous cough or fever: view here
Women who are more than 28 weeks pregnant should be particularly attentive to social distancing and minimising contact with others. Major new measures have been announced for people at highest risk from Coronavirus, this includes pregnant women with significant heart disease (congenital or acquired).
Information about our services during Coronavirus
We know this is a challenging time for expectant mothers and new parents. Information and guidance is regularly changing and we will make every effort to keep women and families updated. Our priority is to provide safe maternity care and to support a positive birth experience for all during this time of change and service reconfiguration.
Despite these changes we will still support you with the many choices available, positions for labour, aromatherapy, relaxation support using music during labour, pain relief options, mobilisation, infant feeding support etc. Please talk to your maternity teams if you require further information.
Please click on the boxes below to find out more about any changes to the services you will be accessing.
Will Midwives wear face masks and protective equipment?
Yes, but remember - we are wearing smiles behind the masks.
Due to a recent change in Personal Protective Equipment (PPE) requirements, staff in all clinical areas of the maternity departments and community will be wearing PPE that is appropriate for the role they are undertaking. This might include wearing a face mask, gloves, apron and eye protection when providing clinical care, even if you don’t have any symptoms of COVID 19.
We know that this might cause some anxiety however the masks are there to keep you and the staff safe and although you can’t see it, the staff will still be wearing their smiles.
One named visitor (ideally from same household) for first dating scan and anatomy scan only, which includes any repeat dating or anatomy scans required.
There is still a very strict set of guidelines to follow and your midwife should have spoken to you before your scan to talk this through with you. Anyone coming into the hospital must wear a face covering which will be provided for you at the entrance if you don’t have one yourself. Your partner must wait outside until you yourself are called in to the scan at which point you may text your partner who will then come in separately – this is to ensure that our waiting area does not become congested and make it more difficult to social distance.
Your partner will be asked the same screening questions as you, intended to assess whether it is safe for you both to attend. When the scan is over, your partner will be asked to leave and wait outside the building with you following shortly afterwards, again this is to make sure our corridors and waiting areas do not become so busy that social distancing becomes difficult.
It is important you attend scans as usual during the current pandemic. Ultrasound practitioners fully appreciate the bonding parents develop during ultrasound scans. It should be remembered an ultrasound scan is a clinical examination and the clinical aspect of these examinations must be priority during these difficult times. With that in mind an ultrasound practitioner should not be distracted in any way. The Society of Radiographers and British Medical Ultrasound Society guidance does not advocate the use of video recording of Ultrasound scans under normal circumstances. We do not allow virtual attendance by partners with on-line video calls or filming of the examination for a number of reasons:
- Having someone recording the examination would be distracting, which would increase scan times and potentially lead to mistakes being made during the examination. Advice recommends limiting anything within a 2 metre range to prevent cross contamination from droplet / contact spread, which would include patient mobile phones.
- The examination time would be extended, putting both patient and sonographer at risk of viral spread.
- Confidentiality could be compromised.
- The need for a relaxed abdomen to perform the scan. Holding a mobile phone during a scan would lead to a taut abdomen, which would make scanning difficult and compromise the examination. This could also potentially increase the risk of work related injury, within an already high risk environment for such injuries.
We are currently providing a free scan picture to the mother and supporting one named visitor/partner to be present at your dating and anatomy scan.
Attending in labour
If you have any symptoms of Coronavirus or are self- isolating due to a family member you must inform us before you arrive at the hospital. If you fall into this category you will be asked to put on a mask whilst we transfer you to an isolation room.
Women attending in spontaneous labour can be supported by one birth partner. Good hand hygiene should be used frequently whilst in the unit and entry to and from the ward area must be kept to an absolute minimum.
A birth partner who is symptomatic /unwell or is self–isolating should not attend the unit and must remain at home.
We are currently not recommending the use of the birthing pool for woman with suspected or confirmed Coronavirus.
Use of the birthing pool
As long as you do not have any symptoms of COVID 19, we are still able to offer the use of the birthing pool. The midwives caring for you will be required to wear PPE.
Induction of labour
Women who require induction of labour will be informed of the date and time to attend the birth centre.
Out-patient induction of labour will be offered where safe to do so. This means that following the start of the induction process and until labour starts, women will be able to return home. Women returning in labour can be supported by one birth partner.
Following a straightforward, uncomplicated birth, where safe to do so, we will be asking you to make arrangements to leave the hospital approximately six hours after the birth. If this is not possible or admission to the ward is necessary, we will encourage the parents to spend time together on the labour ward following the birth and politely ask that the birth partner returns home following admission of mother and baby to the postnatal ward.
Women requiring planned caesarean section will be informed of the date and time to attend the unit. Women attending for a planned caesarean section can be accompanied by their birth partner to the ward and can be present in theatre during the operation. The birth partner will be asked to wear a surgical face mask and adhere to infection prevention and control measures. It is important to understand that all medical and midwifery staff in theatre will be wearing full PPE, we appreciate that this may raise anxiety, however this standard has been agreed locally.
The birth partner will be supported to stay with mother and baby in the theatre recovery area. When mother and baby are transferred to the postnatal ward we would ask that the birth partner returns home.
Women who have undergone planned caesarean section without any complication and where baby is fit for home will be supported to consider discharge after 24 hours on the ward if safe to do so.
In cases of emergency caesarean section where immediate delivery of the baby is required (known as category 1 caesarean section), partners will be asked to wait outside theatre during the operation, this is in line with usual practice. The birth partner will be able to accompany their partner post–operatively in the recovery area prior to transfer to the ward.
Women who have undergone emergency caesarean section may require hospital stay greater than 24 hours.
We are currently providing a homebirth service as normal.
There may be unprecedented times of high activity when midwives who are on call to support the homebirth service need to be allocated to provide safe care for women labouring and birthing within the hospital. We understand that this can be disappointing and frustrating on the rare occasions that this happens for women planning a homebirth. We have a duty to ensure all women needing our services are safe and we sometimes do unfortunately have to make these difficult decisions. When the time comes for your homebirth we will do all we can to facilitate midwives to be available to attend to you. When the time comes if midwives are unable to support your homebirth, you will be informed when you call and we would recommend that you attended the hospital to give birth.
Babies will not be separated from their mothers unless there is a clear clinical need.
Breast feeding is still encouraged.
There is no routine visiting on the postnatal ward due to following strict social distancing recommendations for all pregnant women, the aim of which is to reduce the risk of infection to unwell mothers and babies who require medical admission. Partners are supported to attend pre-booked appointments each day – see visiting information above.
The day after your discharge from hospital you will have a home visit be a community midwife. We politely ask that when the midwife attends she sees the mother and baby alone in a separate room away from other family members. You will have another face to face appointment when the baby is 5 days of age to perform the newborn blood spot test, and to weigh the baby. This appointment may be in your home, or at your nearest community midwifery base, if that is appropriate. You will also receive a telephone appointment on the 3rd postnatal day to check how you are. Your discharge appointment on day 10 may also be by telephone if your community midwife feels that this is appropriate for you. Additional appointments will be organised based on individual needs. Please let you community midwife know if you need more support.
You may find the following information useful:
Your Health Visitor will contact you by telephone during your pregnancy. This could be anytime from 24 weeks. Postnatal appointments with the Health Visitor will be assessed on an individual basis, with the majority being by telephone. As a minimum, you will be contacted by a Health Visitor soon after the birth of your baby, and again when the baby is 6 weeks of age.
If your baby needs to be admitted to the Neonatal Unit:
While you are in hospital we will support you to access your baby as often as we can. If your baby is still on the Neonatal Unit when you are discharged home from hospital, both parents can currently access. In line with national guidance related to visiting on the Neonatal Unit, the parent who is visiting may not leave the unit and return during this time. All parents who are visiting will be asked to wear Personal Protective Equipment (PPE) and staff on the Neonatal Unit will assist with this.
If the baby requires critical care, one or both parents can stay with the baby.
When the baby is nearly ready to be discharged home, one parent can stay overnight in the parents’ room on the Neonatal Unit.
Mothers who are expressing breast milk for their babies will be provided with equipment to do this at home.
Community antenatal clinic appointments
Some appointments have been changed to virtual consultations. Where attendance in person is needed, patients should attend alone unless separate arrangements have been made with the Community Midwife.
Planned hospital antenatal clinic or pregnancy assessment appointments
One named visitor (ideally from same household) for women with complex needs only (for example diagnosed mental health concerns, who require counselling and support to make difficult decisions about their pregnancy such as those receiving joint care from specialist fetal medicine services). In these circumstances we will ask women to attend out of antenatal clinic hours, if suitable, so that a clinic room could be used. Named visitors will be asked to wait outside and will be called in when transfer to the clinic room occurs.
One named visitor (ideally from the same household) supported to visit for a pre-booked hour each day. Virtual visiting (e.g. FaceTime or other virtual platforms is encouraged and supported.
Emergency attendance (e.g. maternity triage)
One named visitor (ideally from the same household).
Birth centre attendance (in labour and for birth)
One identified birth partner (ideally from the same household).
One named visitor (ideally from the same household) supported to visit for a pre-booked hour each day. Virtual visiting (e.g. FaceTime or other virtual platforms is encouraged and supported.
Community home visit appointments
Family members living in the home, or who are within the woman’s support bubble as per government guidance.
Whatever your personal situation please consider the following:
Maternity care is essential, and has been developed over many years with improving success to reduce complications in mothers and babies. The risks of not attending care include harm to you, your baby or both of you, even in the context of coronavirus. It is important that you continue to attend your scheduled routine care when you are well.
If you have any concerns regarding your pregnancy but not related to Coronavirus, you should still contact your maternity team at the hospital you are booked at to give birth. The contact number will be the one given to you at booking. Please note the maternity team may need to discuss the need for an appointment with the medical team and this may take longer than usual to get back to you.
If you think you have symptoms of Coronavirus, contact your maternity service and they will arrange the right place and time to come for your visits.
You should not attend a routine clinic if you have any symptoms of Coronavirus or you or a member of your family is self-isolating.
You will be asked to attend your appointment on your own. This will include being asked to not bring children with you to maternity appointments. If your partner has accompanied you to the clinic they will be asked to remain outside the department.
We politely ask that you use the hand sanitizer on arrival and follow social distancing measures by remaining at least 2 meters away from the reception desk and sit in the waiting areas where the chairs have been placed to maintain distance between patients.
At this time, it is particularly important that you help your maternity team take care of you. If you have had an appointment cancelled or delayed, and are not sure of your next contact with your maternity team, please let them know by using the contact numbers provided to you at booking or contacting your community midwife.