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Coronavirus COVID-19 - With Mother and Child Services

(Last updated 15th February 2024)

Please note that this is an evolving situation and wherever possible I will try to update this page accordingly.

About the Virus

Corona Virus infections include the common cold. A new strain of Corona Virus:- Novel coronavirus (SARS-COV-2) which seems to have originated in Hubei Province in China in 2019 causes Corona Virus Disease. This disease can cause sudden onset of severe breathing problems (sudden acute respiratory distress syndrome) requiring hospital treatment and, in some cases, intensive care with oxygen and/or ventilation support.

Studies from around the world suggest that the majority of pregnant mothers with no underlying health problems who come into contact with COVID-19 will only experience mild to moderate cold or flu like symptoms and fully recover without needing hospital treatment. Around 75% of pregnant mothers will experience no symptoms at all. Findings from the UK Obstetric Surveillance System UKOSS show that a very small  proportion of mothers, mainly those who are unvaccinated can become seriously ill with the virus. Treatment in that instance will involve intensive care. In addition these mothers are likely to have their baby born prematurely or stillborn. 

 Data from UKOSS also showed that the chances of being admitted to hospital with COVID-19 infection in pregnancy are increased for mothers who are over the age of 35, overweight or obese, have underlying health problems such as high blood pressure and diabetes. The data also suggests that, statistically, mothers from Black, Asian and other ethnic minority backgrounds are at increased risk, though the reasons for this are not clear. It is important to note that having a black, asian or ethnic minority heritage does not mean you should be treated as high risk in labour, so long as you are healthy and do not have any symptoms of COVID-19, nor do any member of your household. You can still have the choice of giving birth at home, in water or in a midwife led setting. The Midwife led care principle applies to all women regardless of heritage who are healthy and without symptoms. I will be offering these services to you accordingly with the added benefits of having your own continuity of carer Midwife who is able to liase and share your care with medical and specialist teams if required.

To avoid the potential harms of Covid 19 it is still strongly recommended that pregnant mothers and more so for those in the at risk categories to have the full course of Covid 19 vaccine which is two doses if you have never been vaccinated, followed by a booster dose. For more information about the vaccine and about risks and benefits please feel free to access the link below.

https://www.gov.uk/government/publications/covid-19-vaccination-women-of-chilbearing-age-currently-pregnant-planning-a-pregnancy-or-breastfeeding/covid-19-vaccination-a-guide-on-pregnancy-and-breastfeeding

Services

As from february 2023, having secured insurance for birth care as an Independant Midwife, I am able to provide birth care outside of the NHS. I still work within the NHS but on a flexible basis  in order to be free to support my private clients when needed.

Antenatal and postnatal care are extremely important to ensure the health and wellbeing of both you and your baby. I have been and still continue to provide Private Independent Midwifery Services, which will include home visits where telephone/video conferencing is not appropriate. For home visits I will complete a simple risk assessment prior to each visit to ensure we both continue to be symptom free and have the necessary protective safeguards in place to avoid contracting the virus.The Royal College of Midwives have published a simple guide drawn from Public Health England for families about what to expect from a Midwife Home visit.  https://www.rcm.org.uk/media/3915/guidance-for-women-on-home-visits-4.jpg

To help you decide on the various care bundles and consultations I have to offer, and whether or not to have me as your named midwife  responsible for your maternity care, I can arrange an initial phone or virtual face to face consultation at a cost of £180.00 - refunded on booking a care bundle.This will be to discuss your individual needs and how I can tailor services to support you. This can also include as a one off, some general midwifery advice about your pregnancy, birth or afterwards. Please note that this will be limited to the information you give me at the time and cannot replace the advice and treatment given to you by your existing Healthcare provider/s.

 You can contact me  https://www.withmotherandchild.co.uk/contact/  to arrange this via email or telephone. 

Should you require urgent help if you are ill or suspect you may have the virus, please contact the maternity unit where you have booked for your pregnancy and speak to them over the phone about what to do next. If you are not booked in a maternity unit dial, the NHS 111 service for advice and if you feel you need emergency medical treatment, call 999.

Infection risk concerns

I continue to work on a flexible basis on the labour and birthing centres,  triage assessment, clinics. I appreciate that you may be concerned about possible infection coming into your home either from myself, having worked in the hospital environment or from being with other clients.You may equally have concerns yourself about catching the virus when you go to a clinic appointment or come into hospital to have your baby.

Precautions I am taking, and precautions being taken in the maternity unit where I work - (this is not an exhaustive list, please feel free to contact me to ask further questions about this).

  • Should either you or a member of your family contract the virus and are either symptom free or well enough to remain at home with simple self care remedies, I will continue to attend you at home to provide midwifery care if this cannot be safely reschduled or be carried out as a virtual consultation. In the event that I myself, come into contact with the virus and am having to self isolate/receive treatment I will arrange for another Independent Midwife Colleague to attend you where the appointmnet cannot be safely rescheduled until I am fully recovered. I am obviously taking all precautions necessary to avoid these scenarios as I am sure you are as well.

 

  • Within the Trust that I support, it is no longer mandatory for clinicians including myself to wear a facemask unless we are providing direct care to a mother infected with the virus. I  continue to wear a face mask  and the required PPE in those instances.

 

  •  I continue to practise good hand hygiene when I am out in public places, eg shopping, eating out, etc.

 

  • For visiting you at home to provide midwifery care, I have a supply of additional Personal Protective Equipment - mainly masks and overshoe covers. Aprons, gloves and disinfectants, etc., are already routinely used because of the nature of certain aspects of the job. With regards to my equipment, where it is not disposable single use, I will wash or wipe down with disinfectant as appropriate after each use. I also regularly wipe down surfaces within my car and home with disinfectant.

Reducing the risk of infection further

Midwives are in close contact with mothers we care for, including bodily fluids etc. Most maternity units adopt a universal policy protection against infections.This means that for every mother and baby basic protection e.g. disposable gloves, apron, hand hygiene and waste disposal have always been part of everyday practice. I have followed these including barrier nursing when a mother has required this, very stringently for over two decades both in the hospital and community settings. Thankfully I have never yet inadvertently passed on an infectious disease or hospital acquired infection to anyone.

I am fully aware that the Corona COVID-19 Virus is highly contagious and like other NHS staff and myself as a part time employee, I have been provided with the necessary protective equipment for Corona Virus in addition to the other protective measures we take on a daily basis. I have kept up to date with all the training provided by the Trust where I work and also receive regular updates from the Royal colleges of Midwives (RCM), Nursing (RCN) and Obstetrics and Gynaecology (RCOG). I was also involved with the Public Health England NHS Test and Trace programme and worked on a flexible basis fom home. My role as Contact Trace worker enabled me to keep up to date with knowledge around the virus. This ensured that my everyday working practice as an Independent Midwife continued to be covid-19 secure as far as possible. 

To ensure the health and wellbeing of both you and your baby, it is recommended that you are able to fully access maternity care at all times. Please feel free to contact  me to support you with this if needed. 

If you were planning to have a home birth or birth in a Midwife led Unit, the current advice if you were to be infected with the Corona Virus is to attend an obstetric unit for birth where both you and the baby can be continuously monitored. This is based on evidence from China where out of 18 mothers infected with COVID-19 and 19 babies, (there were one set of twins), 8 out of the 19 babies were compromised as a result of the virus.

Useful Resources

First and foremost, follow the advice you have been given from your own Maternity Unit if you are booked in one.

Midwives, Obstetricians, Paediatricians, Child Health specialists, Obstetricians, Anaesthetists, Public Health, Infection Prevention and Control teams are all highly experienced, well established institutions are working together collectively to give us the best possible evidence based advice on how to manage Coronavirus in pregnancy, birth and in the post birth period.

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

Please revisit this regularly because as the situation changes and evolves the advice and recommendations are adjusted accordingly.

Other Resources

How to check if you have coronavirus symptoms  https://111.nhs.uk/covid-19

General government advice about Coronavirus (COVID-19) https://www.nhs.uk/conditions/coronavirus-covid-19/

www.laleche.org.uk and follow the link for coronavirus

www.lullabytrust.org.uk/safer-sleep-advice/coronavirus-and-caring-for-your-baby/

Some Positives for the moment...

For healthy mothers with no other underlying medical problems, being pregnant does not appear to increase the chances of the consequences of infection with COVID-19 than the general population.   

Previous expert opinion stated that unborn babies were unlikely to catch COVID-19 during pregnancy. Samples from amniotic fluid, cord blood and breast milk including placental swabs from infected mothers all tested negative for the virus. However, recent evidence where a small number of babies have tested positive for the virus soon after birth suggests that transmission of the virus is possible during pregnancy. It is important to note that all reported cases of corona virus positive babies  have remained well and currently there have been no reports of developmental problems to date. The UK Obstetric Surveillance System (UKOSS) is a well-established surveillance system already used by maternity units to monitor the health and wellbeing of mothers and babies, so that healthcare professionals can deliver care that is evidence based and of the highest standards. All mothers infected with coronavirus during pregnancy and their newborn babies have been included.

From the small number of babies testing positive with coronavirus after birth, it is unclear if this occurred in the womb or in the immediate postnatal period. For this reason, healthcare professionals will be adhering to strict, infection control measures to minimise the chances of transmission as much as possible:- For mothers with suspect or confirmed symptoms of  COVID-19, who are well enough to continue to labour, invasive monitoring or proceedures that increase the risk of infection will be avoided as far as possible. Similarly, labouring in water would not be recommended due to the increased risk of transmission from mother to baby.

There is still currently no evidence to suggest that the corona virus is transmitted through breast milk.  Ensure you wash your hands before and after contact with your baby which includes breastfeeding. Regularly clean and disinfect surfaces you have come into contact with and try to avoid touching your face and mouth.

Skin to skin contact with baby immediately after birth including optimal cord clamping can still be facilitated so long as you and your baby have remained well during the labour and birth and you have chosen to have this for your baby.

 Thank you for taking the time to read this document. Please feel free to contact me for further information or a general chat about this or anything that is worrying you about your pregnancy and birth. I will be happy to do so free of charge over the phone. 

Blue footprint and pink footprint inside a heart shape

Independent Midwife Practitioner
Sarah Joy Jones

Providing antenatal, birth and postnatal services including advice to accompany your NHS care. 

07453 081777
sarahj@withmotherandchild.co.uk