Please note that this is an evolving situation and wherever possible I will try to update this page accordingly.
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.
Current data from the World Health Organisation 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. Findings from the UK Obstetric Surveillance System UKOSS show that a small proportion of mothers, mainly in the third trimester of pregnancy, 28 weeks onwards, have become seriously ill with the virus. This is why social distancing is particularly important from 28 weeks of pregnancy. 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.
I continue to work part time for our NHS with additional shifts where needed on the labour ward, antenatal hospital and community clinics.
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 free of charge. This will be to discuss your individual needs and how I can taylor 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.
I continue to work part time for our NHS on the labour ward with additional shifts where needed in the antenatal hospital and community 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).
Midwives are in close contact with mothers we care for, including bodily fluids etc. The maternity unit where I work have always adopted 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 contracted or 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 recieve regular updates from the Royal colleges of Midwives(RCM), Nursing (RCN) and Obstetrics and Gynaecology (RCOG). I have also been involved with the Public Health England NHS Test and Trace programme, working 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 ensures that my everyday working practice as an Independent Midwife continues to be covid-19 secure as far as possible. I feel the role helped me to make a small contribution locally as well as providing me with reliable information to be able to sign post you to and discuss any questions or concerns you may have.
To ensure the health and wellbeing of both you and your baby, it is recommended that you are able to access maternity care during this pandemic. To minimise exposure to the virus, aspects of maternity care accross the UK have been adjusted. I have also redesigned the services I offer in line with the RCOG and RCM guidelines. Neccessary arrangements between myself and the hospital where you are booked for maternity care will be made to avoid duplicate appointments. In addition, where it is safe to do so some home visits will be replaced with telephone /video link consultations as discussed previously.
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.
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.
Please revisit this regularly because as the situation changes and evolves the advice and recommendations are adjusted accordingly.
Most pertinant at the moment is whether or not to have the covid vaccine which is now being offered to pregnant women in the UK. Please follow the link below and click on the RCOG updated information leaflet and decision aid to help you make this important decision. Again please feel free to contact me free of charge to talk this through if you feel this may be helpful.
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 corona virus
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 surveilance 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 the corona virus during pregnancy and their newborn babies have been included.
From the small number of babies testing positive with the corona virus 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.There is a small risk of the baby breathing in infected air from breath droplets and more so if you sneeze or cough directly onto your baby whilst feeding. It is therefore recommended you wear a mask to prevent this. 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 for the duration of the pandemic as I appreciate that these are concerning times for everyone. Here are some words I have personally found helpful.