Is it safe to see my Midwife right now?
Published on: 01/08/2020
Our Trustee and private midwife, Angie Bowles, has kindly sent us the following guidance on having regular contact with your Midwife or Maternity Unit during the Coronavirus Pandemic:
Many women have told us that they are having less contact with their midwife or maternity care team as a result of the Covid-19 pandemic than would normally be the case. In some cases this is because of service restrictions and “rationalisation”. In others it is because the woman feels anxious about attending hospital because of fear of infection or she is unwilling to attend alone.
At the start of the pandemic there were appeals to people to avoid going to hospital to take pressure off the NHS, however this does not apply to pregnancy concerns. If you are worried about your health or your baby, please know that asking for a check up, seeking help and advice is the right thing to do. Things can change very quickly in pregnancy. Trust your instincts.
If in doubt – get checked out!
In most hospitals the maternity unit is distanced from the general wards. Within maternity units there will be a separate area where those who have, or may have, Covid-19 are cared for. Systems are in place to protect you, your baby and the staff, with high levels of cleaning and maintaining social distancing whenever possible. This means that if you need to go to hospital the risk is probably far less than being anywhere else outside your own home. Handwashing remains very important, as it always is in pregnancy and when you have a new baby. Currently you are being asked to wear a mask when you go into a hospital but unless you are thought to have a current infection you should not be expected to go on wearing it if you stay in hospital or during labour.
In response to the pandemic, the Royal College of Obstetricians and Gynaecologists (RCOG) issued advice to providers outlining what they considered would be “acceptable” reductions in services Initially there were very major reductions in the face to face care being offered, stating that “A minimum of six face-to-face (physical) antenatal consultations is … advised”. This is a significant reduction from what is normally considered a safe level of care and the update issued on 10th July states that “the guidance was intended for the peak of the pandemic and that services should return to normal practice as soon as the local risk of transmission and prevalence allows”.
Checks in pregnancy are intended to identify any signs that you or your baby may need extra care and monitoring. For example, your blood pressure can rise to a point which can pose a risk to you and your baby, but without any obvious symptoms. Abnormalities in urine tests may be an early warning sign of problems which could become life threatening. If home monitoring is suggested (or you choose to do it), please make sure that you are clear what results would be considered unusual or worrying. You need to know exactly what you should do and how quickly if you get an unusual result.
Whilst checking your blood pressure and urine may be useful, we strongly advise that you DO NOT buy or use a fetal heart monitor to check your baby’s heartbeat. They don’t always give a true picture of your baby’s health and you may be falsely reassured.
We are particularly concerned about women/babies for whom there is additional concern. We have heard from women with gestational diabetes who have not had contact with the specialist team for many weeks and delays in referrals for specialist advice. The NHS is still there and your pregnancy concerns won’t wait. If you feel you are not being given the information or checks you need please contact your antenatal clinic, the Head Of Midwifery at your local unit or the PALS team (Patient Liaison Service).
There are midwives who work outside the NHS (known as private or independent midwives), many of whom are able to offer occasional antenatal or postnatal care if you want to supplement what the NHS offers. Some also offer complete care, including managing the birth of your baby. They will usually visit you at home, subject to making checks with you about possible infection risks. We will be sharing some information about private midwives in a future post because we have had many enquiries recently about what they can offer, insurance concerns, and how it can work combining NHS and private care.
We know that in many areas the NHS stopped supporting home births. This is very disappointing given the research evidence regarding the safety of homebirth for mothers and babies in usual circumstances, added to the potential benefits of a woman staying out of hospital. In some Trusts the reason was because of a reduced number of staff available (due to shielding etc), in others it was concern about protecting staff when in people’s homes, or the fear that the ambulance service could be overwhelmed with demand due to the pandemic and so back up for transfer to hospital might not be readily available. If you are committed to homebirth, this can be hugely upsetting and women have been reacting in a number of ways. We strongly advise against free birthing (birth without professional support). This includes birth supported by a doula but without a midwife. In many cases birth will proceed absolutely safely and have a happy and successful outcome, but sadly this is not always the case and issues cannot always be predicted. Each birth is unique and having had one (or more) straightforward births does not guarantee that the next will be so.
For more information regarding coronavirus in pregnancy, please visit our website.
To know when to call your maternity team, please visit our When to Call The Midwife page.