Guidance for pregnant women and new mothers

Public Health Services are working closely with the Maternity Services to minimise the risk to service users and the community. In doing this, some changes have been made to the Maternity Services and include:

• All group sessions have been cancelled
• No children or partners should accompany you to your antenatal appointments, including your scan
• Some appointments may be held over the phone
• Ultrasound pictures will be provided at the end of the clinical examination
• Only one birth partner is permitted per labouring woman
• Only one named postnatal visitor per service user is allowed on the ward
• You must inform your midwife if you are expecting a home visit and anyone in your home has influenza like symptoms, has been diagnosed with COVID-19 or is awaiting the result of a COVID-19 test
• Your partner can stay on the ward during the post-natal period and food can be obtained from the canteen.
• No children are allowed to visit at the moment. This is because they can be carriers of the virus without showing symptoms.
• No partners are currently allowed in theatres. However, they are welcome to stay on the ward while their partner is in theatre. Theatre staff will be in full personal protective equipment, including masks. Please do not be alarmed by this.
• Waterbirths are still going ahead on the ward at this time if the mother has no symptoms of Coronavirus. If the mother has suspected or confirmed COVI-19, this will not be possible. This is because the virus is known to be present in faeces, birth pool water may become contaminated and therefore, there would be a risk of infection to the baby, birth partner and healthcare staff.
• Homebirths are not possible at this time. However, all specialities have made preparation for the care of suspected or positive cases in isolation. It is strongly advised against birthing without the appropriate professional supervision, monitoring and expertise i.e. free birthing.
• If you feel you require further support your midwife will facilitate a telephone appointment for you and your partner.

There is no current evidence to suggest that pregnant women are more likely to contract the infection, or to become severely unwell, than the general population. The large majority of pregnant women who have COVID-19 will experience only mild or moderate cold / flu symptoms.

The symptoms you should be aware of are:

• Muscle ache (fatigue, exhaustion)
• Headache (sinus pain, pain around eyes)
• Loss of smell/taste
• Sore throat
• Fever (high temperature, rigors, chills, can’t get warm.) 
• Shortness of breath, chest tightness
• Continuous new cough

What are the effects of COVID-19 on the fetus?

There is currently no data suggesting an increased risk of miscarriage or early pregnancy loss in relation to COVID-19.

There is also no evidence that the virus can pass to your developing baby while you are pregnant (this is called vertical transmission). Two cases of possible vertical transmission have been reported. In both cases, it remains unclear whether the transmission was prior to or soon after birth. Expert opinion is that the fetus is unlikely to be exposed during pregnancy and therefore it is considered unlikely that if you have the virus it would cause abnormalities in your baby and none have been observed currently.

Pregnant women are advised to follow the social distancing guidance and take the usual health protection precautions that they would usually take during pregnancy.

Find out more about social distancing on the how to protect ourselves page.

Women above 28 weeks gestation should be particularly attentive to social distancing and minimising contact with others. It is advised that all pregnant women over 28 weeks gestation should significantly limit face-to-face interaction with friends and family, if possible, and remain at home until they have given birth, except to attend medical appointments, including antenatal care and exceptional circumstances such as labour.

Pregnant women who can work from home should do so. If you work in a public-facing role that can be appropriately modified to minimise your exposure, this should be considered and discussed with your employer.

Women who are pregnant and have significant heart disease, either congenital or acquired, should take further precautions, described as shielding.

Shielding is a measure to protect extremely vulnerable people by minimising interaction between those who are extremely vulnerable and others. This means that those who are extremely vulnerable should not leave their homes, and within their homes should minimise all non-essential contact with other members of their household. This is to protect those who are at very high risk of severe illness from coronavirus (COVID-19) from coming into contact with the virus.

Find out more about shielding and which health conditions categorise an individual as extremely vulnerable.

If you think you fall into the extremely vulnerable category, please speak to your obstetrician to discuss this.

The Maternity Services will inform you if there are any changes in the provision of antenatal care. Your midwife may offer some of your appointments using electronic methods of communication.

Whether you should continue to attend your antenatal care in person will depend on your current situation at the time of your appointment.

If you are well

Attending antenatal and postnatal care when you are pregnant and have a new baby is essential to ensure the wellbeing of pregnant women and their babies, and we would urge all pregnant women who are well to attend their care as normal.

If you are NOT well or are in self-isolation

Pregnant women should not attend a routine appointment if they are unwell or in self-isolation, but should call their midwife and rearrange. However, if there is an urgent need for maternity assistance you should not wait until your symptoms have gone but instead call ahead and inform the team of any symptoms, relevant travel history, if you have been tested for COVID-19 and the result if you have it. We are currently working with our Maternity services to limit the risk to service users.

In an emergency, call 999 and inform them whether you are in self-isolation, any relevant travel history, if you have been tested for COVID-19 and the result if you have it.

If you go into labour, you should call your maternity unit for advice, and inform them that you have suspected or confirmed coronavirus infection.

If you have mild symptoms, you will be encouraged to remain at home (self-isolating) in early labour, as per standard practice. When you and your maternity team decide you need to attend the maternity unit, general recommendations about hospital attendance will apply:

• You will be advised to attend hospital via private transport where possible, or call 999 for advice, as appropriate
• Do NOT use a taxi or public transport if you have been diagnosed as having COVID-19 or are waiting for results from a COVID-19 test

We understand that it must be an anxious time if you work in healthcare and you are pregnant. The latest guidance recommends that pregnant women under 28 weeks’ gestation (in the first and second trimester of pregnancy) with no underlying health conditions, should follow the guidance on social distancing in the same way as the general population.

Subject to taking social distancing precautions in the work environment, in the same way as other colleagues, pregnant women under 28 weeks gestation may continue to work as normal. However pregnant women from 28 weeks’ gestation (in the third trimester of pregnancy), and pregnant women with underlying health conditions, such as lung or heart disease, may experience more severe symptoms of the virus and are therefore advised to take a more precautionary approach and are strongly advised to follow social distancing advice.

For further support around this matter please contact your line manager and the Occupational Health team.

Wherever possible the mother and baby should not be separated anymore than usual, even if the mother tests positive for coronavirus. Provided your baby is well and doesn’t require care in the neonatal unit, you will be kept together after you have given birth.

If you have had a straightforward pregnancy and birth you will be encouraged to leave hospital as soon as it is safe for both you and your baby and postnatal support will be provided outside the hospital setting.

Current evidence supports breastfeeding, even if the mother has a COVID-19 infection, as any potential risks are outweighed by the benefits.

An individual assessment will be undertaken on each mother who has been diagnosed with COVID-19 to provide the correct support for that family.

• Royal College of Obstetricians and Gynaecologists
• Royal College of Midwives

Our wonderful team on Loveridge Ward have a message for expectant parents, who may be feeling anxious about the upcoming births of their babies.

This may not be the experience you dreamt of, or that you planned. You may not have the visitors you would like as new parents, but the team are there for you, every step of the way.

They promise to keep you safe, to hold your hand, to laugh with you and cry with you. They will listen to you and support you and bring you the best cuppa and toast. They’ll be your family and your friends.

Behind the mask, they are just the same - wonderful healthcare professionals who are more determined than ever to ensure the birth of your baby is still magical and amazing.

So please don’t be afraid. You’ve got this mamas. And all the amazing, anxious dads.

We’ve got this. Together we are stronger.

If you would like to speak to the team on Loveridge Ward, call on 01481 707377.

#GuernseyTogether #WeveGotThis