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Wirral University Hospital NHS Foundation Trust

COVID - 19 Updates

Maternity

Maternity

In line with planned changes to government COVID-19 restrictions we welcome a support person for labour and birth.

You can have one person accompany you, to your antenatal hospital and scan appointments. This includes early pregnancy services and all midwifery and obstetric appointments in the hospital setting only and does not cover any community venues which will be on an individualised basis.

In order to continue keeping everyone safe we ask the following:

  • if you wish to bring someone with you, we ask them to provide a negative Lateral Flow Device test
    • they are free of any symptoms of COVID-19
    • if they have had COVID-19, they must have completed their period of isolation
    • that you haven’t been advised to self-isolate in the last 14 days when returning from travel abroad
  • We ask that you and your support person do a lateral flow antigen test 24 hours before your routine appointment and continue to complete these twice a week as recommended by NHS England. Your midwife or doctor will ask you to verbally confirm your test result on attendance at your appointment.

Please do not bring any children or other people with you to any appointments.

Thank you for your help and understanding.

For more information including COVID-19 vaccinations please follow the below link:

IF YOU HAVE ANY CONCERNS ABOUT YOU OR YOUR BABY PLEASE CALL MATERNITY TRIAGE: 0151 604 7111 Remember should you have any queries or concerns the midwives are here to support you 24 hours a day – please get in touch.

Please see below for updates. Please also see the 'related links' to the left of this page for additional information.

Birth partners

We are currently able to accommodate one birth partner to our Delivery Suite and wards areas to limit the spread of Covid-19. Women can be supported by a single birth partner during labour and within the ward environment, they will be encouraged to remain on the ward for the duration of the stay as we cannot facilitate birth partners but they must to freely come and go.

Communications - social media

WUTH have introduced a Facebook page specifically for  Wirral Women’s and Children’s Hospital families, which includes antenatal, labour and postnatal information along with virtual posts to help and support you during this time. You can join by accessing:-  Wirral Women and Children’s Hospital – MATERNITY

Due to the COVID-19 virus we have reduced face to face meetings and we are finding ways to deliver  information to ensure you all feel listened to, cared for & fully informed. This group is being run by midwives and all information given is either Trust Policy or government supported. If you have any questions you can message us directly and we will reply with evidence based research.

What to do if you are pregnant

As soon as you find out you're pregnant speak to a GP or midwife.

They'll support you and give you all the information you need. They'll also make sure you receive safe and personal maternity care.

If you're pregnant, it's important you:

  • wash your hands regularly
  • stay at home as much as possible and follow the advice on social distancing, such as staying at least 2 metres (3 steps) away from other people
  • stay away from anyone who has symptoms of COVID-19

If you’re more than 28 weeks pregnant it’s especially important to follow this advice.

You still need to go to all of your pregnancy (antenatal) scans and appointments unless you're told not to.

 

What effect does Coronavirus have on pregnant women?

If you’re pregnant your chance of getting COVID-19 is not higher than anyone else and it’s very unlikely you’ll get seriously ill with it.

Pregnant women are in the moderate risk (clinically vulnerable) group as a precaution. This is because you can sometimes be more at risk from viruses like flu if you're pregnant.

It's not clear if this happens with COVID-19. But because it's a new virus, it's safer to include pregnant women in the moderate risk group.

Although it's very rare for pregnant women to become seriously ill if they get COVID-19, it may be more likely later in pregnancy. If this happens, there's a small chance your baby may be born early or you may be advised to give birth earlier than your due date.

While the chances of having a stillbirth are low, there is some emerging evidence that the risk may be higher if you have COVID-19 at the time of birth.

It's important to follow advice to stop the spread of COVID-19 throughout your pregnancy, such as social distancing. Especially when you're more than 28 weeks pregnant (in your 3rd trimester). You can also have the COVID-19 vaccine.

If you're from an ethnic minority group, evidence suggests you're more likely to be admitted to hospital if you get COVID-19. Maternity teams are taking extra steps to keep you safe if you're higher risk.

It may be possible for you to pass COVID-19 to your baby before they're born. But when this has happened, the babies have got better.

There's no evidence COVID-19 causes miscarriage or affects how your baby develops in pregnancy.

 

COVID-19 vaccine in pregnancy

You can get vaccinated against COVID-19 if you're pregnant and aged 18 or over.

It's preferable for you to have the Pfizer/BioNTech or Moderna vaccine. This is because they've been more widely used during pregnancy in other countries and no safety concerns have been identified.

If you get symptoms of COVID-19

If you get any symptoms of COVID-19 (a high temperature, a new, continuous cough or a loss or change to your sense of smell or taste):

  1. Stay at home (self-isolate) – you and anyone you live with should not leave your home or have visitors. Anyone in your childcare or support bubble should also self-isolate if you've been in close contact with them since your symptoms started or during the 48 hours before they started.
  2. Book a test – get a PCR test (test that is sent to a lab) to check if you have COVID-19 as soon as possible. Anyone you live with, and anyone in your childcare or support bubble, should also get a test if they have symptoms.
  3. Speak to your midwife or maternity team – they will advise you what to do. You may need to rebook some of your pregnancy appointments or have them online, by phone or as a video consultation (see link to the left of this page).

Please let staff know that you are self-isolating before you come to hospital or are seen by our team in the community. This is so that we can give you the best care to keep you, your baby and our teams safe.

Pregnant women who are exposed to COVID-19 are not thought to be at increased risk of miscarriage. If you are less than 14 weeks pregnant and have any pain or bleeding please contact EPAU for advice.

If you are due to see your midwife for a routine antenatal appointment please contact her in advance and let her know that you are self-isolating.  Your midwife will talk to you and decide whether you need to be seen or if your appointment can be delayed.  Your midwife will agree when and where you will have your next antenatal appointment.

If you are due to see your consultant obstetrician for a routine antenatal appointment you will be contacted by the consultant’s team. You may be able to have a telephone appointment with the consultant’s team if you don’t need to be examined. If you need a face to face appointment with the consultant before your self-isolation ends, special arrangements for you to attend your appointment will be made.

If you are under the care of a consultant and need to be seen for a specialist appointment e.g. with the diabetic team or fetal medicine, please contact our Antenatal Clinic Midwives directly for advice on: 0151 604 7024

If you have any concerns about your pregnancy such as pain or reduced movements please contact the Triage unit as usual on 0151 604 7111. The midwife will give you advice and agree when and where you should be seen.

Call the Maternity Triage unit immediately on 0151 604 7111 if:

  • your baby is moving less than usual
  • you cannot feel your baby moving
  • there is a change to your baby's usual pattern of movements
  • you have any bleeding from your vagina
  • you're feeling very anxious or worried
  • you have a headache that does not go away
  • you get shortness of breath when resting or lying down

Do not wait until the next day – call immediately, even if it's the middle of the night.

 

What can I do to reduce my risk of catching Coronavirus?

The most important thing to do is to wash your hands regularly and effectively as soon as you come from public places to your home or workplace. There is useful advice on the NHS website on the best way to reduce any infection risk, not just for Coronavirus, but for other things like colds and flu.

What should I do if I think I may have Coronavirus or been exposed to it?

If you are pregnant and:

  • you think you might have coronavirus
  • you've been in close contact with someone with coronavirus

you should phone NHS 111 or use the NHS 111 online tool for further advice, and say you are pregnant.

You should also contact the maternity unit looking after your pregnancy to inform them of the advice you have been given by the NHS 111 service.

Please let staff know that you are self-isolating before you come to hospital or are seen by our team in the community. This is so that we can give you the best care to keep you, your baby and our teams safe.

Pregnant women who are exposed to COVID-19 are not thought to be at increased risk of miscarriage. If you are less than 14 weeks pregnant and have any pain or bleeding please contact EPAU for advice.

Pregnant women are not thought to be at increased risk of contracting COVID-19 virus or to be more likely to experience complications if they do have it. Please follow the current advice for self-isolating. https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-advice/ .

If you are due to see your midwife for a routine antenatal appointment please contact her in advance and let her know that you are self-isolating.  Your midwife will talk to you and decide whether you need to be seen or if your appointment can be delayed.  Your midwife will agree when and where you will have your next antenatal appointment.

If you are due to see your consultant obstetrician for a routine antenatal appointment you will be contacted by the consultant’s team. You may be able to have a telephone appointment with the consultant’s team if you don’t need to be examined. If you need a face to face appointment with the consultant before your self-isolation ends, special arrangements for you to attend your appointment will be made.

If you are under the care of a consultant and need to be seen for a specialist appointment e.g. with the diabetic team or fetal medicine, please contact our Antenatal Clinic Midwives directly for advice on: 0151 604 7024

If you have any concerns about your pregnancy such as pain or reduced movements please contact the Triage unit as usual on 0151 604 7111. The midwife will give you advice and agree when and where you should be seen.


 

Giving birth

Any woman who has someone in her household who is unwell or has been self-isolating due to COVID-19 contact will be asked to come into hospital to give birth in our designated maternity isolation area.

We have been advised that we should care for women who are unwell or at risk of developing COVID-19 in hospital, and offer them additional care in labour:

  • The current recommendation is that we ask you to have continuous fetal monitoring in labour so we can monitor your baby closely.
  • We may ask to take blood tests whilst you are in labour.
  • We will delay clamping the baby’s umbilical cord for a short time when he or she is born unless there are specific reasons why this is not advisable.
  • We will have a member of our neonatal team present (on standby – won’t be in the room) at the birth in case your baby may need some additional help with his or her breathing when he or she is born.
  • We will assess your baby at birth and he or she will remain with you unless you or the baby are unwell and need extra care in our high dependency or neonatal unit.
  • We will make a specific plan with you for the care of yourself and your baby after birth. This will depend on your condition at the time, the type of birth you have and whether you and your baby need any further treatment.

We will also do these things if you are having a planned caesarean section.

There is no evidence that women who may have COVID-19 need to change the way they are intending to give birth. If you are seriously ill the team caring for you will make a plan for your birth with you and your birth partner.

We are strongly advising women to breastfeed their baby as this may offer the baby additional protection and other health benefits.

You will be given advice as required about ways to limit the chance of baby catching the virus after birth.

How will I be tested for coronavirus?

The process for diagnosing coronavirus infection is changing rapidly. At the current time, if you need a test for coronavirus, you will be advised individually.

Why would I be asked to self-isolate?

You may be advised to self-isolate because:

  • You have come into contact with someone who has coronavirus
  • You have symptoms suggestive of coronavirus and are waiting to be tested, or for your results
  • You have tested positive for coronavirus and you’ve been advised to recover at home

What should I do if I’m asked to self-isolate?

Pregnant women who have been advised to self-isolate should stay indoors and avoid contact with others as the government guidance.

The NHS guidance on self-isolation currently recommends people should:

  • Not go to school, work, NHS settings or public areas
  • Not use public transport
  • Stay at home and not allow visitors
  • Ventilate the rooms where they are by opening a window
  • Separate themselves from other members of their household as far as possible, using their own towels, crockery and utensils and eating at different times
  • Use friends, family or delivery services to run errands, but advise them to leave items outside.

You may wish to consider online fitness routines to keep active, such as pregnancy yoga or pilates (please see our Facebook page).

Can I still attend my antenatal appointments if I am in self-isolation?

You should contact your midwife or antenatal clinic to inform them that you are currently in self-isolation for possible/confirmed coronavirus and request advice on attending routine antenatal appointments.

It is likely that routine antenatal appointments will be delayed until isolation ends. If your midwife or doctor advises that your appointment cannot wait, the necessary arrangements will be made for you to be seen. For example, you may be asked to attend at a different time, or in a different clinic, to protect other patients.

How will my care be managed after I have recovered from coronavirus?

We recommend that you contact the Maternity Triage Unit on 0151 604 7111 for advice.

As a precautionary approach, an ultrasound scan will be arranged 14 days after your recovery, to check that your baby is well. This 14 day period may be reduced as more information on how infected people are in recovery becomes available.

A risk assessment will be undertaken if you require any medication to thin your blood.

If you have recovered from coronavirus and tested negative for the virus before you go into labour, where and how you give birth will not be affected by your previous illness.

What do I do if I feel unwell or I’m worried about my baby during self-isolation?

Pregnant women are advised not to attend maternity triage units or A&E unless in need of urgent pregnancy or medical care.

If you have concerns about the wellbeing of yourself or your unborn baby during your self-isolation period, contact your midwife, or out-of-hours, your maternity team/triage. They will provide further advice, including whether you need to attend hospital.

If attendance at the maternity unit or hospital is advised, pregnant women are requested to travel by private transport, or arrange hospital transport, and alert the maternity triage reception once on the premises, prior to entering the hospital.

Will being in self-isolation for suspected or confirmed coronavirus affect where I give birth?

As a precautionary approach, pregnant women with suspected or confirmed coronavirus when they go into labour are being advised to attend an obstetric unit for birth, where the baby can be monitored using continuous electronic fetal monitoring, and your oxygen levels can be monitored.

Continuous fetal monitoring is to check how your baby is coping with labour. As continuous fetal monitoring can only take place in an obstetric unit, where doctors and midwives are present, it is not currently recommended that you give birth at home or in a midwife led unit, where only midwives would be present.

This information will be updated as new evidence emerges.

What happens if I go into labour during my self-isolation period?

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.

Your maternity team have been advised on ways to ensure you and your baby receive safe, quality care, respecting your birth plan as closely as possible.

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 111/999 for advice as appropriate.
  • You will be met at the maternity unit entrance and provided with a surgical face mask, which will need to stay on until you are isolated in a suitable room.

Could I pass coronavirus to my baby?

As this is a new virus, there is limited evidence about managing women with coronavirus infection in women who have just given birth; however, there are no reports of women diagnosed with coronavirus during the third trimester of pregnancy having passed the virus to their babies while in the womb.

Will I be able to stay with my baby/give skin-to-skin if I have suspected or confirmed coronavirus?

Yes, if that is your choice. Provided your baby is well and doesn’t require care in the neonatal unit, you will be kept together after you have given birth.

There are some reports from China which suggest women with confirmed coronavirus have been advised to separate from their baby for 14 days. However, this may have potential negative effects on feeding and bonding.

A discussion about the risks and benefits should take place between you and your family and the doctors caring for your baby (neonatologists) to individualise care for your baby.

This guidance may change as knowledge evolves.

Will I be able to breastfeed my baby?

Yes. At the moment there is no evidence that the virus can be carried in breastmilk, so it’s felt that the well-recognised benefits of breastfeeding outweigh any potential risks of transmission of coronavirus through breastmilk.

The main risk of breastfeeding is close contact between you and your baby, as you may share infective airborne droplets, leading to infection of the baby after birth.

A discussion about the risks and benefits of breastfeeding should take place between you and your family and your maternity team.

This guidance may change as knowledge evolves.

If you choose to breastfeed your baby, the following precautions are recommended:

  • Wash your hands before touching your baby, breast pump or bottles
  • Wear a face-mask for feeding at the breast ( this probably applies to bottle feeding too as held close)
  • Follow recommendations for pump cleaning after each use
  • Consider asking someone who is well to feed expressed breast milk to your baby.

If you choose to feed your baby with formula or expressed milk, it is recommend that you follow strict adherence to NHS sterilisation guidelines. If you are expressing breast milk in hospital, a dedicated breast pump should be used.

Can I have a support person with me during labour?

Having a birth partner is important for your safety and wellbeing during labour and birth.

You'll be able to have a support person with you during labour and the birth if they do not have symptoms of COVID-19 and they can stay with you on the delivery suite and postnatal ward.

If your birth partner has symptoms or has been asked to self-isolate, they may not be able to come with you. You might want to have a backup support person just in case.

Women's health

Please visit wuth.nhs.uk to see the latest updates. This website is still under construction.

Children's Services

Please visit wuth.nhs.uk to see the latest updates. This website is still under construction.