Changes to Maternity Services during COVID-19 pandemic

Royal United Hospital, Bath:
https://www.ruh.nhs.uk/patients/services/maternity/antenatal_education/index.asp  

Great Western Hospital, Swindon:
https://www.gwh.nhs.uk/wards-and-services/a-to-z/maternity-services/information-for-parents-and-parents-to-be/

Salisbury Foundation Trust: 
https://www.salisbury.nhs.uk/InformationForPatients/Departments/Maternity/Pages/Home.aspx

Another source of information about maternity provision is the local Maternity Voices Partnership:  https://www.bswmaternityvoices.org.uk/

Bath & North East Somerset, Swindon and Wiltshire (BSW) Maternity Voices Partnership Plus is a group of volunteer parents and birth workers, midwives, doctors and commissioners. We work together to review and contribute to the development of local maternity services.

Local Area volunteers are parents who have recently used the local maternity services, or people involved in providing services for pregnant and new parents, such as antenatal teachers or breastfeeding supporters. They are a crucial part of the team – the MVP couldn’t function without these volunteers.

Your baby’s movements in pregnancy are a sign that they are well. If you baby moves less or if you notice a change this can sometimes be an important warning sign that your baby is unwell.

Please do not hesitate to contact your local maternity services if you have any concerns about your baby’s movements. Please follow the advice and guidance that you have been provided by your midwife relating to observing your baby’s movements and please do not delay contacting your midwife or maternity service due to worries about hospitals being too busy to see you or concerns about catching COVID-19.

Maternity services are focused on keeping you safe and are available to provide care if you have concerns about your baby’s movements. Please do not put off calling until the next day. It is important to know for the midwives and your doctors to know if your baby’s movements have slowed down or stopped. Information is available on the hospital websites.

If you have been asked to attend scans to check your baby’s growth it is very important that you attend these scans so that we can check that your baby’s growth and wellbeing.

Some Registration offices may not be registering baby’s births at this time. Your GP practice should still be able to register your baby as a patient without the birth registration.

There is no evidence showing that coronavirus can be carried in breastmilk. 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 if you cough or sneeze, this could contain droplets which are infected with the virus, 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.

When you or anyone else feeds your baby, the following precautions are recommended:

• Wash your hands before touching your baby, breast pump or bottles
• Try to avoid coughing or sneezing on your baby while feeding at the breast
• Consider wearing a face mask while breastfeeding, if available
• Follow recommendations for pump cleaning after each use
• Consider asking someone who is well to feed your expressed breast milk to your baby.

UNICEF infant feeding recommendations during COVID19: https://www.unicef.org.uk/babyfriendly/infant-feeding-during-the-covid-19-outbreak/

If you are feeding your baby with baby formula milk it is important that formula milk is prepared as directed on the manufacturer’s instructions and is not watered down as this will result in your baby not receiving the adequate nutrients required for health.

It is also important that the correct stage baby milk is used for your baby e.g. First Infant formula (Stage 1 milk). Follow on formula milk should never be used for babies under 6 months and they can continue to have First Milk up the age of one year as part of their diet. 

It is understandable to feel more anxious and stressed than usual in times like these.  It’s important to look after yourself if you are staying at home more than usual, and in particular to look after your mental health

Taking active steps to stay healthy and well will help you manage anxiety and help you feel more in control. Try to:

• Stay active as best you can
• Avoid caffeine
• Don’t smoke or drink alcohol
• Eat well
• Drink plenty of water
• Establish regular sleep habits

Useful guide to support mental health when staying at home: https://mentalhealth.org.uk/coronavirus/staying-at-home

Tommy’s wellbeing resources for pregnancy and post birth:

• https://www.tommys.org/our-organisation/about-us/charity-news/new-wellbeing-resource-pregnancy-and-post-birth
• https://www.tommys.org/your-babys-mum

Mind resources to support mental health during pregnancy and post birth:

• https://www.mind.org.uk/information-support/types-of-mental-health-problems/postnatal-depression-and-perinatal-mental-health/self-care/#collapse6e2be
• https://www.mind.org.uk/mumsmatter

Maternal Mental Health Alliance:

https://maternalmentalhealthalliance.org/news/mmha-members-offer-reassurance-amid-coronavirus-outbreak/

Consider taking a daily supplement containing 10 micrograms of vitamin D to keep your bones and muscles healthy. We are all spending more time indoors and at home and this can impact the amount of sunlight we get from sunlight.

Please note this advice is not about preventing coronavirus (COVID-19) or mitigating its effects. 

You can buy vitamin D supplements at most pharmacies and supermarkets. 

You can get vitamin supplements containing vitamin D free of charge if you're pregnant or breastfeeding and qualify for the Healthy Start Scheme

Further information is available here:

• COVID19 NHS vitamin D advice: https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/

• NHS vitamin and mineral supplements in pregnancy: https://www.nhs.uk/conditions/pregnancy-and-baby/vitamins-minerals-supplements-pregnant/

For pregnant women or those with children under 4 who are on benefits or if pregnant and under 18.  Go to Healthy Start website to see if someone qualifies and for more information.  Due to COVID-19 a signature from health professional is now not required on the application in section B. In Wiltshire - Children's Centres can support with this process.

With COVID-19, more people are going to be claiming Universal Credit and you not be aware that this, in turn, means you can claim Healthy Start Vouchers.  There's more information on: https://www.unicef.org.uk/babyfriendly/infant-feeding-during-the-covid-19-outbreak/outbreak/ 

Exercise is important in pregnancy. Keep your distance from others, wash hands and follow guidance for social distancing if you are excercising outdoors. There are lots of free classes on social media platforms to follow that are pregnancy-related.  If you are concerned about safety check with your midwife first.

Further useful information can be read here:

• NHS exercise in pregnancy: https://www.nhs.uk/conditions/pregnancy-and-baby/pregnancy-exercise/
• NHS Prenatal and postnatal yoga video: https://www.nhs.uk/conditions/nhs-fitness-studio/prenatal-and-postnatal-exercise/

In addition to seeking advice from your midwife, do use reliable sources of advice and information in relation to pregnancy. The following links give reliable information and advice in relation to staying healthy and well during pregnancy and early parenthood:

• RCOG information for pregnant women and their families during COVID19
• Tommy’s Pregnancy Hub
• NHS – Your pregnancy and baby guide
• Baby buddy App – provides trusted, evidence-based information and self-care tools to help parents build their knowledge and confidence during the transition to parenthood and throughout early stages of parenting
• Start4life - pregnancy

During this challenging time stress levels at home may be increased and it is important to find ways to cope with a crying baby. Infant crying is normal, and it will stop!  Babies start to cry more frequently from around 2 weeks of age. After about 8 weeks of ages babies start to cry less each week. It's okay to walk away if you have checked if baby is safe and the crying is getting to you.

Never, ever shake or hurt your baby - it can cause lasting brain damage or death

Follow the ICON guidance for coping with crying:

I – Infant crying is normal

C – Comforting methods can help

O – It’s OK to walk away

N – Never, ever shake your baby

Useful links for further information:

• ICON Lockdown Self Care ICON Video 2020
• ICON video message
• ICON leaflet

DadPad is a guide for new dads, developed with the NHS.  This resource supports Dads and their partners to give your baby the best possible start in life.  The DadPad supports dads to get involved and gain confidence which can help reduce anxiety.

You can find out more here and download the DadPad app: https://thedadpad.co.uk/

Staying at home can cause anxiety for those who are experiencing or feel at risk of domestic abuse. Pregnancy is a time when domestic abuse can start or worsen.  For anyone who feels they are at risk of abuse, it is important to remember that there is help and support available to you.

Guidance: Coronavirus (COVID19): support for victims of domestic abuse

Refuge – Freephone 24-hour National Domestic Abuse Helpline: 0808 2000 247

https://www.refuge.org.uk/get-help-now/phone-the-helpline/

Women’s Aid: https://www.womensaid.org.uk/covid-19-coronavirus-safety-advice-for-survivors/

Respect helpline offers help for domestic abuse perpetrators who want to change and provides confidential advice and support: 0808 802 4040, https://respectphoneline.org.uk/