Changes to Maternity Services during COVID-19 pandemic

Updated 5/5/2020

We appreciate this is a worrying time for pregnant women and mums who have recently had their baby. We want to ensure we give you the latest information about how we have had to change our services to keep everyone safe. We also want to reassure you that you are not alone in your pregnancy and that we are still here to help and support you throughout your pregnancy to parenthood journey.

As you are aware Covid-19 presents a significant challenge to the NHS. The health, wellbeing and safety of everyone accessing and working in maternity services is our utmost priority. In a rapidly changing situation, the care we provide is guided by national evidence for safest practice as this becomes available.

In our maternity services and the wider hospital, we are minimising all face to face contact appointments including obstetric clinic appointments and cancelling all group appointments such as antenatal preparation. In addition, we are making amendments in our community services to limit non-urgent face to face contacts between women and our midwives. Your midwife will be in contact with you and will continue to provide support and virtual consultation with face to face visits provided when necessary and will provide information on antenatal education and all other aspects of maternity care.

As part of the social distancing strategy to protect staff and patients, the public are being asked to limit visitors. In line with national guidance we have taken the decision to restrict birth partners to one per woman at this time. We know how disappointing this will be for everyone and want to reassure you that the midwives and maternity team are focused on supporting you and your birth partner through your pregnancy, birth and following the birth of your baby.

If required, your partner can drive you to your appointment and wait in the car for you.

To enable us to ensure that you have the most up to date information for care within the area that you live we encourage all pregnant women, mums and partners to access your local hospitals website. Here you will find up to date information relating to important issues such as visiting policies, birth partners and contact numbers if you have any concerns. Contact numbers are also available on these websites. Please do not hesitate to contact maternity services if you have any concerns.

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

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

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

For parent education and videos

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

Maternity Voices Partnership

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.

Baby’s movements and growth scans

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.

Registration of Babies

Some Registration offices are not currently 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 and they have been sent information about this.

Breastfeeding

There is no evidence showing that the virus 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/

Formula feeding of babies

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. If you have any problems obtaining formula milk, try shopping around smaller shops if you can’t find it in your usual supermarket. The manufacturers are still distributing regular supplies to shops and increasing production.

Emotional health and wellbeing

It is understandable to feel more anxious and stressed than usual in times like these and it’s a big adjustment to stay inside all day. It’s important to look after yourself whilst you stay at home, 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:

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

Maternal Mental Health Alliance:

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

NHS vitamin and mineral supplements in pregnancy

Vitamin D: Consider taking a daily supplement containing 10 micrograms of vitamin D to keep your bones and muscles healthy. This is because with the current government advice of staying at home you may not be getting enough vitamin D from sunlight if you’re indoors most of the day.

Please note this advice is not about preventing coronavirus (COVID-19) or mitigating its effects. There have been some news reports about vitamin D reducing the risk of coronavirus. However, there is no evidence that this is the case.

You can buy vitamin D supplements at most pharmacies and supermarkets. Please don’t buy more than you need.

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/

Healthy Start Scheme

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/

Physical health and wellbeing

Exercise is important in pregnancy. It’s okay to go out for a walk once a day. Keep your distance from others, wash hands and follow guidance for social distancing. 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

Coping with a crying baby

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:

Support for Dads

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/

Domestic abuse in pregnancy

The current advice to stay 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/