Coronavirus (COVID-19) updates: Maternity Services

There have been some changes to our maternity services as we respond appropriately to national guidance on Covid-19. However, we would like to reassure you that we will continue to provide outstanding maternity care and prioritise your safety.

We are taking extra care in how we are looking after all women who use our services to make sure that they stay safe. We have created separate areas and are following government guidance to care for those who have or are suspected to have coronavirus. This ensures that those women who are unaffected are also kept safe and well. 

 

Update: 29 December 2020

Visiting maternity during the Coronavirus (COVID-19) pandemic

Following the announcement on Saturday (19th December) detailing the restriction of Tier 4 the maternity service has reviewed their guidance for partners attending the maternity service.

To help reduce the spread of infection, this has meant taking difficult decisions around our visiting policy.

We will continuously review our safety measures so that we can reintroduce welcoming a support person  during antenatal and postnatal stay at the right time in line with the recommendation from “Supporting pregnant women using maternity services during the coronavirus pandemic” (NHS, 14 December 2020),  recognising the importance of keeping our communities and staff safe at the same time.

We request that a named visitor (the same person through the woman’s stay) wears a face mask, a plastic apron and disposable gloves throughout the time on the ward. They are requested not to leave the ward until they are going home (toilet facilities are available for visitors on the ward). Please ensure that following removal of the apron and gloves hands are washed.

Induction of Labour

We recognise that induction of labour can take several days from the start of the process to the birth of the baby. It is our aim to welcome women’s birthing partner to be present as soon as women require support from their partner.

During Labour

Birthing partners are welcome to stay with women from admission and throughout labour, birth and until mum and baby are transferred to the maternity ward.

Antenatal and Postnatal Ward

Only one partner or accompanying adult can visit between 2pm and 7 pm daily. This ideally should be the same visitor throughout the duration of the stay

 Ultrasound Scans

We fully understand the importance of women having the support of a partner or companion during their scans. We are continuously reviewing our approach and listening to the views of women.

One companion or partner is welcome to attend the 12 week and the 20 week ultrasound scan.

All other outpatient appointments

 All outpatient appointments including antenatal and postnatal appointments and attendance to the Maternity Day Assessment Unit and Triage, there are no changes to the current guidance. Women should continue to attend unaccompanied.

Neonatal Unit

Parents have unrestricted access to their babies on the neonatal units.

 

Please keep us informed

It is important for your care and safety that you let us know if you have confirmed or suspected Covid-19, or if anyone you live with is self-isolating because they have symptoms. Please email the following information to: LG.e-midwife@nhs.net or telephone 020 8836 4491:

  • Name
  • MRN No / NHS No
  • How many weeks pregnant are you?
  • Date of next appointment:
  • When is your baby due?

A midwife will contact you the next working day to discuss your care and any maternity appointments or scans that you may miss if you need to stay at home. These will be rescheduled only if it is necessary to protect you, or for the safety of others.


 

What to do if you think your labour has started

If you think your labour has started, or you need to attend the hospital due to an emergency or concern about the baby, please call us and a member of staff will advise you where and when to come in:

University Hospital Lewisham: Tel 020 8333 3026  
Queen Elizabeth Hospital: Tel 020 8836 6180

 


Appointments and scans

  • If you, or anyone in your household have any symptoms suggestive of Covid-19 (fever or a persistent cough, a loss or change to your sense of smell or taste), please do not come into the hospital.
  • Please do not bring any children with you to the hospital. They will not be allowed to accompany you to your appointment and you’ll be asked to reschedule. Children are often carriers of Covid-19 and can easily spread it whilst not displaying any symptoms themselves.
  • A companion/partner is permitted to attend your nuchal (12 week) and anomaly (20 week) obstetric scans only, providing all guidelines around social distancing and masks are met. Companions/partners will have to wait outside the hospital (not in the corridor) until you are called, as waiting room space is limited. They will also be required to fill in a companion health declaration form, which can be collected from community midwives or on arrival at the hospital.
  • Some appointments will now be done by telephone rather than face to face. We will let you know if this applies to your appointment.
  • All parent education classes and tours of labour ward have been cancelled for the foreseeable future. We have been offering some information sessions virtually on our social media feeds through Edie the e-midwife (see below for more information). We have also filmed virtual tours of our maternity services at University Hospital Lewisham. Virtual tours of Queen Elizabeth Hospital will be available soon. 

 


Homebirth Service

Our homebirth service is up and running as usual. The maternity service is committed to offering a choice to you about where you birth your baby and offering the option to women of a homebirth is important to us. 

 

Greenwich Birth Centre

The Greenwich Birth Centre remains open in its usual capacity. 
 

Revised schedule of antenatal care

During the current pandemic we would like to reassure you that you will still receive antenatal care from a midwife. The way we deliver that care, however, will change.

Where it is practical to do so your appointments will be conducted by phone and where clinical care is needed we will arrange to see you face-to-face.

Please see the revised schedule of care below:

 

10 weeks gestation

Telephone consultation

Full medical, social and obstetric history taken

12 weeks gestation

Hospital appointment

Dating/first trimester screening scan

Booking blood tests, height, weight, blood pressure checks and Midstream Specimen of Urine (MSU) sample

 

16 weeks gestation

Telephone consultation

Confirmation of booking blood test results, welfare conversation, confirmation of ‘Local Hub’ location and contact details for future face to face appointments and ongoing care, telephone helpline number and how to obtain urgent care if you are feeling unwell.

 

20 weeks gestation

Hospital appointment

Anomaly scan (sonographer)

Face to face midwifery appointment

Review ultrasound scan

Urinalysis and blood pressure check

 

28 weeks gestation

Local Community Hub

Urinalysis, blood pressure check, abdominal palpation, symphysial fundal height, full blood count, confirmation of next appointment date (midwife and maternity support worker)

Rh Negative women for 28 week appointment at the hospital (A/N check and bloods)

 

32 weeks gestation

Local Community Hub

Urinalysis, BP, abdominal palpation, symphysial fundal height, confirmation of next appointment date (midwife and maternity support worker)

 

36 weeks gestation

Local Community Hub

Urinalysis, BP, abdominal palpation, symphysial fundal height, confirmation of next appointment date (midwife and maternity support worker)

 

38 weeks gestation

Local Community Hub

Urinalysis, blood pressure check, abdominal palpation, symphysial fundal height, confirmation of next appointment date (midwife and maternity support worker)

 

40 weeks gestation

Local Community Hub

Urinalysis, blood pressure check, abdominal palpation, symphysial fundal height, membrane sweep, confirmation of next appointment date (midwife and maternity support worker)

 

41 weeks gestation

Local Community Hub

Urinalysis, blood pressure check, abdominal palpation, symphysial fundal height, membrane sweep, offer induction of labour (midwife)

 

 

Coronavirus and pregnancy

In general, it is expected that the large majority of pregnant women with Covid-19 will experience only mild or moderate cold/flu like symptoms. There is no evidence that pregnant women who get this infection are more at risk of serious complications than any other healthy individuals. The Royal College of Obstetricians and Gynaecologists have published information for pregnant women and their families surrounding Covid-19.

If you think you may have symptoms of Covid-19 you should use the NHS 111 online service for information.

If you develop more severe symptoms or you do not start to feel better within one to two weeks, this may be a sign that you are developing a more significant chest infection that requires enhanced care and you should contact your maternity care team:

  • University Hospital Lewisham: Tel 020 8333 3026
  • Queen Elizabeth Hospital: Tel 020 8836 6180

As a precaution, you should follow government advice about social isolation; stay away from public places and avoid anyone who has symptoms suggestive of Covid-19. Please refer to the current guidance on social isolation both for yourself and your household. 

If you are self-isolating, you can get support with collecting shopping, medication or other essential supplies from a  Volunteer Responder.

 

 

Advice for pregnant BAME women during the coronavirus pandemic

Evidence suggests you may be more likely to become seriously unwell if you develop coronavirus compared with women from other ethnic groups.Your midwife or doctor will help you to understand the risk and support you and your baby. You should continue to follow government guidance on social distancing, particularly in your third trimester.

If you develop coronavirus symptoms and have a slow recovery, or your symptoms worsen, please do seek medical help.  You can contact NHS 111, your maternity team, or 999 in an emergency.

Find out more at www.rcog.org.uk/covid19

 

 

Domestic violence and coronavirus

Click here for information on organisations providing domestic abuse support locally during the Covid-19 pandemic.

 

 

Postnatal care

During the current pandemic we would like to reassure you that you will still receive postnatal care from a midwife after you are discharged from hospital. The way we deliver that care, however, will change.

For the protection of yourself, your family and our staff we will be in touch with you by telephone the day after you leave hospital to plan your care. It is important that we have a correct contact telephone number for you. Please check the number on your discharge papers you are given is correct before you leave and inform the midwife if this needs to be changed.

Where it is practical to do so your appointments will be conducted by phone and where clinical care is needed we will arrange to see you face to face. Our midwives will not see you unless they have spoken to you by phone so please ensure your phone is switched on and that you look out for a call that could come from a mobile number, office phone or may appear as an unknown number.

 

 

Maternity discharge 

Please see the video below which aims to answer some of the questions you have may as a new parent. 


 

See, hear, respond, Barnado's

Best Beginnings and Barnado’s have teamed up to provide expectant and new parents with advice and support during the Covid-19 pandemic, all free of charge, without needing to leave home. They provide:

Online advice and Support

Daily information, access to hundreds of films and to other support including the confidential 24/7 crisis messenger text line. This is delivered via the RCM endorsed and NHS approved Baby Buddy app.

Group Work 

A series of three antenatal or postnatal sessions with other parents or parents-to-be covering a range of topics; including managing anxiety and stress to understanding your baby.  The sessions are run by two experienced facilitators one of which will be a midwife or an antenatal educator.

Therapeutic support

For parents that would benefit from one-to-one support, three hours of free customised support delivered by phone, or online by experienced practitioners.

If you are struggling with anxiety or difficult circumstances and need some extra help, sign up for three hours of free one-on-one support customized to suit your needs. Please follow this link for more information and to sign up: bestbeginnings.org.uk/see-hear-respond

 

 

Infant crying and how to cope

ICON provides support to help you cope with infant crying. During this challenging time stress levels at home may be increased. Please follow the ICON guidance for coping with crying. ICON stands for:

I – Infant crying is normal

C – Comforting methods can help

O – It’s OK to walk away

N – Never, ever shake a baby

See the following leaflet for information:

ICON LEAFLET

 

Breastfeeding community groups

We have had to suspend our community breastfeeding antenatal classes until further notice. We are committed to ensuring that you still get the information that will help you make informed decisions and get the support you need to feed your babies.

We have put together a written antenatal infant feeding class with links to lots of videos and information about feeding. This is what would have been discussed if you had come to a class:

Antenatal infant feeding class

We are also aware that some mums will find it helpful to speak to someone to get feeding support. There are a range of support options below:

  • You can get in contact with your community midwife and your health visitor
  • The Infant Feeding team work with women who are experiencing more complex feeding issues up to 28 days post birth. This service is available Monday to Friday from 9am to 5pm. If you feel you need support or advice, you can email our Infant Feeding Midwife  kerstinlelubre@nhs.net, who will aim to get back to you within 48 hours. Please state your name, phone number, address, the age of your baby and outline the reason you feel you need some support

Other telephone support (these calls will be taken by qualified volunteers in their own homes):

In addition, useful links to online support can be found at the bottom of our breastfeeding page.