Coronavirus/Covid-19 key information for patients and visitors

Click/tap here for key public-relevant Coronavirus/Covid-19 information for patients, visitors and members of the public.

Covid-19 Maternity-specific information

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Message from the Head of Midwifery

As you can appreciate, we are continuing to live in challenging times, and I wanted to continue to reassure you of the following information specific to maternity services at the Trust.

  • We remain committed to providing the highest standard of maternity care to you and your family despite the challenges being presented by the current ongoing situation. We have had to make some changes to the way we are working, but this is with your safety at the heart of these decisions and the safety of all our staff working in maternity services.
  • We have continued to make plans to manage COVID-19 and we are receiving regular information, updates and recommendations from our professional bodies; Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM) as well as other national groups.
  • Midwives in the department are continuing to only work within maternity services and are not being asked to support other wards or departments within the organisation. This means that we can continue to support you throughout your pregnancy and birth experience.
  • We continue to have senior medical cover/support 24 hours a day.

Unfortunately, we have had to make the decision to tighten visiting arrangements in Maternity Services. This is a decision we have taken reluctantly as we know how much it means for partners and family members to be present at all stages of pregnancy and birth and the importance of visitors during this time. The health, safety and wellbeing of our patients, communities, individuals and teams remain our absolute priority. We continue to review the visiting arrangements and to follow the guidance we receive.
Thank you for your continued cooperation and patience during these difficult times. If you have any questions or require any further information, please speak to your named midwife/midwifery team.

Alison Pedlingham
Head of Midwifery

Useful links

Here are some links and patient information leaflets about Covid-19 that you may find of help:

The Government website for national advice.
The NHS website for health advice relating to the virus.

The Royal College of Obstetricians & Gynaecologists have also issued specific information for pregnant women about risks and management of coronavirus (COVID-19). Please see the link for the latest guidance.

Please click here for parent information for newborn babies during coronavirus.

Please click here for information on planning your birth during coronavirus.

Please click here for information on looking after yourself during coronavirus.

Antenatal care and Covid-19, including information on scans, appointments and parent education

I have just found out that I am pregnant, what do I do?
Congratulations! Complete the online self-referral form as normal. Typically, you will then be contacted by telephone within 2 weeks to arrange to complete your booking appointment. When you attend for your first antenatal scan at 12 weeks you will be provided with your completed handheld pregnancy notes. Your midwife will talk you through your schedule of appointments, and things to look out for during your pregnancy that may require investigation. However, it is essential that you contact us with any physical or emotional concerns relating to your pregnancy (including concerns about your baby’s’ movements, suspected labour, abdominal pain, bleeding or loss of fluid from the vagina). Please telephone our Maternity Assessment Centre on 01432 557531 (Mon-Fri 8am-8pm), or Delivery Suite 01432 553184 (out-of-hours).

Until you receive your completed handheld notes from your midwife, an example can be viewed here. Your handheld notes contain lots of useful information and advice on important symptoms to be aware of in early pregnancy.

What advice is there on Covid-19 vaccination and pregnancy?

Click here to download guidance from the relevant national bodies.

   

Are there any special precautions I should take now I know I am pregnant?
Try not to worry but follow the normal advice about social distancing. Check out the NHS website for more information.

I have underlying health conditions and have been advised by my GP to self-isolate for 12 weeks – what about my appointments?
In these situations, please inform the Antenatal Clinic (01423 553010) so that an individualised plan can be made for providing your care and ensuring your safety.

Do I need to let you know if I am pregnant and have symptoms of Covid-19?
If you are due to have an appointment within the next seven days or are contacting the Maternity Assessment Unit (MAC) with pregnancy concerns or in labour, it is important that you notify us if you have suspected or confirmed COVID-19 infection, or if members of your household are symptomatic. This will enable us to triage your call appropriately and make the necessary preparations if we need to see you, your appointment may be delayed if considered safe to do so following discussion with a Consultant Obstetrician.

If you are symptomatic or have confirmed COVID-19 infection and have been advised that you need to come into hospital, additional precautions will be taken. You will be asked to remain in your vehicle in the hospital car-park and notify the ward of your arrival. A member of staff will come to greet you, where you will be provided with a mask and escorted to the ward.

What should I do if I have any pain or bleeding?
Some bleeding and/or pain in early pregnancy is not unusual and does not necessarily indicate a problem, but it should always be investigated. Our Early Pregnancy Assessment Unit (EPAU) opens Monday- Friday 8.30am-2.30pm and Sundays 9am-3pm and accepts referrals to see women between 6-13 weeks of pregnancy. You will need to contact your midwife or your GP if you have not had contact with a midwife yet to seek referral.

Your partner may attend the scan slot with you, we will supply them with a visor to be worn in addition to their mask, they may be asked to wait outside the unit while the nurse completes your history taking prior to your scan.

Any heavy bleeding or severe pain making you feel lightheaded or unwell needs urgent care in the Emergency Department.

What will happen about my antenatal appointments?
Attending for antenatal care when you are pregnant is important to ensure the wellbeing of you and your baby. We are undertaking a triage of patient appointments to try to reduce any unnecessary visits and may be undertaking pregnancy bookings and contacts by telephone where possible.

If you are well and free of any symptoms of COVID-19, you can attend antenatal appointments as normal.

It is important that you maintain social distancing and observe strict handwashing procedures during your appointment.

In cases where pregnant women or members of the household are symptomatic, it is essential you let us know in advance. Your appointment may be amended or delayed if considered safe to do so following discussion with a Consultant Obstetrician.

For more guidance about your routine antenatal appointments, please see the flow chart below:

Can my partner attend my antenatal appointment with me?
Partners are currently not able to attend any midwifery antenatal clinics or drop-in clinics in children’s centres or GP surgeries. This decision is out of our control and due to the required reconfiguration of GP surgeries and temporary closure of some children’s centres because of Covid-19.

From Monday 19 October 2020 partners are welcome to attend all consultant antenatal clinic appointments at the hospital:

  • To avoid too many people being present in the waiting area of the antenatal clinic at the hospital, we ask that you arrive on time, please do not arrive too early as you will not be allowed into the clinic area until the booked appointment time.
  • Partners will be allowed to attend any booked consultant antenatal appointment after scans if a consultant appointment is required. Partners will be asked to attend this antenatal appointment only, not the scan unless it is at 12 or 20 weeks (see further guidance below).
  • We ask that face coverings are worn by all attending the antenatal clinic, and that those attending are not experiencing symptoms of Covid-19 or in a self-isolating period.
  • Children are not allowed to attend appointments at the hospital with you.

Can my partner attend with me for my ultrasound scan?
As from Monday 12 April 2021 partners can attend all scans in the antenatal clinic with you.

We ask that face coverings are worn by all attending the scanning department, and that those attending are not experiencing symptoms of Covid-19 or in a self-isolating period, we may need to delay or amend appointment times to enable us to take additional precautions, so it is essential you let us know in advance. Your birth partner will be provided with a visor to wear in addition to their mask, this is a mandatory requirement. Please ensure that these are put on in anticipation of the appointment to reduce any delay in scan appointments. Children are not able to attend.

Should I take any extra precautions when visiting the hospital?
We ask that face coverings are worn by all attending and politely request all patients and birth partners to wash their hands upon entry/exit from the ward areas. Sinks are located just inside the door to Delivery Suite and Pannal for this purpose, alcohol gel dispensers in Antenatal Clinic. Please try to observe the social distancing guidelines of 2 metres where possible in all areas. Those attending should not be experiencing symptoms of Covid-19 or in a self-isolating period, even if these symptoms are mild or intermittent, due to the risk they pose to others:

  • High temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
  • New, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
  • Loss or change to your sense of smell or taste – this means you have noticed you cannot smell or taste anything, or things smell or taste different to normal.

I have a concern about mine or my baby’s’ wellbeing, what should I do?
Please continue to contact us with any physical or emotional concerns relating to your pregnancy (including any concerns about fetal movements, suspected labour, abdominal pain, bleeding or loss of fluid from the vagina). Please telephone our Maternity Assessment Centre on 01432 557531 (Mon-Fri 8am-8pm), or Delivery Suite 01432 553184 (out-of-hours) and we can give you individualised advice relating to your stage of pregnancy, your past medical history and your pregnancy history to date. The midwife will ask you if yourself or any members of the household have symptoms of Covid-19, so that we can make the most appropriate plan for your care should you need to attend the hospital. We do not advise the use of home Dopplers for listening to your baby’s heartbeat, any concerns of reduced movements need assessing thoroughly by a midwife.

What if I am considering a Vaginal Birth After Caesarean (VBAC)
Women who have had a previous Caesarean section and considering a vaginal birth in their current pregnancy would normally be invited to an appointment to discuss the relative benefits and risks of VBAC. This will now be undertaken by telephone consultation. Please see the link to view the VBAC presentation, which will be used to support the telephone call.

VBAC

I am a smoker, am I at increased risk of COVID-19?
The World Health Organisation (WHO) have commented that smokers are more likely to be vulnerable to Covid-19 as the act of smoking means that fingers (and possibly contaminated cigarettes) are in contact with lips which increases the possibility of transmission. Additionally, smokers may already have lung disease or reduced lung capacity which would greatly increase risk of serious illness. Conditions that increase oxygen needs or reduce the ability of the body to use it properly will put patients at higher risk of serious lung conditions such as pneumonia.

You will be offered carbon monoxide screening in your pregnancy and we would recommend you stop smoking both for your health and wellbeing, and that of your baby. We will provide ongoing support and referral to specialist smoking cessation services to help you to quit. #QuitforCovid

Am I able to attend any parent education classes?
At the present time, all face to face parent education classes have been cancelled.

The Birth and Beyond Parent Education classes that were previously offered face to face are now all available in video format: Parent Education video classes

Your community midwife will be able to answer any questions you may have after watching these.

There are also the PowerPoint presentations from the Birth and Beyond classes and Infant Feeding workshop you may wish to look at, please be aware that some of the presentations may also contains notes which need to be viewed separately, or by enabling the Presenter View in Microsoft PowerPoint.

Active Birth

Pain Relief

Meeting Your Baby

Breastfeeding Workshop

Safer sleep for babies – Sleep position, sleep environment and bedding

Safer sleep for babies – Overheating, temperature and over-wrapping

Safer sleep for babies – Breastfeeding

A useful online resource for breastfeeding has also been developed which can be accessed by clicking this link.

Covid-19 home testing – information for pregnant women and support partner

The government has recently advised voluntary home testing for Covid-19 for all pregnant women and support partners. We would like to share the following information with you:

During pregnancy it advised that pregnant women and their support person perform Covid-19 self-testing twice weekly throughout the pregnancy. This will help to ensure that any Covid infection is picked up early and managed.

Self-testing prior to any planned antenatal appointment and scan – pregnant women and their support person are being advised to self-administer a Covid – 19 test within 24 hours before an antenatal appointment or scan. This is being advised to provide safe and personalised maternity care and to enable support people’s attendance at antenatal appointments. A test is suggested to increase the safety of women, hospital patients, staff and the wider community.

Home lateral flow testing

There are now more options available to those not exhibiting any symptoms of Covid-19 to obtain testing kits that can be used at home. Many pharmacies have signed up to offer pharmacy collect. You can go to a participating pharmacy and collect a free box of tests to use at home. NHS England’s site finder allows you to search for pharmacies near you that offer pharmacy collect. If your test is negative, you will be asked on arrival for your result, ahead of your antenatal appointment or scan.

You can also order testing kits from Gov.UK – Order coronavirus (Covid-19) rapid lateral flow tests by using this link: https://www.gov.uk/order-coronavirus-rapid-lateral-flow-tests

If the support partner’s test is positive, please DO NOT attend the appointment and self-isolate in line with guidance from the government. If the pregnant woman’s test is positive, please contact the department you are due to attend for advice.

Tests are on a voluntary basis, but women and their support people should be encouraged to test to help keep the hospital environment safe for other women, their families and for staff.

We would like to reassure you that the hospital will continue to follow the trust’s COVID-19 infection control procedures: ensuring social distancing and wearing of PPE as directed by national guidance.

Further information is available by clicking here.

We will continue to test all pregnant women booked for induction of labour, elective caesarean section prior to the date of admission and all women on admission in labour.

 

Care during labour & birth on Delivery Suite, home birth and Covid-19

Will I be tested for Covid-19?
Yes, all inpatients will be asked to give consent to a Covid-19 swab being taken on admission (unless this has been taken prior to a planned admission, e.g., for induction of labour). The swab involves a swab similar to a cotton bud to swab the back of the throat and the top of both nostrils. Results take a few hours to come back and helps us as a unit to provide safe care to all. It may be that we ask your consent to repeat the test if you are with us for a few days. Birth partners are not tested but we ask they are symptom free, always wear a mask, an additional visor (supplied by us) if you are in a bay where social distancing is not possible, practice good hand hygiene as social distancing where possible. We do not test babies.

Do I have to wear a facemask when I am in labour?
No, please be reassured that you would not be expected to wear a facemask during your labour. If attending Maternity Assessment Centre (MAC) for assessments during pregnancy we ask that you wear a mask as supplied at the entrances to the hospital.

How is labour and birth affected if I have Covid-19?
If you or anyone in your household has symptoms of Covid-19 infection, you should contact the Maternity Assessment Centre or Delivery Suite as normal for further advice when you think labour might be starting. It is recommended that you come into hospital for your labour and birth if you have tested positive for Covid-19. This is so that your baby’s heartbeat can be monitored using continuous electronic fetal monitoring, and your oxygen levels can be monitored hourly. The continuous fetal monitoring is to check how your baby is coping with labour. Your midwife will discuss your birth preferences with you.

If you have had Covid-19 earlier in your pregnancy and 10-14 days have passed and you no longer experience symptoms, your care during labour and birth should be no different.

Can I still plan for a home birth?
Yes you can. As of 25 January 2021 the home birth service has been reinstated.

If you or anyone in your household has symptoms of COVID-19 infection, it is recommended that you come into hospital for your labour and birth. This is so that your baby’s heartbeat can be monitored using continuous electronic fetal monitoring, and your oxygen levels can be monitored hourly. The continuous fetal monitoring is to check how your baby is coping with labour.

We would like to emphasise that the criteria for a home birth remain the same; available to women with a low risk pregnancy, women who have a high risk pregnancy will still be advised to deliver within the hospital environment. If you are interested in a home birth or require further information, please discuss with your named community midwife.

If you or anyone in your household have symptoms of Covid-19 infection at the time of your labour starting it is important that you let us know. We will request that you come into hospital for your labour and birth. This is both to protect our Community Midwifery staff and to ensure the appropriate care and monitoring is available for you and your baby.

Can I have a water birth still?
It is a recommendation of the Royal College of Obstetricians and Gynaecologists that birthing pools should only be avoided for women with suspected or confirmed Covid-19 infection. Additionally, the use of an epidural may be recommended for women to reduce the risk of needing a general anaesthetic (which has an increased risk of transmission).

Can I still always have a birth partner with me?
You are welcome to always have one birth partner with you during your labour and birth, we would ask that they have no symptoms of Covid-19 and will be required to always wear a face mask. It is not possible to have more than one birth partner or to request partners that ‘swop over’ during your labour and birth.

If your birth partner is symptomatic or has had a positive Covid-19 test in the last 10 days, they should remain in self-isolation and not attend the unit. It is advised that you should make plans to identify potential alternative birth partners, should the need arise.

If I am induced can my birth partner be always with me?
You are welcome to always have one birth partner with you during your induction process, the same guidance applies as above.

For planned inductions, you will be asked to attend the hospital for a Covid-19 swab 48-72 hours prior to your planned date, we then ask you to isolate at home before your admission.

Induction of labour typically starts on Pannal ward in a 4-bedded bay. We ask birth partners to keep their mask and visor on (these are supplied). Please limit the number of times you exit and enter the ward, wash your hands on entrance to the ward and frequently when on the ward. Please follow social distancing recommendations on the ward where possible.

If you have had a low risk pregnancy and are being induced at 10 to 14 days after your due date because there are no signs of your labour starting, you may request an outpatient induction of labour. This is where you can return home (if you live within 30minutes of the hospital) for the first 24 hours of the process. This enables you to feel more relaxed, feel more comfortable in the privacy of your own home and likely get better rest. At 24 hours the induction process continues in hospital. Please speak to your midwife for more details.

How long can my birth partner stay with me following birth?
Typically, you will have around four hours as a family following your baby’s birth, at which point unless you wish to have an early discharge home you will be transferred to Pannal Ward and your birth partner will return home. There may be exceptional circumstances where you require your partner’s support in addition to the maternity staff for longer, then please bring these to the attention of your named midwife so that these can be discussed with the midwife in charge.

Partners are then allocated a visiting slot for the following day unless you plan on being discharged (see guidance for Postnatal and Pannal ward). 

I am having a planned (elective) caesarean section, how does Covid-19 affect my care?There is no change other than in addition to a pre assessment appointment you will also be asked to attend for a Covid-19 swab 48-72 hours prior to your admission. Your birth partner can attend with you on your admission to hospital then the same applies as to wearing a mask and visor. Typically, you will have at four hours as a family following your baby’s birth and then your birth partner will return home. There may be exceptional circumstances where you require your partners support in addition to the maternity staff for longer, then please bring these to the attention of your named midwife so that these can be discussed with the midwife in charge.

Partners are then allocated a visiting slot for the following day unless you plan on being discharged (see guidance for Postnatal and Pannal ward).

Postnatal care, Pannal Ward, Special Care Baby Unit (SCBU) and Covid-19

Can my birth partner visit Pannal ward?
If you have any of the following symptoms you should not visit, even if these symptoms are mild or intermittent, due to the risk they pose to others:

  • High temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
  • New, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
  • Loss or change to your sense of smell or taste – this means you’ve noticed you cannot smell or taste anything, or things smell or taste different to normal.

The two metre social distancing rule should be adhered to on Pannal wherever possible. You may witness that this is not possible for staff when caring for patients. Please note, only one person is permitted to visit and unfortunately no children will be permitted as visitors at present.

Please could we kindly ask that face masks and visors be worn for the entirety of your visit on Pannal Ward and that these are not removed. If you have any concerns regarding this please speak with the midwife in charge.

Antenatal patients – If you are admitted to Pannal ward in the antenatal period of your pregnancy, your birth partner may visit between the hours of 8am-8pm.

Postnatal patients – Following the birth of your baby the midwife in charge on Pannal ward will allocate visiting slots for birth partners to ensure that safety is maintained on the ward for you and your baby. If you are being discharged home your partner will be asked to attend to collect you and your baby from the entrance of the ward. A member of the team will assist you and your baby to the door.

What if my baby is on Special Care Baby Unit (SCBU)?
Both parents are welcome to be with your baby 24 hours a day. Unfortunately, we are not able to extend visiting to siblings or other family members currently.

Can I have a private room so my partner can stay with me on Pannal ward after the baby is born?
Paying for a private room is not available at present, these are allocated solely on clinical need.

Will I get any postnatal visits?
At the point of discharge, you will have contact details for your named community midwife and the team they work within, in addition how to contact a midwife for advice outside of ‘office hours’.

Typically, the midwife will contact or visit the day following discharge (or birth if you have birthed at home) and then discuss with you a plan of care to support you. There may be some telephone contacts instead of face to face visits, if appropriate. However, please be assured that additional visits will be undertaken if considered clinically necessary for you or your baby. It is essential that you inform us in advance if you or anyone in your household are symptomatic so that appropriate precautions can be taken.

For patients that are required to return to the ward areas for any follow up appointments, we request that partners and other children remain at home or within their vehicle, to minimise unnecessary risk of Covid-19 exposure to patients and staff.

Am I still able to register my baby’s birth?
Harrogate Register Office is still open for birth registration appointments during lockdown. Parents living in North Yorkshire can book online to register babies born in Harrogate District Hospital here. Please be reassured that staff working in the office are working in a Covid-secure way, taking every precaution to ensure the safety of their customers and staff.

I need to discuss my Birth Experience, what should I do?
The normal Pregnancy and Birth Revisited (PABR) debriefing service is running again face-to-face. Please click here for the self-referral document.

You may also wish to contact the department manager if you wish to discuss any immediate concerns:

  • Lucy Kitching (Antenatal Clinic Team Leader, Public Health Midwife and Named Midwife for Safeguarding) :01423 552298.
  • Mary McCaul (Continuity of Carer Team Leader): 01423 553607
  • Sarah Harris (Delivery Suite and Maternity Assessment Manager) 01423 557431
  • Charlie Kent (Pannal Ward Manager): 01423 553190

Am I still OK to breastfeed?
There is currently no clinical evidence to suggest that the virus can be transmitted through breastmilk. Infection can be spread to the baby in the same way as to anyone in close contact with you.

There is a wealth of evidence that breastfeeding reduces the risk of babies developing infectious diseases. There are numerous live constituents in human milk, including immunoglobulins, antiviral factors, cytokines and leucocytes that help to destroy harmful pathogens and boost your baby’s immune system.

If I stopped breastfeeding and want to start again can this be done?
Re-lactation is generally possible. Ask your midwife for support.

Can I still express milk if my baby is on the neonatal unit?
Yes. Breastmilk is essential for sick and preterm babies as it significantly reduces the risk of serious complications both in the short and long term.

Can parents touch and hold their newborn baby if they have Covid-19?
Yes, touch, comfort and communication are vital for your baby’s wellbeing and development. Good hygiene habits are important and will keep the risks to your baby as low as possible.