Maternity Covid-19 FAQs

Pregnancy

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

If you are pregnant and you have a high temperature or a new, continuous cough or a loss or change to your sense of smell or taste, you should stay at home for 10 days and organise getting a Covid test.

Do not go to a GP surgery, pharmacy or hospital without contacting them on the telephone first.

You should contact your maternity unit via Medicom to inform them that you have symptoms suggestive of coronavirus and are awaiting a swab result, if you feel unwell or have any appointments in the next 10 days.

Please also be alert to the other possible causes of fever in pregnancy.

These include urine infections (cystitis) and waters breaking.

If you have any burning or discomfort when passing urine, or any unusual vaginal discharge contact your maternity care provider as early as possible, who will be able to provide further advice.

Call Medicom to speak to a midwife or for a non-urgent query 01603 481222 

What should I do if I have tested positive for coronavirus?

If you test positive for coronavirus outside of a hospital setting, you should contact your midwife or maternity team to make them aware of your diagnosis.

• If you have no symptoms or mild symptoms, you will be advised to recover at home.
• If you have more severe symptoms, you might be treated in hospital.
• If you are infected with coronavirus you are still most likely to have no symptoms or a mild illness from which you will make a full recovery.

If you are covid positive then you will be called daily by a member of our team to check your symptoms, baby’s movements and how you are feeling.

If you feel your symptoms are worsening or if you are not getting better, this may be a sign that you are developing a more severe infection that requires specialised care.

You should contact your Maternity Care team via Medicom, your GP, use NHS 111 Online  or call 111 for further information and advice.

In an emergency, call 999

This advice is important for all pregnant women, but particularly if you are at higher risk of becoming seriously unwell and being admitted to hospital.

This includes women who are

• In their third trimester
• From a Black, Asian or ethnic minority background
• Over the age of 35
• Overweight or obese
• Have a pre-existing medical problem, such as high blood pressure or diabetes.

If you have concerns about the wellbeing of yourself or your unborn baby during your illness you can still contact your Maternity Care team at any time.

You can contact your midwife for non-urgent queries or call the Maternity Assessment Unit (MAU) from 22+0 weeks of pregnancy if you have urgent concerns (01603 287328).

They will provide further advice, including whether you need to attend hospital.

Why would I be asked to self-isolate?

You may be advised to self-isolate because:

• You have symptoms of coronavirus, such as a high temperature or new, continuous cough, or loss or change in your sense of smell or taste
• You have tested positive for coronavirus and you’ve been advised to recover at home
• You have an elective caesarean birth or induction of labour planned and you have been asked to self-isolate  for 72 hours ( 3 days) prior to your admission to hospital
• You have a home birth planned and have been asked to self-isolate prior to your due date
• You have been informed by NHS Test and Trace to self-isolate

What should I do if I’m asked to self-isolate because I have symptoms or confirmed coronavirus?

Pregnant women who have been advised to self-isolate should stay indoors and avoid contact with others for 10 days. If you live with other people, they should all stay at home for at least 10 days, to avoid spreading the infection.

Follow the NHS guidance on when and how to self-isolate.

You may wish to consider online fitness routines to keep active, such as pregnancy yoga or Pilates.

Keeping mobile and hydrated, even if you are self-isolating, is important to reduce the risk of blood clots in pregnancy. Find out more about exercise in pregnancy.

All pregnant women are recommended to take 10 micrograms of vitamin D supplementation daily. This is especially important if you are self-isolating as you may not be getting enough vitamin D from sunlight.

Vitamin D supplements are available from most pharmacies and supermarkets, and for some families through the NHS Healthy Start scheme.

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

If you have an appointment scheduled you should call to inform the relevant team that you are currently in self-isolation for suspected/confirmed coronavirus and ask for advice.

If you have a community midwife appointment scheduled in the following 14 days you should call Medicom 01603 481222.

If you have an Ultrasound Scan or hospital antenatal clinic appointment scheduled you should call Antenatal Clinic 01603 286795.

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, in a different clinic or been seen virtually or by telephone to protect others.

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

If you have concerns about the wellbeing of yourself or your unborn baby during your self-isolation period, contact your midwife or, if out-of-hours, the Maternity Assessment Unit 01603 287328.

They will provide further advice, including whether you need to attend hospital.

If you are advised to go to the maternity unit or hospital, you will be asked to travel by private transport, or arranged hospital transport and to alert the maternity unit reception once on site before going into the hospital.

You will be required to wear a mask or face covering.

How will my antenatal care look during Covid-19?

We are offering a slightly amended schedule of care to women during Covid-19 including a mixture of telephone contacts and face to face appointments. See below:

If you need any appointments with Antenatal clinic or any of our specialist midwives you will be sent a letter inviting you to attend these in addition to the above schedule. The majority of the appointments offered from antenatal clinic are via video call or telephone. If they are face to face you will be informed of this in your letter.

Swab testing for Covid-19 when attending Maternity Services

All women admitted to maternity services are recommended to have a Covid-19 swab on every admission.

Your birthing partner will also be recommended to have a swab.

A Covid-19 swab is recommended to ensure maternity services can remain as safe as possible for all women babies and all staff. This is also to ensure you are given the most appropriate advice regarding place of birth and any potential self-isolation. 

What does a Covid-19 swab involve?

• A swab is taken from two areas – one from the back of the throat and one from inside the nose.
• Results should be available within 24 hours of admission.
• A repeat swab may be taken from yourself and your birthing partner if you are unable to self-isolate for 72 hours (3 days) prior to your induction of labour or caesarean birth, or are an inpatient every three days of your admission.

Induction of labour or elective Caesarean birth

• If you are being admitted to hospital for an elective Caesarean birth or induction of labour you and your birth partner will be recommended to have a Covid-19 swab prior to admission.
• The Covid swab team will call you to arrange this to be performed 3 to 5 days before your induction or Caesarean date.
• After your swab, usually undertaken at a local test centre, we ask that you and your family self-isolate from the date of your swab until admission. 

What happens if I am Covid-19 positive?

• If you are found to be Covid-19 positive within 10 days pre-birth or on admission in labour you will be advised to labour and birth or delivery suite – even if you were planning a home birth.
• You may have a single, asymptomatic, Covid-19 negative birthing partner during labour, birth and to visit during a postnatal stay.
• This individual should stay with you during your entire admission and self-isolate once they leave hospital premises as per government guidelines.

Will being Covid-19 positive affect the way in which I can give birth?

• We will make sure you get the best care and respect your birth choices as closely as possible.
• Being diagnosed with Covid-19 will mean that you will be unable to have a water birth as we know Covid-19 is transmitted in faecal matter.
• We recommend that you give birth on Delivery Suite, even if you had planned a homebirth, so that you and baby can be continually monitored.
• It will only be recommended to give birth via caesarean section if you are significantly unwell or there are concerns about your baby (unless it is already your birth plan).
• You should still be able to have skin-to-skin and breastfeed your baby if you wish to and are feeling well enough.
• If your symptoms are mild and you and your baby are otherwise fit for discharge then you will be able to return home after the birth and continue to isolate as per government advice.

What happens if my birthing partner tests positive for Covid-19?

• If your birthing partner tests positive for Covid-19 they will unfortunately not be permitted to attend with you in labour or for any time that you are an inpatient within the hospital.
• We do invite you to choose an alternative birthing partner from outside your bubble who is happy to attend with you if you are positive or negative for Covid.
• They will need to stay with you in your room throughout the duration of your stay until discharge, or if they need to leave before this time will not be permitted to return.
• They must also socially isolate in line with government advice if they have been in contact with you or your partner who have tested positive, once they return home.
• If either you or your partners are found to test Covid-positive during your hospital stay, when you are discharged home you are advised to continue to isolate in line with government advice.
• You will continue to receive postnatal visits from your community midwife as deemed clinically appropriate.

Will my baby be tested for coronavirus?

We are not routinely swabbing babies for Covid-19 at NNUH but if baby begins to show symptoms then they may be swabbed.

Labour and Birth

We have created separate zones in the hospital for known Covid-positive patients and those of negative or asymptomatic and unknown status.

We are also following government guidance to care for those who have or are suspected to have Covid-19.

This aims to keep women who are unaffected safe and well.

Maternity staff will take all appropriate precaution including strict hygiene measures, social distancing when possible and appropriate use of protective clothing like gloves, gown and a medical mask.

It is important that you contact us if you think you are going into labour. We will be able to talk to you and give you the most appropriate advice.

• Homebirth 01603 481222
• Midwifery Led Birthing Unit 01603 288260
• Hospital Birth 01603 287328 / 287329

When will I need to wear a face mask?

• We request that women and their birthing partners wear masks at all times while in at an antenatal appointment with a midwife in the community, attending antenatal clinic or scans or in the hospital.
• Women in labour or having a planned caesarean birth won’t be expected to wear a mask whilst in labour or giving birth.
• Women do not need to wear their masks when alone (and with baby) in your own bed space on the wards

Can my birthing partner be with me when I am induced?

Your partner can attend the initial assessment of induction but will then be asked to leave again until you are moved to Midwifery Led Birthing Unit (MLBU) or Delivery Suite in labour.

They may also attend during visiting hours which are 2-6pm. We ask that it stays the same person throughout your time in hospital.

Can my birthing partner attend with me when I am coming in for C-section?

Yes, if you are attending for a planned caesarean birth then your partner may attend with you from admission until 6pm on the day of your birth and then 2-6pm any subsequent days. We ask that this remains the same person throughout your time in hospital.

Do I need to isolate before my planned C-section and induction date?

Yes, we request that you and your partner self-isolate for 72 hours prior to your planned caesarean birth or induction of labour date.

Who can be with me during labour and birth?

• We ask that you attend in labour or to your planned caesarean birth with one birthing partner, ideally from your bubble who is Covid-19 negative, or if not yet tested has no symptoms of Covid-19.
• They should stay with you at all times to minimise contact with other people around the hospital.
• It should also be the same person who supports you during birth and visits you if you stay in to minimise the amount of people who attend the hospital.
• If your birthing partner tests positive for Covid-19 they will unfortunately not be permitted to attend with you in labour or for any time that you are an inpatient within the hospital.
• We do however invite you to choose an alternative birthing partner from outside your bubble who is happy to attend with you if you are positive or negative for Covid.
• They will need to stay with you in your room throughout the duration of your stay until discharge, or if they need to leave before this time will not be permitted to return.
• They must also socially isolate in line with government advice if they have been in contact with you or your partner who have tested positive, once they return home.

Can I still use gas and air in labour?

If you do not have symptoms of Covid-19 there is no evidence that gas and air (Entonox) cannot be used in labour.

If you have suspected or confirmed Covid-19 the Obstetric and Anaesthetic teams will discuss your pain relief options with you.

Is water birth still an option?

Yes it is, however, it is not recommended for people with suspected or confirmed Covid-19 due to the virus being transmitted in bodily fluids.

Is the homebirth service still available?

• The homebirth service will be provided as long as it continues to be safe to do so.
• If you have a home birth planned please follow the process as confirmed with your midwife at your homebirth discussion.
• If you have, or have had symptoms of Covid-19 you will be asked to give birth on Delivery Suite as additional monitoring for you and your baby is recommended during labour.
• To provide safety for your family and our staff we ask that you only have one birthing partner and that they wear a mask at all times during your home birth 

Could I pass coronavirus to my baby?

• Current evidence suggests that it is uncommon for transmission from a woman to her baby during pregnancy or birth (vertical transmission).
• Whether or not a newborn baby gets Covid-19 is not affected by mode of birth, feeding choice or whether the woman and baby stay together.
• It is important to emphasise that in most reported cases of newborn babies developing coronavirus very soon after birth, the babies were well.
• A small number of babies have been diagnosed with coronavirus shortly after birth but it is not certain whether transmission was before or soon after birth.
• Your maternity team will maintain strict infection control measures at the time of your birth and closely monitor your baby.

Feeding my baby if I have suspected or confirmed coronavirus

• There is no evidence showing that the virus can be carried or passed on in breastmilk.
• The well-recognised benefits of breastfeeding and the protection it offers to babies outweigh any potential risks of the transmission of coronavirus through breastmilk.
• Provided your baby is well and does not require care in the neonatal unit, you will stay together after you have given birth, so skin-to-skin contact and breastfeeding can be initiated and supported if you choose.
  The main risk of feeding 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.
• If you choose to feed your baby with formula or expressed milk, it is recommended that you follow strict adherence to sterilisation guidelines.

However you choose to feed 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 or from a bottle
• Consider wearing a mask or face covering while feeding
• Follow recommendations for pump/bottle cleaning after each use
• Consider asking someone who is well to feed your expressed breast milk or formula milk to your baby
• Taking care to avoid falling asleep with their baby, see Co-sleeping and SIDS, Safer sleep for babies.
• If you are expressing breast milk in hospital, a dedicated breast pump should be used

Further information on infant feeding during the coronavirus pandemic is available from Unicef.

Postnatal Care

In many cases you will be well enough, regardless of Covid status, to be discharged home 4-6 hours after delivery following routine checks. In this case your birthing partner may stay with you until you are discharged.

Depending on your circumstances your partner may be asked to go home when you are transferred to Blakeney our postnatal ward a few hours following delivery.

Blakeney Ward

Blakeney ward is an inpatient ward with 32 beds, where some women and their babies stay after birth if they require ongoing care or observation for either themselves or their baby.

This is also where you will attend on the morning or afternoon before your planned Caesarean Section if this is your birth plan and where you and your baby will return afterwards to recover.

• Our current visiting for birthing partners only is 2-6pm, and we ask that this birthing partner does not change throughout your stay with us.
• On the ward we ask that you and your birth partner wear a face mask at all times when walking around the ward (such as to use the bathroom or to collect meals) or when moving around the hospital premises.
• You may take your mask off in your bed space if you are alone when interacting with your baby (such as feeding or changing their nappy), to sleep and to eat and drink.
• We ask that if a member of our team enters your bed space that you please kindly put your face mask back on.

What contact will I have with my midwife when I go home?

Upon discharge home, your community midwifery team will be informed that you have returned home.

• The number of face-to-face visits may be reduced but there will be additional telephone contacts.
• A community midwife will contact you the first day you are discharged home, via telephone to check you and your baby are well and decide if a visit is required dependant on your clinical needs.
• In some instances a home visit will be clinically indicated instead of a phone call, and you should be informed of this prior to discharge from hospital.
• At the first contact with the community midwife, a plan will be made for future visits and telephone contacts.
• You will then receive a telephone call from the community midwife when your baby is three days old (noting that the day of birth is day 0), or a face-to-face visit.
• An appointment in one of the community postnatal clinics may be offered.
• On day five, you will have a face-to-face contact with the midwifery team, your baby will be weighed and the new-born bloodspot test (heel prick test) will be offered.
• At this visit future contacts will be planned, again these may be either at home, in a clinic or via telephone and are arranged based on you and your baby’s clinical requirements.
• If all is well your care is usually transferred to the Health Visiting team at approximately 14 days following birth.
• A health visitor will make contact with you shortly after this. If you have any concerns about yourself or your baby up to 28 days following birth then you can contact Medicom (01603 481222) and speak to a midwife who can arrange further visits if needed.

Registering the birth

• Norfolk county council are currently prioritising births that took place earlier in the pandemic, so if you wish to register a more recent birth please do not be concerned if they do not respond immediately.
• The deadline of 42 days within which a birth must be registered has been temporarily suspended by the Government. Registrations are by appointment only.
• The offices are closed except for customers with scheduled appointments. Up to date information regarding the registering of your baby’s birth can be found on the Norfolk County Council site.
• You will be able to make a claim for child benefit or universal credit prior to the birth being registered during this period.

Norwich Maternity Voices Partnership

• A Maternity Voices Partnership (MVP) is an NHS working group, a mix of individuals who use or provide maternity services.
• This can include service users, birth workers, doulas, service commissioners and service providers such as midwives and doctors.
• These people work in partnership to review and develop local maternity care.
• The Norwich MVP is linked to the Norfolk and Norwich University Hospital (NNUH) and the group is led by service user chair and Jenny Whatling.
• The MVP takes forward issues raised by maternity services users (mostly, parents & parents-to-be), by looking at aspects of the service in detail and making recommendations for improvements.
• Service users, providers and commissioners then work together on putting these changes into practice.
• We are interested in hearing about your experiences of maternity care so that we can represent the voices of as many families as possible.

Useful leaflets and additional information

We’d highly recommend visiting Just One Norfolk which is filled with lots of useful maternity information.