Delivering Maternity Services during Covid-19
The upcoming birth of a baby is a bundle of anticipation, excitement and nerves for many parents-to-be. However, the Covid-19 pandemic has brought an extra layer of worry with social distancing and pregnant women in the vulnerable group.
A number of changes have been made in maternity services at NNUH as a result of the coronavirus outbreak, including the introduction of more virtual clinics and changes to ward visiting to minimise infection risks.
Emma Hardwick, NNUH Divisional Midwifery Director, said: “We understand that the Covid-19 pandemic is a particularly worrying time for parents-to-be and we would like to reassure expectant mums that we are still here for you and the health and safety of you and your baby continues to be a priority to us. National guidance is being issued regularly and we have put measures in place to keep our patients and staff as safe as possible.
We completely understand what a difficult time this is for women and their families and we are working alongside the local Maternity Voices Partnership to help keep parents-to-be updated and as reassured as possible about the care they will be receiving and to answer any questions or matters that are being raised. We also have a NNUH midwife answering questions that are being posted by women on the NNUH Bumps and Babies Facebook page.”
Since the start of the pandemic, hundreds of babies have been born at NNUH. But what is it like to have a baby during the lockdown?
For Vicki Rowland, from Bracon Ash, Covid-19 meant that she had to take her maternity leave early and completed antenatal classes online.
Her biggest worry prior to the birth was the prospect of her husband Greg not being her hospital birthing partner, if he developed coronavirus symptoms.
Thankfully, Vicki and Greg stayed virus-free and baby Violet was born on 1 May at NNUH.
Vicki said: “Everything went as smoothly as I could expect. I was able to start my birth on MLBU and the care couldn’t have been more amazing.
“Everyone was so calm and professional. I didn’t feel uneasy about being on the ward or in the hospital. The changes have to been put in place to help protect everyone and that was the important thing to remember.
The only difference was the staff wearing PPE, but it wasn’t intrusive in any way. I also had to have a spell on the Blakeney ward which meant I was on my own for a period of time, but on reflection it meant my husband could go home and have some sleep!”
She added that having a baby during Covid-19 lockdown had brought an “additional layer of worry”.
“It has allowed me and my husband to have time alone with our daughter to get to know her. However, there is no denying that our friends and family not being able to meet her and have a cuddle has taken its toll and isn’t how we would of imagined starting parenthood.
We still have access to all the maternity services we would normally have with a newborn, but a lot of this is carried out over the phone. It does worry me what the immediate future is going to look like because I am unable to attend the various support groups and social events which are all important during those first few months as a new mum and a newborn, but for the time being we are just trying to remain positive and are hopeful we will be able to share her with everyone in the near future.
Nicole Daniel gave birth to baby Maisie on 22 April after being induced on Cley ward. Her husband Adam was able to join her when she was transferred to the Delivery Suite.
“The midwives were superb in helping me deliver Maisie with as little interventions as possible. The staff were very supportive and happy to provide what advice and information they could to help me understand.
“Not having my husband present throughout the process was a strong source of anxiety in the final weeks of my pregnancy. During my stay on the ward, staff did all they could to offer support to me, although there were still times I was saddened by his absence, they did help me cope and stay focused on my birth and new baby. My husband’s experience left him feeling a bit lost and like he wasn’t able to support me as much as he wanted.
The postnatal care was amazing, I felt fully supported throughout my stay. We were grateful for being able to access breastfeeding support and checks on Maisie’s weight, jaundice and tongue tie whilst in Blakeney as we knew this might not be possible once we left because of home visits being restricted or changed to phone calls.”
For me, having a baby during the lockdown does have some positives. Most importantly for us, having my husband working from home has provided invaluable support to me during the first few weeks of Maisie’s life – just because it is reassuring to have him in the house. It’s also been great to not have to worry about visitors and just focus on bonding with Maisie. Having said this, I do miss the extended support network I would have had in my close family and friends, and wish nothing more then to be able to introduce Maisie to them in person – no matter how wonderful technology is for keeping in touch, it’s just not the same!”
The Antenatal Ultrasound team are urging women to continue to attend their scans and they are encouraging them to record a 10-15 second video clip that can be watched with their partner at a later time.
We understand that it maybe upsetting to attend a scan alone. However, the measures are in place to protect women, babies and their families and the maternity staff. This is a challenging time for healthcare professionals but we will continue to do our best to give you a positive pregnancy and birth experience.
The antenatal clinic has begun to embrace a new way undertaking appointments that do not require face-to-face contact. The clinic rooms have been equipped with headsets and webcams which allow the obstetric and midwifery teams to undertake a ‘virtual’ consultation. Amidst the Covid-19 pandemic the innovative way of working can reduce the time that women need to spend in the hospital and also means their partner can be involved. This new project is in its infancy and is still yet to be rolled out across all the clinics but it is proving to be beneficial in these challenging times.
Penny Drewy has worked as a midwife at NNUH for ten years. She said the biggest challenge of the pandemic was wearing PPE and adapting how she communicates with patients and their partners.
“Parents-to-be have been so understanding and sensible through this pandemic. I can’t but praise them for their ability to adapt and cope with the pressure to keep themselves and their babies safe. If you have any questions or concerns, please don’t hesitate to contact your midwifery team or the maternity assessment unit. Midwives are very much at the end of the phone to answer any questions regarding your pregnancy.”
“I have had to adapt how I communicate as I have to rely on mostly my voice and verbal communication. Wearing the masks has really shown me how much of my communication with service users is non-verbal. I really do hope that the women and their families can see me smiling behind my mask!”
“The managers, matrons and sisters have excelled in adapting our delivery suite to deal with the pandemic. I can’t thank them enough because I feel that their actions have considered the safety of everyone. The midwifery team has too shown great resilience to the pandemic fears and have acclimatised to the changes easily.
She added that she was proud to work as a midwife at NNUH.
“I get a feeling of pride when telling someone I’m a staff member of the NNUH. The NNUH is such a truly inspiring hospital to work at. I’ve worked for the NNUH for ten years and trained there three years prior. I have seen many new practices put in place demonstrating the great sense of dedication to patient safety and service users’ experience.”
Ruth Todd, Community Midwife, said her colleagues have overcome many challenges during the pandemic.
“We are constantly on a level of high alert dealing with fear of the virus and keeping safety at highest priority. We have had to make changes to our working practices at very short notice including moving clinics when GP surgeries have closed, informing families what their care will look like, keeping all staff supported and updated with all new guidelines and much more.
“Initially we were having lots of enquiries about Covid-19 and how it affects pregnancy. As time has gone on, we tend to get more enquiries about antenatal care schedule, appointments, where/when to attend. It has been evident that women are adapting to new ways of being cared for, they are heeding advice, staying indoors and keeping themselves and their families safe. They have been very accepting of new ways of being seen and appreciate the need to be seen alone and very grateful for the level of care they are receiving. Sometimes, and understandably so, women are anxious about not having a support person with them, not having someone to care for their other children and being scared of attending clinics/hospital, we do our best to reassure them and advise them that we our doing our utmost to keep them safe and reduce risk of infection to all.
In our community team we have witnessed amazing flexibility and willingness to adapt to meet safety needs and keeping care levels at a high standard. The midwives have displayed a positive attitude to the changes and challenges faced every day. Support from Professional Midwifery Advocates and Matrons has been consistent and accessible. As a team we support one another and ‘share the load’ as much as able.”
The local Maternity Voices Partnership (MVP) continues to seek people’s views of maternity services at NNUH and continue to do this virtually during the pandemic.
“One of the most significant changes for women and families is not being able to have a partner at scans and appointments. Although it is still possible to have a partner alongside while giving birth, for some families this is made impossible due to the partner needing to care for siblings or self-isolating if they have symptoms. We have shared this feedback with the maternity teams who are endeavouring to offer reassurance that they will be well supported during birth and postnatally.
We are really pleased with the positive way feedback and suggestions from the MVP has been received. Many of the measures put in place in the community and at NNUH are simply unavoidable at the moment but the maternity team have been very supportive of our requests to communicate the changes with families as much as possible. We have had feedback from families that the MVP updates are helping them feel prepared and informed so appointments and visits to NNUH are a little less daunting.
Some of the main feedback from the families that contact us is the worry and pressure that isolation is causing. Attending scans, appointments and sometimes giving birth alone can be upsetting when it is not what you had planned or expected.
New parents are unable to introduce their new baby to family and friends which has both an emotional and practical impact. Social distancing precautions mean that new parents have less practical support to help lighten the load when adjusting to life with a newborn. Although there is no replacement to real life interactions our Facebook group has some due date groups to help expectant parents find others at the same stage of pregnancy to chat.
We would urge anyone with worries or concerns to reach out to their midwife or health visitor who can signpost them to some of the adapted support being provided by the NNUH, charities and other organisations.”