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Maternity Care Update; April 1st 2020

Maternity Care Update; April 1st 2020

So the HPSC and HSE released new guidance for management of women in pregnancy on the 1st April much to everyones surprise. I have summarised it below along with some of my own thoughts on the situation.

It’s important to note that the first line states “explicit guidance” which I’m guessing allows the individual hospitals to decide whether or not to implement it. Guidance doesn’t infer that it must happen. You can read the full text of the guidance here.

It goes on to state that women should be PERMITTED and ENCOURAGED to have a birth partner present with them during labour and birth. Having a trusted birth partner present during labour is known to make a significant difference to the safety and well-being of women in childbirth.

Women attending for labour who DO NOT HAVE suspected or confirmed COVID-19

If the mum is symptomatic, same rules apply for partners as above.

Please realise that this is for the health and safety of mum, baby & staff. If someone is in self isolation or sick with COVID-19 then they should not be there. I think this is completely understandable. Please don’t lie either, we have all heard horror stories and we have to protect everyone.

Most maternity hospitals have implemented visiting restrictions for antenatal and post natal wards and appointments. And again, as difficult as this is, I completely understand the logic. Its to protect mum, baby and staff. You can get full details on the HSE website here.

While an inpatient don’t forget, hand washing and respiratory etiquette will be paramount to keep everyone safe.

In the guidelines they don’t specifically mention c-sections or theatre, so I’m not sure what to say about that. Again each maternity hostpiajl is different.

So, what does this mean for mums?

First of all it’s important to be aware that this is a very fluid situation and these guidelines might change again soon. No sooner have I written a post than it’s out of date.

I think it’s important for us all to check in with our maternity units to see what their own guidelines are, and again remember these might change. You will be informed of the changes at your antenatal appointments as much as is possible. Remember it will just be mum now at antenatal appointments and scans. Prepare for this. It’s difficult. Some of us might get bad news, so maybe have your partner or support person on FaceTime or Skype for the consultation? No staff member will mind this.

When it comes to labour, coming closer to your due date check in and see what current guidance is.

When it comes to birth plans I think we are going to have to have a little bit of flexibility here unfortunately. As far as I’m aware entonox is out in most Irish hospitals. I’ve personally never been a big fan of birth plans, as I would leave most decisions to my doctor, but that’s the medic in me. If you have set plans, maybe try and think around them. Come up with alternatives. If you really want your husband or partner there but they can’t be, thinking about FaceTiming then. Have a calming playlist you want to listen to. Practice gentle birth or use calming exercises.

At the end of the day, the maternity services we have In this country are second to none and the staff just want you to have an uneventful birth, successful and safe birth.

For those who have had traumatic births in the past - I would recommend having a long chat with your antenatal team in advance of birth, so that you are prepared. I think the teams will make time for this.

For first time mums, look online for prep courses. Do as much reading as you can. Prepare yourself. Talk to your antenatal team and see what your options are.

If you’re pregnant, as I know a lot of you are. Let me know what you are thinking on my instagram post @drlauragp. What are your worries? When are you due?

Please bear in mind that this isn’t ending anytime soon folks either. We need to prepare ourselves for this. So limitations are going to be in place for quite some time.

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