Maternity Unit updates

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COVID-19 testing of women under maternity care

All women who need to stay overnight in hospital for any reason will be offered testing for Covid-19, whether they are showing symptoms or not.

We will offer you a test if you:

  • need an overnight stay in hospital during pregnancy, labour or the postnatal period
  • are having a planned Caesarean birth

unless you have symptoms of Covid-19, we will not routinely offer you a test if you:

  • come to hospital for a check-up
  • attend routine maternity appointments
  • have a home birth

Coming into hospital

When you arrive at the hospital, you will be assessed by your midwife or doctor. If you need to be admitted to the hospital, we will offer you a test, even if you do not have any symptoms of Covid-19.

We will use swabs to collect samples from the back of your throat and inside your nose. This is not painful but may be a little uncomfortable.

Consenting to the test

If you are offered screening for Covid-19, we recommend that you have the test. This will help us to provide you and your baby with the care you need as safely as possible. However, the test cannot be done without your consent and you can decline the test if you wish.

If you decline the test, your midwife / doctor will make a plan for your care based on other factors, such as whether you have symptoms of Covid-19 or not. In some cases, we may need to treat you as though you have had a positive test result and this may have an impact on your choices.

We want to support you to make the right decision – if you have any concerns about the testing or want to know more about the implications of declining the test, please discuss this with your midwife / doctor.

Getting your results

We will usually get the results of your test within 72 hours. We will contact you with your result whether it is negative or positive. If you have already been discharged home, we will call you on the contact number that we have for you so please ensure this is up to date.

We know that you might feel anxious waiting for the result, but please don’t call us to get your results. Please wait for us to contact you – we will let you know the results as soon as we can.

If your test result is negative

You will continue to receive maternity care as planned by your midwife/doctor.

If your test result is positive

Your midwife will be sent your test result – if any changes are needed to your maternity care, they will contact you to discuss this.

If you don’t have any symptoms or your symptoms are mild, you will be able to recover at home. If you become unwell after testing positive, you should contact NHS 111 for help and advice.

If you test positive for Covid-19 during the third trimester (over 24 weeks), we will arrange an ultrasound scan at least two weeks after your recovery. This is just a precaution, to make sure your baby is well.

Birth Choices

Your birth choices may be impacted if you have a positive Covid-19 result or you have symptoms of Covid19. Your midwife or doctor will discuss this with you to make sure you understand what changes are needed and why. Changes will only be made where they are necessary to protect you, your baby and the staff at the hospital.

If you have a positive test result:

  • We recommend that you labour on Central Delivery Suite where your baby’s heart rate can be continuously monitored with a CTG (cardiotocograph) so that we can ensure your baby is well
  • You will not be able to use a birthing pool, as there is evidence that the virus can be transmitted through faeces (poo) in the water. If you had planned a water birth, your midwife will discuss the alternative pain relief options with you.
  • Staff will need to wear personal protective equipment (PPE) and there may be brief delays in some aspects of your care while staff put this on

If you are admitted during labour and you have no symptoms of Covid-19, your birth choices will not be affected until the results are received. If you receive a positive result before your baby is born, we will discuss this with you and develop an updated birth plan.

If you are concerned about the test results impacting your birth choices, please discuss this with your midwife / doctor before you make a decision.

Concerns about yours or your baby’s wellbeing

Our Maternity Services remain open 24/7. It is just as important as ever that you contact us if you have any concerns about your pregnancy or your baby’s wellbeing (for example your baby’s movements are reduced). If you are concerned, it is very important that you call Labour Line without delay on 0300 369 0388 for advice. You may be advised to come in to hospital, even if you have tested positive for Covid-19.

We want you to feel that it is safe to come into hospital if you need to. We have set up a dedicated section of the maternity unit for women who have tested positive and who need urgent maternity care.

Further Information

Maternity Matters Dorset

Royal College of Midwives

Royal College of Obstetricians & Gynaecologists

Contact details

For further general health-related information, please ask the relevant department for an information prescription or contact:

Patient Experience Poole Hospital NHS Foundation Trust

Longfleet Road

Poole

Dorset

BH15 2JB

Telephone: 01202 448499

www.poole.nhs.uk

We can supply this information in other formats, in larger print or have it translated for you. Please call the Patient Experience Team on 01202 448499 or email patient experienceteam@poole.nhs.uk for advice.

If you wish to make any comments or to ask about any research evidence used to write this leaflet, please contact the Patient Experience Team on 01202 448499, write to the Patient Experience Team (address above) or email patientexperienceteam@poole.nhs.uk.

Review date: 11/11/2020

All women who need to stay overnight in hospital for any reason will be offered testing for Covid-19, whether they are showing symptoms or not.

All women who are admitted as an inpatient during pregnancy, labour or the postnatal period will be offered testing. Women who are admitted for a planned Caesarean Section will also be offered testing in line with guidance from Public Health England.

We are not routinely screening women who attend for antenatal/postnatal check-ups if they do not have symptoms of Covid-19 and do not need to be admitted into hospital.

Coming into hospital

• Once you have been assessed by your midwife/doctor, if a decision is made that you need to be admitted to hospital, you will be offered a test for Covid-19
• You will be offered a test even if you do not have any symptoms of Covid-19
• The test involves a swab being taken from the back of your throat and your nose
• You can choose not to have the test

Getting your results

Test results will normally be available within 72 hours. We will contact you with your result whether it is negative or positive. If you have already been discharged home, we will call you on the contact number that we have for you.

We understand that it may be frustrating to wait but please do not call us to get your results. Please wait for us to contact you.

If your test result is negative

You will continue to receive maternity care as planned by your midwife/doctor.

If your test result is positive

Your midwife will be aware of your result and will contact you if any changes are needed to your maternity care.

If you have no symptoms or mild symptoms, you will be advised to self-isolate and recover at home. If you become unwell after testing positive, you should contact NHS 111.

As a precaution, if you are over 24 weeks pregnant and you have a confirmed Covid-19 infection requiring hospital admission, an ultrasound scan will be arranged at least two weeks after your recovery.

Birth Choices

If you are symptomatic or test positive for Covid-19 this may affect some of your birth choices:

• It is recommended that you labour in the hospital where your baby’s heart rate can be continuously monitored with a CTG (cardiotocograph)
• The use of a birthing pool will not be available as there is evidence of transmission of the virus in faeces
• There may be brief delays in some aspects of your care whilst staff put on personal protective equipment

Concerns about yours or your baby’s wellbeing

Our Maternity Services remain open 24/7. If you have any concerns about your pregnancy or your baby’s wellbeing (for example your baby’s movements are reduced), it is very important that you call Labour Line without delay on 0300 369 0388 for advice. You may be advised to come in to hospital, even if you have tested positive to Covid-19.

Please be reassured that we have made special arrangements to see women who have tested positive for Covid-19 and need urgent maternity care in a dedicated section of the maternity unit.

Further Information

Maternity Matters Dorset

Royal College of Midwives

Royal College of Obstetricians & Gynaecologists

Review date: 19/11/2020

Coronavirus infection and pregnancy

Information for pregnant women and their families

Access to emergency and urgent care for pregnant women

Labour Care during the COVID-19 Pandemic

Birthing plan

We understand that this is a worrying time for pregnant families and those with newborn babies. Our role is to keep you and your family safe, and to ensure that our staff are protected. We have some new guidelines in place during this period, based on national guidance, and these may change as the situation develops. We will keep you informed of any changes, and continue to support you and your baby.

Maternity care is essential and there is no need to avoid scheduled scans and check-ups if you and your family are well. If you have symptoms of COVID-19, it’s important to let your midwife know so that we can provide the care you need in the safest way.

As always, if you are worried or concerned about anything relating to your pregnancy or your baby, please contact us.

The national bodies representing midwives (RCM), obstetricians (RCOG) and paediatricians (RCPCH) have released guidance which can be found in an easy Q&A format on the main COVID-19 page.

The key messages are:
• Pregnant women are not at greater risk from COVID-19 than other healthy individuals than other healthy individuals, according to current evidence
• Women who are not in isolation should continue to attend all routine appointments.
• Women who are isolating because they have symptoms (or someone in their household has symptoms) will have routine appointments rescheduled for when their period of isolation is over.

We are taking every possible step to make sure you receive the maternity care you need, as safely as possible.

It is just as important as ever for you to consider your birth preferences and write a birth plan. You will still be able to discuss this with a midwife, but this is likely to be done over the phone or using a video call.

There is lots of information on the Maternity Matters website to guide you in making your decisions, and your midwife will answer any questions or address any concerns you have.

Throughout labour we will discuss your birth preferences and plan your care together. We will consider the latest guidance and up-to-date information to ensure the safest care for you and your baby.

At present time (7th April) we are still able to offer:

  • home birth
  • the Haven birth centre (an alongside midwife-led birth centre in Poole maternity unit)
  • the labour ward in Poole maternity unit
  • Dorchester maternity unit (midwife-led or consultant-led care)

Unfortunately Bournemouth Birth Centre is currently closed.

For further information on the available birth places, what to expect during labour and birth, and your pain relief options at each site, please visit the ‘labour and birth’ pages.

A home birth is only recommended:

  • if your pregnancy has been uncomplicated and you are under midwifery-led care
  • if you have an agreed birth plan with the consultant midwives and wider team if there are other considerations.

To ensure everyone’s safety, we ask that you have only one birth partner during a home birth.

For most women there will be no need to transfer your care to the hospital. However, if a transfer if needed, this will be via an ambulance which we usually suggest can take between 40-60 minutes from the call to arriving in hospital.

If you or a member of your household had symptoms of COVID-19 at the time of labour we will ask you to come into hospital, where we can care for you and your baby safely.

We know that having continuous support during labour and birth is important for you and is known to make a significant difference to the safety and wellbeing of women in childbirth.

We want to ensure that you have access to this crucial support wherever possible. Therefore a single birth partner is welcome and encouraged to accompany you in labour. This also applies to home births.

If your planned birth partner has symptoms of COVID-19 they will not be able to attend the birth. It’s a good idea to think about one or more back-up birth partners, such as a family member or friend, in case your planned birth partner is affected. This person can be from another household, as long as they do not have symptoms of COVID-19.

Your birth partner will be able to stay with you in the immediate postnatal period. Please refer to your individual hospital’s guidance on visiting for further details.

All birth partners will be asked to wash their hands regularly following national guidance.

When you call the maternity unit in labour or if you are scheduled to come in for a caesarean section, we will be asking you if you have any symptoms of COVID-19. It is important you let us know so we can care for you in the right place.

You will be asked to enter the maternity unit through a separate entrance. There is a designated area for your care. Healthcare professionals will be wearing personal protective equipment (PPE) at all times. We know this may be strange at first but we will try to make you feel as relaxed as possible. We will also ask you and your birth partner to wear a mask, unless you are using gas and air.

We will check your oxygen levels more often during labour using a simple finger saturation monitor. It is also recommended that your baby’s heart is monitored continuously throughout labour – you can find out more about monitoring in our Birth section.

National guidance states that women with suspected or positive COVID-19 should not use the birthing pool for labour or birth. It is safe to use Entonox (gas and air) and we will show you how to use this if you would like to try it.

The RCOG has recommended an epidural for labour if you are unwell – we will discuss this with you at the time.

For emergency caesarean births, staff will need to put on PPE. This is time-consuming but necessary to keep staff safe. This could mean it takes us longer than usual from deciding you need a caesarean to delivering your baby.

Online Antenatal Classes

We have provided live webinar antenatal classes for women in Dorset. These were provided by midwives and support workers across all sites covering a range of topics. We are currently filming more antenatal classes, these will be available soon and will be added once complete. You can watch our antenatal videos here.

Changes to Antenatal classes during COVID-19

Infant feeding and postnatal

To keep you and your baby safe, we have made some changes to postnatal care and feeding support in Dorset. We are still here to provide you with all the support you need.

The staff will give you the support you need to feed your baby. Depending on your needs, this might include:

  • help with positioning and attachment if you choose to breastfeed
  • advice on hand expressing or using a pump
  • advice on safely making up formula feeds, sterilising equipment and bottle feeding
  • other methods of feeding where needed, such as syringe or cup feeding colostrum.

You will receive a phone call from a midwife the day after you return home, to see how you and your baby are doing. They will ask lots of questions about your physical and emotional health, your baby’s wellbeing, including feeding and nappies. If you are concerned about anything or have any questions, your midwife can help you. If you need additional feeding support, you may be offered support via video call or telephone call, using your smartphone or tablet, and this is available at all three hospital trusts.

You can also access the Dorset Breastfeeding course online as often as needed.

As always, if you have concerns, you can contact the community midwives at any time for help and advice. You can also find lots of help and advice on the Maternity Matters website.

If no-one in your house has symptoms of COVID-19, we will still visit you at home five days after your baby is born. During visit we will weigh your baby, and perform the newborn blood spot test (if you have consented to this) and make sure you are recovering well.

If you do have symptoms of COVID-19 we will make a personal plan with you based on when you started to notice symptoms.

This visit will be limited to less than 15 minutes as evidence suggests that the risk of transmission increases after this time. You will still be given the opportunity to discuss any concerns you have about yourself or your baby and ask for advice – your midwife will call you before the appointment to discuss as much as possible on the phone before seeing you.

When we arrive, we will be wearing an apron, gloves and a face mask – please don’t worry, this is to protect you and your family, and the midwives. It doesn’t mean we think you are sick or that the midwife visiting you is sick. Please know that, while it might feel scary to have a visitor wearing protective clothing, we will be smiling at you from behind the mask! We will ask that we can be alone in the room with you and your baby, to reduce the risk of spreading the virus.

Smoking in pregnancy

Quitting smoking in pregnancy is the best thing you can do for your baby particularly with the increased risks of COVID-19 and smoking. Our Pan Dorset Service currently offers a very personal 1-2-1 based telephone chat so that we can offer you support and help on a personalised 12 week quit programme. Free nicotine replacement medication can be arranged for you also.

If you would like help and support please contact:

Royal Bournemouth Hospital: Live Well Dorset

Poole Hospital: SmokingInPregnancy@poole.nhs.uk or 07557322620

Dorset County Hospital: smokingcessation.midwife@dchft.nhs.uk or 07795317656

Quit smoking for COVID

Smoking and coronavirus advice for parents

Babies cry, you can cope!

During this difficult time we understand the additional stresses that families are facing with a new born baby. ICON can help show you how you can cope with a crying baby, and what a normal crying pattern is. A midwife will talk to you about this before you leave the hospital.

I infant crying is normal and it will stop
C comfort methods can sometimes soothe the baby and the crying will stop
O its ok to walk away and you have checked the baby is safe and the crying is getting to you
N never shake or harm your baby

Remember this phase will not last, you can cope with their crying, its ok to have a break from your baby.

If you require further support contact your midwife, health visitor or GP or visit: ICON.

FAQs

Yes, you will. We understand that having to attend scans alone can be really upsetting for you and for your partner. We wanted to let you know the reasons we had to make this difficult decision, and why we can’t change things yet.

Our scanning rooms are small and not well ventilated, so at this time we can’t safely increase the number of people coming into the departments. Our priority has to be the safety of those attending for scans, and the safety of the staff.

We have also been asked about videos of scans. Some of the machines don’t have the functionality to capture video so unfortunately it’s not something we can offer.

We know this is important to you and we thank you for being patient and understanding. We want to be able to return to normal as soon as we can, but it’s crucial that we do this safely. We are regularly reviewing these decisions alongside national guidance, taking into account our facilities, and we will keep you informed.

We have provided live webinar antenatal classes for women in Dorset. These were provided by midwives and support workers across all sites covering a range of topics. We are currently filming more antenatal classes and these will be available in the following weeks and will be added once complete, but until then we have these videos and resources available. 

At Poole partners can come in to the unit when women are in labour and are asked to leave when the lady is transferred to the Postnatal Ward. Unfortunately there are only four bedded bays and shared bathroom facilities so it is not possible to allow partners into this area.

In Dorset County hospital we will do all we can to provide you with a single room after the birth and your partner can stay with you for up to 24 hours. If your partner has to leave at any time he/she will not be allowed back into the unit. If we do not have any single rooms available, your partner will not be allowed to stay overnight, even if that falls within the 24 hours.

Yes. We ask for you to be dropped off at the unit and when you need one to one support your partner will be invited back. We ask that you have the same birth partner throughout your stay and don’t swap.

If you have any of the following or need to speak to a midwife, please call Labour line 0300 369 0388.

  • Your waters break.
  • You’re bleeding.
  • You have unexplained abdominal pain.
  • You think you are in labour.
  • Your baby is moving less than usual, or the pattern of movements has changed.
  • You’re less than 37 weeks pregnant and think you might be in labour.
  • You feel unwell or feverish.
  • You are unsure or worried about your labour, yourself or your baby.
  • Any non emergency queries following birth of the baby.

The safety of our patients and staff is our main priority and to protect them we are reducing footfall through the hospitals. If you need support your partner can be called in if required.

You will be contacted in advance to arrange your booking appointment. Please read about your screening choices beforehand and we can discuss these during your booking which will be completed virtually. We are minimising face to face contacts and try to keep these to 15 minutes maximum when we see you. We ring you in advance to discuss as much as possible over the phone so that when we see you we can perform our checks efficiently. This might mean that we call you again afterwards to discuss the appointment findings and any questions you may have.

Booking appointment Full history, initial screening for medical, psychological and social risk factors Virtual appointment
Dating (12 week) scan All blood tests, BP and urine testing to be taken at dating scan appointment. Face to face
16 week appointment Review results of screening review, discuss and record the results of all screening tests.  Give information about ongoing care. Poole and Bournemouth – Face to face

Dorset County – Virtual

18-20 weeks Routine anomaly scan
Check BP and Urine at this visit instead of 16 week appointment.
Face to face
25 weeks Measure fundal height, BP and urine; review scan results. Poole and Bournemouth – Face to face

Dorset County – Virtual

28 weeks Routine antenatal appointment
Measure fundal height, BP and test urine
Face to face
32 weeks Routine antenatal appointment
Measure fundal height, BP and test urine
Face to face
36 weeks Routine antenatal appointment
Measure fundal height, BP and test urine
Discuss plans for birth
Face to face
40 weeks Measure fundal height, BP and test urine; discuss information about options for prolonged pregnancy Face to face
41 weeks + Measure fundal height, BP and test urine; discuss fetal movements and wellbeing Discussed and planned with maternity team

If you have any concerns about you or your baby after you have been discharged by your midwife team please contact your health visiting team.

Do not use a home doppler (heartbeat listening kit) to try to check the baby’s heartbeat yourself. This is not a reliable way to check your baby’s health. Even if you hear a heartbeat, this does not mean your baby is well. If your baby is moving less than usual, or the pattern of movements has changed ring Labour line straight away on 0300 369 0388. They will arrange for you to have your baby’s movements and heartbeat checked. Do not wait until the next day – call straight away, even if it’s the middle of the night.

You can call Labour Line for non-urgent questions on 0300 369 0388.

This will depend on what hospital you’re going to. Poole have separate teams for community and the hospital, and Dorset County Hospital have teams that work in both. So while it is possible to have the same midwife, this depends on shift patterns. However, it is something we are aiming to happen more often and are currently undertaking work to improve the continuity of your care.

There isn’t the option to pay for private rooms at Dorset County Hospital, they do have single rooms and these are allocated on a first come first served basis and in consideration of clinical need.

We understand that coming to your scans alone can be unsettling, please be assured that the staff are aware of this and are doing all they can to support you. If you need extra support your partner can be called in if required.