COVID-19 information and advice

Studies by the Royal College of Midwives (RCM) & Royal College of Obstetricians and Gynaecologists (RCOG) have shown that pregnant women are at risk of severe illness with COVID-19, particularly in the later stages where it can have serious consequences for both mother and baby.  Becoming unwell in the last trimester doubles the risk of stillbirth, and triples the risk of having your baby prematurely, whilst increases the risk of admission to intensive care.

Royal College of Obstetricians and Gynaecologists strongly recommend COVID-19 vaccines in pregnancy as the best way to protect against the known risks of COVID-19 in pregnancy for both women and babies.

We want to reassure all pregnant women that the COVID-19 vaccines are safe and effective for them to use at all stages of pregnancy.

We are offering a COVID-19 test to everyone who requires admission to our maternity unit. This enables us to

• Ensure that you and your baby are cared for safely
• Ensure that we give you advice and information about yourself and your baby if either of you become unwell
• Ensure that we protect our staff from infection, especially if women have the infection without any symptoms are admitted to the maternity unit.

Guidance: Coronavirus infection in pregnancy
A guide to COVID-19 vaccination – all women of childbearing age
RCOG – Information for pregnant women and their families

Testing Procedure

A midwife or doctor will explain the test to you and ask for your verbal consent. The test involves taking a swab form your throat and your nose (up into both nostrils). A tongue depressor may be used to hold your tongue down to get to the back of your throat. It takes a few seconds to collect each swab.

The swabs are put into a universal container and sent to the laboratory. The results usually come back within 24 hours. We will let you know your results even if you have been discharged home prior to the result being available.

When will I have the test?

If you are having an elective casaeraen section or an induction of labour you will be tested three days before your admission date so that your results will be available on admission.  This means that we can provide appropriate care to you and your baby in an environment which is safe for both you and the staff .You will receive a phone from a midwife four  days before your admission to discuss the details your testing the following day  i.e time and place.

If you plan to delivery in Causeway Maternity Unit  you will attend the Fetal Maternal Assessment Unit (FMAU) in Causeway there for your planned test. Likewise,  if you plan to deliver in  Antrim you will attend the FMA) , Antrim Hospital for your test.

All other women will have their test performed in FMAU in Causeway/Antrim if they are being admitted to the ward/labour ward.

Will my birth partner be tested?

We are not currently offering a test to your birth partner.

We encourage you to have a birth partner present with you during labour and birth. Having a trusted birth partner present throughout labour is known to make a significant difference to the safety and well-being of women in childbirth.

If your birth partner has symptoms of coronavirus, they will not be allowed to go into the maternity suite, to safeguard the health of the woman, other women and babies, and the maternity staff supporting you. In cases like this we would encourage to ask a friend, who is well, to be your birth partner.

What happens if I decline testing for COVID -19?

Testing is not compulsary . If you choose not to be tested , we will respect your choice. We will continue to treat you based on your symptoms and observations.

If you have a cough or fever we will provide care to you as per suspected/positive COVID -19 women. This means you will be isolated in an appropriate area and not mix with women and babies who are known to have negative test results.

Will I be told if anyone who cared for me or was in the ward with me tests positive?

Yes , if someone who was in the same area as you tests positive for COVID-19 , we will tell you and give you advice re self-isolating for 14 days as a precaution. We will only offer you retesting for COVID-19 if you develop any symptoms.

Will my baby need testing or special care if I test positive for COVID-19?

If your baby is healthy and well at birth they will stay with you and care provided as per normal guidance.  We will not test your baby unless they are unwell.

We still recommend breastfeeding as the benefits of this far outweigh any potential risk to your baby. While feeding and in close contact with your baby we recommend that you would wear a facemask , apron, and  practise good hand hygiene.

When you go home we will give you an information leaflet about the signs of concern to look out for in your baby , and how to seek advice and help if you need it .

Advice for women discharged within their 7* day isolation period following a positive test result for COVID-19.

Transport Home

In order to return home, you may be transported in private transport by a family member who has already had contact with you.

The person who drives you home must be aware that you have Covid-19 and must have already had prolonged close contact with you, or may themselves have Covid-19 and be well enough to assist.
If not already self-isolating, the person must be willing to self-isolate for 14 days as a close contact of a confirmed case.

During your transport home, catch any coughs and sneezes with a tissue. Dispose of the tissue directly into a waste bag. Seal the waste bag and take it directly into your house.

Do not use public transport or taxi. Stay at home

You (and the person who transported you home if applicable) must remain in your home, except for getting medical care.

Do not go to work, school, or public areas, and do not use public transport or taxis until your isolation period has ended.

You will need to ask for help if you require groceries, other shopping or medications. Alternatively, you can order by phone or online for contactless delivery.

Use a separate bathroom from the rest of the household, if available. If you have to share these facilities, cleaning after every use will be required, paying particular attention to surfaces you have touched.

Cover your coughs and sneezes

Cover your mouth and nose with a disposable tissue when you cough or sneeze. Dispose of tissues into a plastic waste bag (see below for managing rubbish), and immediately wash your hands.

Carers should wash their hands before and after every patient contact as well as helping the person they are caring for do so regularly.

Wash your hands

Wash your Wash your hands often and thoroughly with soap and water, for at least 20 seconds, rinse and dry thoroughly.

Avoid sharing household items

You should not share dishes, drinking glasses, cups, eating utensils, towels (including tea towels), bedding, or other items with other people in your home when you have used them. After using these items, wash them thoroughly with soap and water; dishwashers may be used to clean crockery and cutlery.
Laundry, bedding and towels should not be shaken out and should be washed as per manufacturers’ instructions.
If you do not have a washing machine wait a further 72 hours after the end of the isolation period before taking dirty laundry to a public laundrette.
If anyone in the household is shielding it is important to be particularly vigilant. Allow them to use the kitchen/bathroom first and keep a distance of 2m (3 steps) until after the isolation period ends.

Waste

Personal waste including used tissues, cleaning cloths, and masks if used, should be put in a plastic rubbish bag and tied when full. The plastic bag should then be placed in a second bin bag and tied.
We suggest that you do not dispose of this waste in the routine waste until 72 hours after the isolation period has ended. Other household waste can be disposed of as normal.

Do not have visitors in your home

Only those who live in your home should be allowed in.

What to do if you become unwell during self-isolation at home

In the first instance, please contact the Fetal Maternal Assessment Unit on 028 9442 4345 and they can assess you over the phone initially.

If it is an emergency and you need to call a 999 ambulance, inform the call handler that you are a confirmed case of Covid-19.

Caring for your baby

We still recommend breastfeeding as the benefits of this far outweigh any potential risk to your baby. While feeding and in close contact with your baby we recommend that you would wear a facemask, apron, and practise good hand hygiene.

We will give you an information leaflet about the signs of concern to look out for in your baby, and how to seek advice and help if you need it .

Duration of self-isolation and follow up plan

Unless you have been in ICU you should remain in isolation for 7 days provided you have not had a temperature in the last 48 hours. The 7 days are counted from date of hospital admission or date of positive test, whichever is longer. If you were admitted to ICU during your hospital stay you should remain in isolation until 14 days after your positive test, or the date of hospital admission, whichever is longer, this will be discussed with you on discharge.

If you are antenatal, your doctor /midwife will discuss the follow-up arrangements for your appointments prior to discharge.

If you are postnatal your community midwife will visit the day following your discharge and agree a plan for your postnatal care with you.

Getting ready for a Midwife home visit