Maternity services at UHDB
Our maternity teams know that childbirth is an incredibly important time for women, their partner and their families. During the pandemic we have had to reduce the number of visitors in our maternity services to keep women, babies, families and our staff safe. We want to support reintroducing partners to scan appointments, and to have more time on the ante/postnatal wards, but any changes must be done safely, after careful risk assessment, and when it is safe to do so for women, babies, partners and our colleagues.
It is essential that our maternity services continue to operate at full capacity, which we have been able to do throughout the pandemic. Our team of specialised midwives, obstetricians and sonographers need to continue to be at our hospitals to provide care to women and their babies.
Every hospital and maternity service is set up differently, with sized waiting rooms, clinic appointment rooms, ward layouts and labour rooms. As safety is our number one priority, all areas and rooms are risk assessed to determine how many people can safely be in each room while following the national guidelines on safe social distancing. Our staff have only been able to continue the service uninterrupted by restricting the number of people into our maternity units, minimising the spread of Covid-19.
We have welcomed a partner to accompany women during labour throughout the pandemic. When women are induced partners are welcome to attend for the initial assessment, once this is complete we ask partners to leave and return when the mother is in established labour. We are sorry that we have to do that, but the space where women are cared for whilst undergoing induction of labour does not allow for social distancing. In addition, we have re-introduced timed visiting slots on maternity wards for partners.
We were preparing to get partners back into dating and anomaly scans this week and we are really keen to reintroduce this as soon as possible. However, there have been a rise in cases of Covid-19 in some of the local communities we serve and this has meant that we have had to delay this.
We have been also unable to lift our current restrictions in relation to antenatal appointments due to social distancing measures. GP surgeries will have their own restrictions for the antenatal clinics run there.
We want to assure you that reintroducing visitors to maternity services is a priority for us and we know how sensitive this is and how important it is for women and their families. We will keep reviewing the situation weekly and will adjust and will advise when we are able to lift the current restrictions on visiting. Thank you for your patience and understanding.
If you have individual concerns not addressed in this briefing, please speak to one of our team at your next appointment, or you can contact us through our Patient Advice and Liaison Service >
Frequently Asked Questions
Q: What is classed as “active labour”?
A: The clinical definition of active or established labour is when contractions become regular and painful, and the cervix (neck of the womb) begins to continuously dilate from about 4cms dilated. However, every woman’s labour is different and we assess each woman’s needs on an individual basis and do not focus on just the dilatation of the cervix.
Before active labour commences many women experience early or latent phase of labour. This is when women start to notice contractions which may be painful and there is some change to the cervix as it begins to dilate. Woman may also notice a mucous plug or “show” which is passed vaginally.
This stage of labour can come and go and can last for a few hours or a few days. During this time we would encourage women to remain mobile, make sure that baby is moving well and stay at home if possible. Using some coping strategies such as warm baths and relaxation to support this early labour phase often helps.
Q: If I attend with my partner when I am in not in “active labour” will they be asked to wait elsewhere while I am examined?
A: If you present in spontaneous labour and appear to be progressing, you will be admitted to a single labour room and your partner will be able to accompany you.
If you are in early labour and are admitted to a multiple bedded area for assessment of the onset of labour, I’m afraid we will ask you partner to wait outside. If labour is not progressing, you do not appear to be in active labour and you and your baby are well, you will be encouraged to return home with your partner and come back to the hospital when you feel you need to.
Q: How will partners know when they can return, will staff contact them promptly?
A: Our experience is that many women like to call their partner themselves to ask them to return either when they know labour is progressing or if they are being moved to a single room for labour to be started. Our staff know how important it is for partners to accompany women during childbirth so if a woman is not able to contact their partner directly, our staff will do this for you. Please make sure that you give the correct contact details for your partner to the Midwife who is caring for you.
Q: What support would I get on the post-natal ward when my partner has to leave?
A: Our wards are staffed by a team of maternity staff, Midwives, Maternity Support Workers, Health Care Assistants, housekeepers and receptionists. We also have student Midwives on the wards as part of their training. We understand that this is a very unsettling time for women and their partners, however we want to reassure you that the staff are there 24 hours a day to help and support all our new mothers and women who require a hospital stay whilst still pregnant. The staff will help you with, personal hygiene needs, infant feeding and caring for your baby as well as completing the daily examinations you and baby will require. Please ask for help or support if needed.
Q: If I am being induced but it is taking a long time, is my partner allowed to visit?
A: Our hospitals wards, bays and departments are varying sizes. Due to the layout of some of these areas we are not able to support safe social distancing. Having several people together in a small space, even when wearing face coverings, increases the chance of spreading infection. Therefore, if your induction is taking place in an induction bay, your partner will not be allowed to visit.
Q: If you’ve been living with your partner this whole time whilst being pregnant, why can’t they come with you to all of it?
A: COVID-19 affects different people in different ways. Many people do not experience symptoms, known as ‘asymptomatic’, and therefore will not know they are carrying the virus and are able to pass it onto others. Throughout the pandemic we have put the safety of our patients and staff as our highest priority and therefore have had to limit the number of people allowed into clinical areas. This plays an important part in reducing the spread of infections in a hospital environment.
Whilst many women have healthy pregnancies, we do provide care for many other women and babies who may be vulnerable to infection and therefore it is vitally important that we adhere to strict social distancing rules and minimise the number of individuals who have access to our wards.
We are swabbing all women who are admitted to our wards, but are not able to swab partners. Your partner will be asked screening questions if they are attending with you in labour and as long as they do not have any symptoms, they can remain present. A birth partner isolating due to suspected or confirmed COVID-19 should not attend the unit.
Q: Am I better to have my baby at home where my partner can support me at all points of labour?
A: We have recently reinstated our homebirth service. Where it is safe to do so, we are able to support women’s choice for a homebirth. It is important to make sure that you have discussed this with your Community Midwife or the team that are providing maternity care to you beforehand so that the appropriate plans to support your choice for place of birth can be made.
However, in some of the communities we serve we have seen an increase in COVID-19 cases since the start of September and are regularly reviewing the services we provide.
Q: Given the recent NHSE guidance, in partnership with RCoG, RCM and SCoR, why has this not changed at your trust?
A: We welcomed the recent guidance. In the past couple of weeks we had used this guidance to plan the reintroduction of partners to some areas in maternity. However, as the guidance outlines, if some of the communities we serve have seen an increase in Covid-19, then pausing the reintroduction of visitors may be warranted, and this is the case at UHDB where since the start of September there has been an increase and we have therefore had to pause the easing of restrictions.
Q: This damaging women’s mental health and the partners – what are you doing to support them?
A: We understand that these are very unsettling times for pregnant women, their partners and their families which is not helped by frequent public health information changes. If you are concerned regarding your mental health, please speak to your midwife or a member of your maternity team. We are able to direct families to local support networks and groups who are able to offer additional support if required. Your maternity teams are here to listen to you.
Q: Should I consider changing the hospital I give birth at?
A: Patient choice is important in the NHS and we would encourage all families to carefully consider where they wish to be cared for. We’re very clear that the safety of our services is the highest priority and would therefore encourage women and their families to continue to choose University Hospitals of Derby and Burton for their care.